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The Link Between Cycling Posture and Neck Pain
Dr. Miller: If you're a cyclist and you have neck and back pain, what is the best way to avoid that or treat it?
I'm here with Rich Kendall. Rich is a doctor of osteopathy, and he is the chair of the Department of Rehabilitative Medicine. Rich is going to talk to us a little bit about how we can keep our necks and shoulders healthy when we're on the bike for long periods of time.
Rich, I know you're an avid cyclist, and so you have a good sense about these problems and probably have a lot to do with how to prevent them.
Dr. Kendall: That's true. I've been on a bike for a lot of miles and have done a lot of neck stretches and postural exercises to get rid of my neck pain.
Dr. Miller: Yeah, I saw you blow by me one day. You were going 100 miles an hour, and I was only going about 5, so I know you're a good cyclist.
Dr. Kendall: I must have been doing my neck stretches. Yes, neck pain is very common in cyclists. The funny positions that we get ourselves into both on mountain and road bikes can really put a lot of strain on the neck, especially when most of us sit at a computer most of the day and have the head-forward posture, which will increase some of the stress on our necks.
The Importance of a Proper Bike Fit
Dr. Miller: What's the best way to deal with that?
Dr. Kendall: One of the best ways is a good bike fit and making sure that your handle bars are about the level of your saddle, not trying to be in an overly aggressive arrow position for 100 mile ride because you just won't really do that unless you're a nice, pliable 25-year old. We want to make sure that everybody has a really well-supported neck, that their head is not forward, that their upper back is not rounded too much, and they are supported pretty well with their arms.
Dr. Miller: So a professional bike fit would also help, do you think, or are most people able to do their own bike fitting? What do you recommend there?
Dr. Kendall: I think a professional bike fit is a good idea for most people who are going to spend more than token time on their bike. If you're riding 100 miles or more a week, you really need to have a bike fit done. Especially long term, especially early in the season where all of your muscles are tight, your chest muscles are tight, your hips are tight, you're going to want to have a nice bike fit where you're not overextending.
Stretching and Strengthening Exercises That Help
Dr. Miller: As a younger cyclist, it sounds like it's a little easier to avoid the problem, but as you get older, are there certain stretches you can do prior to getting on the bike?
Dr. Kendall: Probably the three most helpful exercises that I give to cyclists all of the time is one, they really need to stretch their hip flexors and quadriceps. So for a yoga warrior pose to really stretch your hip flexors and quadriceps out because in cyclists these are very tight. Your hip angles are very narrow, and that's going to make your back round quite a bit.
The other is to really strengthen your back muscles. Exercises like Supermans or back extension exercises where you really can strengthen your back muscles. If you've ever gone that 100-mile ride, you come back, and your triceps are the sorest muscles that you have, it's because your back isn't supporting you, and you're supporting yourself with your tiny little cyclist arms the whole time.
Signs It's Time to See a Doctor
Dr. Miller: What happens if you're riding long enough that even if you're doing these exercises, you develop pain coming down one of the arms and your fingers, or you've got pain in your neck that won't go away?
Dr. Kendall: If you've done all of these things and you are having continued neck pain or you start to get shooting pain down your arm or numbness in your hands and fingers, you really should be checked by your physician to make sure that you don't have a pinched nerve in your neck as a cause of these.
updated: April 15, 2025
originally published: June 9, 2015
