NECK PAIN ON THE BIKE – COULD YOUR ABDOMINALS BE THE PROBLEM?

I find it extraordinary that in my years of reading articles and books about pain and discomfort while cycling, I have never found a discussion of the potential impact of the abdominal muscles on neck pain. This is striking because there is a remarkably direct connection between the abdominal muscles and the neck, and this connection can be particularly problematic for cyclists due to the very nature of the position of the human body on a bicycle. While there are a variety of potential causes for neck pain in cyclists, the link between the abs and the neck should not be overlooked.

HOW CAN THE ABDOMINAL MUSCLES AT THE MIDDLE OF THE BODY CAUSE PAIN IN THE NECK?

It may not be obvious, but the abdominals can exert a strong and direct force on some of the muscles of the neck via the rib cage. The relatively large abdominal muscles connect the pelvis to the bottom of the rib cage, and the relatively small scalene muscles connect the vertebrae of the neck to the top of the rib cage. Thus, any time the abs are shortened, they pull the rib cage downward toward the hips and put tension on the scalenes as they are pulled “down” toward the hips as well.

Both the abdominal muscles and the scalenes are connected to the rib cage. To keep the eyes up and forward when the abdominals curl the ribcage down towards the pelvis, the scalenes must be stretched, and this pulls on and compresses the small vertebrae of the neck (click to expand).

If the head is kept in a neutral position, then the scalenes are maintained at the same relative length and are not usually an issue, but in cycling the head must be lifted and held in a tilted-upward position in order to keep the eyes forward. In this case the scalene muscles can be pulled in a tug-of-war between the downward-anchored rib cage and the upward-pulling head and neck. The result is taut scalene muscles that can compress the vertebrae of the neck while cycling. Not every cyclist will feel neck pain as a result of this tension and compression, but many do.

Notice how neck is much more curved and stressed as the cyclist gets into a lower position, and is worsened by the back rounding due to shortened abs (click to expand)

WHEN IS THIS CONNECTION LIKELY TO RESULT IN PAIN FOR CYCLISTS?

This issue of neck pain due to shortened abdominals is most likely to arise when a rider has relatively long and weak muscles along the upper spine and around the shoulder blades. These weaker muscles, combined with short, stiff abdominal muscles, encourage the trunk to passively curl forward, i.e. pull the rib cage – and therefore the scalenes in the neck – downward toward the hips. Without corrective steps, this posture becomes semi-permanent, and very often the rider has at least a mildly curved or hunched posture off the bike, and he or she can have a visibly rounded upper or middle back while on the bike.

This is not to say that a rounded back guarantees neck pain or that a flat back prevents it, since any given rider’s anatomy may tolerate longer scalene muscles or increased tension on those muscles without experiencing pain. In general, however, a more rounded upper back when on the bike involves curling of the trunk toward the hips, and therefore is more likely to produce strain on the neck as the head is held up to keep the eyes on the road.

It is not uncommon to see cyclists who have a rounded back posture both on the bike and off, since over time their short, stiff abdominals have become “permanent” (click to expand).

A RIDER’S DAILY ROUTINE OFF THE BIKE CAN AFFECT THEIR POSITION ON THE BIKE

The biking position is not the only position that tends to reinforce or cause forward curl of the trunk. Our muscles become accustomed to long hours of being kept in positions that are too short or too long, and they even eventually adapt to maintain those short/stiff or long/loose positions twenty-four hours a day. It is easy for us to visualize this happening during long miles on a bike where a rider is bent over the top tube for hours, but it can also be a common occurrence during a cyclist’s daily routine, one which then is made worse once they get on the bike.

In particular, riders whose daily routine involves sitting at a desk may be especially prone to neck pain when on the bike due to shortened abs and stressed scalene muscles. Sitting in a chair and reaching forward to a desk or computer is not something humans are evolved for, and many desk workers will tend to hunch or even slump forward as the hours pass, effectively “training” their abdominal muscles to shorten and stiffen, and their back muscles to lengthen and loosen, allowing the spine to round forward.

Eventually this becomes their default sitting posture, and the result is a constant downward pull on the rib cage by short and stiff abdominal muscles and by default on the scalene muscles as well.

In fact, it is fairly common to diagnose non-cycling desk workers with neck pain due to scalene stress simply from trying to keep their eyes up on their computer screen while sitting in a chair. You can imagine the neck stress those same desk workers would experience if they were to climb on a bike, bend over to the handlebars, and have to extend their neck even further upward to keep their eyes on the road!

It is not uncommon to see cyclists who tend to default to a full-time slouched posture due to short, stiff abdominal muscles (click to expand)

HOW CAN YOU TELL IF THIS IS A POTENTIAL CAUSE OF YOUR NECK PAIN?

Ideally, a rider with neck pain would consult a skilled physical therapist that is familiar with cycling. A complete movement assessment on and off your bike is the best way to address the variety of potential causes of neck pain. In a clinical setting, your PT should use various methods to lift your rib cage and elongate the abdominal muscles, and then move your neck into various positions to see if decreasing the tension on the scalenes addresses your issue. If your neck discomfort or limited range of motion remains the same with the rib cage lifted and the abdominal muscles elongated, then the problem likely lies elsewhere in your neck biomechanics. However, if your neck moves more freely or with notably less discomfort, then your neck pain may be linked directly to your short and stiff abs.

