Andy Somnifac 

When I ride, I have a shoulder/back issue. The more I ride, the worse it gets. This is a chronic condition that persists the entire riding season, unless I take a 2+ week break. Even if I take a break, once I start riding again, the issue reoccurs.

The typical way it goes is: beginning of the season all is well. I get into my regular evening ride schedule of 25-30 mile rides 3-4 weeknights a week, with longer rides each Saturday and Sunday.

As I work into it, the shoulder isn't too bad. After a couple of weeks, I can feel it, but it's nothing more than an annoyance. By the time I'm doing 50 miles in a ride, the shoulder is very uncomfortable on the ride by the end. By the time I do 100 miles, the shoulder is downright painful.

I did a century ride this weekend (into very, very stiff winds, but that's another story), and that 100 miles was definitely the limit. I was more than ready to be off the bike by 75 miles, and at 100 miles I was completely over it. By the 75 mile mark it is painful even to look up while on the bike.

If I get off the bike for a little while, the pain subsides quite a bit, but the area still feels inflamed. Even now, almost 48 hours off the bike, if I shrug my shoulders I can feel what feels like some form of connective tissue running over each other. I'm no expert on human anatomy, so that's the best description I can give. When I turn my head to look over my right shoulder, that area feels like it's getting stretched out. Turning my head left does not do the same with the opposite shoulder.

I've circled the affected area on an anatomical drawing below:



Would anyone think this is related to riding position? I've tried adjusting my position every way I can think of, but nothing really seems to alleviate it.

I tried to go to the docs about it last year, but the doc I saw (a physician that's part of my PCP's practice) basically told me to man up.

Over this winter it was great to not have to worry about this, but now that I'm riding again, and it's returned, I'm completely over it....

Any thoughts?

yos9

I was also having a lot of shoulder pain after longer rides and I just did a Specialized BG fitting and my fitter told me this was because my arm reach was too short. He extended me with a new stem (120mm) and then did something that I thought was odd- he suggested 40 cm handlebars. This brings my hands closer to the center of my body, which makes my upper back profile straight to almost rounded out at my traps. This helps to keep them in a relaxed position.

I wa pleasantly surprised at the results and after getting over the tighter handlebars for turning (feels much more sensitive) I like the position and the should pain has subsided.

So maybe you need a little more reach in your positioning on the bike?

EventServices

You've made several adjustments to the riding position. Did you start with a good fit? It all starts there.
And that means finding someone who really knows how it works. We have a guru of bike fit in our area who checks everything: where your shoes are showing wear, what your spine is doing, and where your eyes are looking.

Seattle Forrest

It's definitely position, or, more to the point, it's likely your posture on the bike. Ask me how I know.

First, take everything people online say with a great, big heaping grain of salt. Especially on a site like this. To that extent, talk to your doctor again, and ask for a prescription to physical therapy. ( The prescription isn't necessary, but may get your insurance to pick up most of the bill. )

Is it your lower traps entirely/mostly, or do your uppers bother you, too?

My doctor sent me to a few PT sessions to get almost exactly the same problem sorted out. The therapist said it sounds like I'm using my back muscles out of balance, and probably too much through the day; it's like holding a small amount of weight in an outstretched arm, until the muscle gives out, screaming bloody murder. They attached a biofeedback machine to my traps to measure how much I'm actuating the different muscles, and that proved the theory. Then, they refit the bike with the biofeedback machine, to get a position that was as well suited as possible to my particular issue. Finally, we went over posture, and they gave me a number of exercises to help strengthen the muscles I've been under using.

The problem is going away, slowly, for me. I used to be ready to jump off a bridge after a half century, and my shoulders felt red hot. Now, most days, a metric century means sore shoulders. It's not 100 %, but that's a huge improvement.

Andy Somnifac 

To answer questions posed above:

re: bike fit.

Yes, I have been through a bike fit. The shop that does it does not use one of the fancy computer driven systems, but we were at it for a good bit of time with all sorts of measuring devices and tools to move this and that to get me into what the shop thought was a good position.

re: position of pain.

