Training & Nutrition

How to: Fix Neck, Hand and Back Pain for Cyclists

Cycling can be many things, but it certainly doesn't need to be painful

Cycling can be beautiful, exhilarating and exhausting in equal measures. One thing it doesn’t need to be is painful.  We’ve worked with Scott Holz – the expert who trains Specialized dealers in their Body Geometry Fit fit system (using advanced Retül bike fit tools) to bring you a series of guides on common problems and their equally common solutions. Holz has been helping riders discover their optimum fit for over 30 years, providing expertise for amateur everyday cyclists right through to World Champion Lizzie Armitstead. He’s well qualified, we assure you. 

We’ve already taken a look at knee pain – its many potential causes and fixes. Next up, we’re looking at how to solve problems around the neck, back, and hands. 

Body Geometry FIT, Lea Davidson

Fixing Cycling Neck Pain

When you’re cycling your key contact points are your hands, feet, and bottom. Everything else fits around these contact points. If this fit is less than ideal, parts of your body become uncomfortable.

Neck pain often coincides with shoulder, upper back or wrist pain, and hand numbness. Holz told us that there were too key causes: riding with the handlebars too high, or riding with the handlebars too low. Most of us are aware of the latter as a cause, but few associate an upright position with these kinds of pains.

Fitting a Female Body to a Unisex Bike

Holz explains the cause: “A really common mistake is having the bars too high. People often sense they have too much weight on their hands, so they ask to have the bars higher. Then all that does is shove their hands up and their shoulders move up even further. Your torso knows where it wants to be, your glutes know where they want to be to fire effectively. If there’s not enough room between your shoulders and the bars you’ll try to make room by hunching them up.”

Asking to move the bars further away from a rider who is struggling with pressure on the hands doesn’t always go down well initially. Holz says: “Sometimes for riders it’s really counter intuitive to say ‘hey, I’m going to lower your handlebars, and your shoulders are going to relax’ – but you literally are moving the handlebars out of their way and it can make a huge difference.”

How to: Loosen up on a Road Bike

A professional bike fit is the best way to determine ideal handlebar height – but if you’re getting pain around your shoulders and notice that they’re often hunched up next to your ears, have a go at lowering the bars. You can do this by removing spacers from beneath the stem. Angling the bars so they’re parallel with the ground is also a good idea – many bikes come with the handlebars in a very upright position with the hoods sitting high up.

Of course, on the other end of the spectrum is the rider who feels the need to emulate the pros, when their body just isn’t as flexible and their core strength just isn’t as strong as their idols. Holz explains: “At the other extreme, you’ve got the person who has got everything slammed [the stem has all the spacers removed from below it], and doesn’t have he flexibility for that position, so has everything totally extended. They’re beyond the sweet spot and can’t look up comfortably. They may have less pain in the hands, but generally neck pain is the problem.”

You can fix this by raising the handlebars up with a couple of spacers, by using a positive angle stem or rotating the bars so they sit slightly higher. You can also reduce the reach by using a shorter stem, and if the handlebars measure much wider than your shoulders it may be a good idea to swap them for a narrower pair which will likely feel much more comfortable.

Fixing numbness in the hands in cyclists

Body Geometry FIT, Lea Davidson

Though numbness in your hands can be caused by the bars being too low and far away, or too high and creating overly tight angles – there are some other potential issues that are purely to do with the ergonomics around the cockpit.

Holz explains what’s going on at hand level: “You’ve got two big nerve groups running through the hands – the Ulner nerve works with the outer two fingers, the Medial nerve works with the inner two fingers. After periods of compression in the nerves, the fingers will fall asleep.” If you’re getting numbness in just two fingers, it’s a clear sign that you’re compressing one of those nerves.

It’s common to simply look for gloves with more padding – in fact Holz tells us that a high proportion of bike fits start with someone coming into a store searching for a pair of mitts that will act like pillows: “Hood shape and handlebar shape not being ideal can put pressure on the nerve and cause problems and hand numbness. A lot of bike fits I’ve done have started at the glove level – people come in looking for better gloves. Very often if someone is trying to fix numb hands with gloves, it is a bike fit problem.”

There are many styles and shapes of handlebar available these days – bars with a shallower reach are often best suited for women who have smaller hands. You can also adjust the reach between shifters and your handlebar, to reduce the stretch you have to make to operate the levers. The actual lever hood is a little more difficult to change, as shifters are quite an expensive upgrade. However, SRAM, Shimano and Campagnolo shifters are all very different shapes and some will suit you better than others so it’s not an avenue you should ignore completely.

Finally, though gloves aren’t a solution for extreme numbness caused by nerve compression, they can help if you’re feeling just a few tingles. Specialized offer their new Grail glove, which was created using blood flow analysis carried out by Dr. Kyle Bickel M.D. Holz says: “The Grail glove is pretty cool and innovative. It acts a lot like a foot bed, the padding is in the centre. This fills in the middle of the hand creating an even pressure, equalizing it across the hand instead of just padding out the areas where the nerves are as most gloves do.”

Fixing lower back pain from cycling

Photo: Iri Greco / BrakeThrough Media

Finally – we come to lower back pain – something that can plague riders, particularly towards the end of a long ride or after a lot of climbing. Holz says: “A lot of the time lower back pain comes from the rider having a saddle that’s too high for their flexibility. Tight hamstrings will pull the pelvis back when the rider is trying to get to the bar.” This often results in rocking hips, causing constant movement in the lower back and it’s something a fellow rider will probably spot.

Another common cause is having the handlebars too low and far away – again as per the issues with neck pain, the rider is having to constantly over extend. The best option here is to raise the front end of the bike up with a positive angle stem, using the spacers, or by twisting the bars up slightly. The reach can be reduced by using a shorter stem.

Working on flexibility and core strength is also a good idea – lengthening the hamstrings will allow you to adopt a more aggressive position if you want to, without pain, and a stronger core will provide you with more support in that long and low position.

We do hope that helps clear up a few questions around shoulder, neck and hand pain and cycling, helping any reader’s suffering to overcome issues that are easy to solve. If you’re experiencing ongoing problems, check in for a bike fit.

The average fit can cost around £100, which might seem a lot to be leaving an identical bike, just altered a bit here and there. However, being comfortable on your bike is a performance aid greater than any wheel, frame or groupset upgrade, so we’d wholeheartedly recommend it. 

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