If I had to narrow it down (and referring to the diagram above), I'd say the center of the pain is probably just to the inside of where the light colored connective tissue (?) points inward towards the center of the back. It feels that it runs up and down at an angle similar to the direction that the muscle fiber runs.

I'm going to have to talk to a doc again and see about being referred to a physical therapist. If a physical therapist would be able to do a more in depth bike fit to get me in a better position on the bike, I'm all for it. Especially since my insurance allots me 30 PT visits per calendar year.

Campag4life

If you want to resolve it, post a picture of yourself on the bike. For even better perspective, post your body dimensions and bike dimensions.
Trap pain is many times due to compression up the arms. This is typically the result of a handlebar that is too high and or too short a reach to the bars. As you pedal your torso wants to naturally assume about a 45 deg angle with your hands on the hoods. If your cockpit is too short and your arms are in compression holding up your torso, this will go right to your traps. The poster that stated about going to a longer stem but in particular a narrower bar is right on the money. A narrow bar promotes the separation of the traps and helps hold the torso up with skeleton versus musculature.
Fit is quite complex. 1 deg of saddle tilt and 10mm of setback can change a rider's position enough to take pressure off the arms.

rogerstg

I had/have that same issue. My chiropractor, who has solved the handful of back and hand numbness issues I've had over the last decade, did not think this was a big deal. He explained that the burning sensation is from overuse of those muscles and resulting inflammation. IOW, not relate to joints and nerves.

He suggested icing it after every ride and when it bothered me. That solved the problem. When it recurrs, a little ice nips it in the bud.

Campag4life

While your chiropractor was correct about it being an overuse injury and icing helps, there is no need to live with it. It is due to improper fit resulting in a bad position on the bike. If the fit on a bike doesn't comport with the bodies' attempt to assume its natural position when powering the pedals, not only does this rob power but pain will many times occur.

rogerstg

You're assuming that fit is the cause of all pain. Sometimes riding long distances just aggravates a problem that occurred from other activities, like moving a couple cords of wood, or spending three days on the water in a shark tournament. And of course, there's being over 50 when a person is haunted by every failed dumb-ass stunt from his youth.

I suppose as long as a rider is not experiencing the same pain issue consistently (after it's been addressed), it's probably not a fit issue.

Machka 

Welcome to my world.

I tore my rotator cuff in my left shoulder in 2001, and then fell on the shoulder and separated it in 2007. When the initial separation healed, it started doing a subluxation thing where it would partially dislocate at will. I've been through all sorts of physio, chiro, etc. etc. for that shoulder and it is finally starting to feel a little bit better, although still not 100% .... not even 75%.

And just when it started feeling a little bit better, for some unknown reason, my right shoulder started bothering me in about the same spot yours is bothering you. I've been in a lot of pain with that shoulder for several months now. I have been cycling more in the last several months ... what with it being summer ... so that might have something to do with it. But I suspect it might also have something to do with the fact that I mouse with my right arm. Could be that something isn't set up quite right for optimum mousing at home or at work.

I feel like if I swung my arm around like a windmill, there would be a loud crunch somewhere in the shoulder area, and everything would suddenly feel better ... but it doesn't seem to work that way.

I've been to a chiro here, and that hasn't helped much. I've been to a massage therapist twice, and while that was wonderful, it didn't really help much. There is a physiotherapist here I'm considering now, but I'm not convinced that will help either.

So now, both shoulders are quite painful, and I'm not really sure what to do.

pmt

OP, you need a paid fitting session with a good system like Retul, and you need to see a massage therapist at least once a week for a while. That should go 99% of the way towards pain-free riding. Guesswork isn't going to help.

Andy Somnifac 

I'd love to get a Retul fit, but there aren't any Retul centers in my area...

And if this were confined to just long rides, I'd deal with it, but it's not... Once it's inflamed, jumping back on the bike for a short ride is enough to bring it back. Last night I did my normal 20 mile loop and by mile 5 or so looking up or down was enough to cause a pretty good amount of pain... Sort of like being jammed with a hot poker just to the inside of my right shoulder blade.

If I stay off the bike for a week or so, I'd probably get back down to the point that I could do the 20 mile loop pain free. So, my immediate choices are to either deal with it (which is certainly not fun) or not ride for a week and ride only shorter rides so I don't inflame the shoulder (also not something I want to do)...

Campag4life

See a MD. Get a MRI.

Campag4life

Can't you read? The number 1 cause of trap pain is bad fit. Change your fit as I suggested.
Where are the pics of you on the bike? Own a $20 digitial camera? Some people if given a roadmap can't help themselves.

Campag4life

His bad fit IS his cause of pain. He isn't in pain when off his bike for a certain period. Trap pain with cyclists is common. It is due to too much arm compression due to improper position on the bike. Arms shouldn't be holding up the torso. If the rider doesn't have trap pain off the bike, he shouldn't have it on the bike. All the arms should do in a proper fit is steer the bike, not hold up the torso.

Andy Somnifac 

Jesus christ. At what point have I been argumentative or combative, or willfully ignored advice? I plan on making changes. It has been one freaking day, and I've ridden a puny 20 miles since the original post. I did not expect the pain to be as bad as it was on a short ride, and was merely making a report.

Yes, I own a camera. I have access to a far greater amount of photographic gear than most people (including very successful pro photogs) would ever dream of having access to. I'm sorry that I did not immediately run out last night and take photos for you. I wanted to ride, so I went to ride.

Someone mentioned a Retul fit, and I responded that there unfortunately isn't one nearby. I'm sorry I don't live closer to one.

I'm sorry that I didn't immediately go out and buy a new stem and/or new bars to make wholesale changes on my bike based on the recommendations of people on the internet. I plan on going into the shop that did my fit when I have time and working with them. I'm sorry my work day shift lasts 11 hours a day, and getting to the shop during the week for a couple hours is difficult.

I'm sorry to have disappointed you. May the internet gods take mercy on my soul.

Campag4life

You didn't disappoint me. Why should you?
Fit on the bike is critical is all if you want to enjoy the sport without pain. Most you see that are strong riders didn't come across their fit by accident. It was the result of a lot of hard work.
Most of what you need to know is incorporated into this great recent thread:
https://www.bikeforums.net/showthread...ight=discovery


If you watch the videos and understand what Cobb is saying and why, you will be much closer to being a better cyclist.
Cycling is highly repetitive. If you do something wrong long enough, its gonna hurt....and there are a lot of ways to hurt your body with poor mechanics riding a bicycle for hours with exertion.
Good Luck.

pdxtex

good fit 1, start doing pushups if you don't already, 2....or bench presses.

Machka 

The thing is ... the shoulder pain may have nothing whatsoever to do with the bicycle. It could be caused by his car seat, or by his office setup either at home or at work, or by other hobbies.

The OP should take a look at what goes on in the rest of his life and see if there might be something else causing the shoulder pain ... and the cycling is only making it worse.

Andy Somnifac 

Working with the shop I frequent to dial in my fit. I'm test riding a 100mm stem, rather than my 90mm stem. So far the pain seems to greatly reduced. It's not gone, but I'm not sure if that's due to it already being inflamed.

ghostryder

I had the exact same issue. You probably have a pinched nerve in your cervical spine in the neck. You could have a protrusion in the c4 to c6 area and it might be a very slight protrusion that hits the nerve.

When you ride it inflames the nerve, and you cannot raise your head and look up, so you probably just look down as much as you can. Maybe your stem is too long, which can aggravate the problem even more.

The pain got so bad i could not ride for months, and every time i would ride the pain would come back. I bought a smaller size bike and which helped. I wasn't so stretched out.

You should go to a spine doctor and get an MRi.

Andy Somnifac 

I've gone from a 90mm to a 100mm stem and it seems to be helping quite a bit. I'm going to give it another couple hundred miles and see how it goes before seeing a doc, but if it keeps going the way it's gone the last couple rides, it's going in the right direction.

STP

Massage therapy once or twice a week.

rangerdavid

^^this^^ .... and try a couple of visits to a chiropractor for some adjustments. Once things are property aligned, then you start over with the 100mm stem and see how that goes.