It is important to note that this problem is challenging to self-diagnose, since the people who have the shortest, stiffest abs are also going to be the least able to intentionally relax those muscles and assess the results of lengthening and loosening them. Nonetheless, here are a few things you can do on your own to get the process of healing underway. This may also help you to understand what your PT is (or should be!) doing when you are evaluated for a neck issue as a cyclist.

There are some simple assessments of your riding experience that may give you clues. Is the problem worse when you’re in the drops or in your time trial position? Compared to other riding positions, these positions require your head to be more extended (i.e. pulled higher) with increased tension on the scalene muscles. If you have neck pain but feel better with your hands on the hoods or top of the bars versus when you are in the drops or hooks, short or stiff abdominal muscles might be a contributing factor.

Is your neck pain worse in the time trial position compared to riding on the tops?

You can also try to simulate some of the tests a PT should be doing in the clinic, using certain positions to lift or release the downward tension on the rib cage. This process can be awkward to do on your own, but there are some things you can try.

First, stand with your back against a wall and raise your arms up high to raise the rib cage. Be sure to keep you back and hips against the wall – you don’t have to mash your back against the wall but we don’t want it to dramatically arch. Next, with your arms overhead and your rib cage held high, rotate your head to the left and right, and then tilt your head back. If you experience less neck pain or tension, stiff abdominals may be contributing to your neck problem.

You can also do this lying on your back, which may help prevent your back from arching.

Another good test is to sit in a chair and physically lift your rib cage with your hands as you take in a very deep breath, then assess your neck tension or pain in the same way – by rotating your head left and right and tilting your head back. Get a sense of how tight your abs are as well – I have tested clients whose abs were so short and stiff that I had trouble getting my hands under their rib cage to even do the test!

Three potential self-tests – standing arms raise, lying arm raise, and rib cage lift (click to expand).

Finally, try getting on all fours and totally relaxing your abdominal muscles to the point that they are hanging and floppy. I’m talking about mimicking a full-on dad-bod belly. Then lift your neck as you would in the biking position to see whether there is a change in the ease of moving your neck or a decrease in neck pain.

This is potentially the best method for assessing cycling-position-specific pain, but keep in mind that many cyclists with ab/scalene related neck pain are unable to let their abs “flop” like this. Their abdominal muscles are accustomed to constant engagement and they are unable to relax and be “unengaged” without specific training and practice. If this is the case for you, that’s already one (strong!) indicator that you likely have short and stiff abdominal muscles.

Even in a clinical setting with my specific instructions, I often find that cyclists with short abs cannot intentionally let their abs release and become floppy. So be aware that while this is a good assessment method – and one that your PT is likely to use in a clinical assessment – the cyclists who are most vulnerable to this specific problem are also those who are least likely to be able to correctly do the assessment on their own.

The all-fours test. In the lefthand image, the cyclist has just assumed the all-fours position and defaults to a rounded back and sucked-in abs position. In the center image, he is corrected to make his back flat, but still cannot release his abdominals. In the image on the far right, this cyclist does not over-tense his abs and easily keeps a flat back (click to expand).
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HOW CAN YOU PREVENT THIS PROBLEM, OR CORRECT IT IF YOU ARE ALREADY EXPERIENCING NECK PAIN?

Here are four useful steps you can take to address your neck pain, or to prevent it if you are worried that your rounded posture on the bike may eventually lead to neck pain.

1. Retraining your abs

Learning how to relax and elongate your abdominal muscles is the first and most important step. As noted above, this is often difficult for cyclists to do. Some of the assessments discussed above are also great daily exercises if you do them for repetitions.

For example, stand with your back against a wall and raise your arms up high to raise the rib cage. Again, you don’t have to mash your back against the wall but don’t let it dramatically arch. Keep your focus on really lifting your rib cage upward away from your pelvis. You should feel a significant stretch in your abdominal muscles.

Then take in a deep breath, using the inhalation to expand and lift your rib cage even more and feel a further stretch in your abdominals. As you inhale, you can visualize expanding or widening the angle of your ribs.

You can do this exercise lying on your back as well. Again, focus on a deep inhalation during each repetition to really help stretch the abdominals.

two exercises for stretching the abs
Two tests now turned into exercises by doing them for repetitions. Raise the arms overhead, lifting the ribcage, then inhale deeply while visualizing expanding the rib cage upward and outward. Don’t let the back arch, and let your abs relax as best you can (click to expand).

You can also get onto all fours and let your belly sway and “flop” while your chest relaxes toward the ground. This position will help to elongate your abdominal muscles and to shorten the muscles in your upper back and shoulder blades. Again, many cyclists with excessively tight abs find that they actually can’t do this very well to start – they can’t get their brain to tell their abs to relax rather than contract. With time and practice though, combined with exercise and attentive posture off the bike, you will be able to release that trunk curl and with it some of the strain on your neck.

Next, if you’re working through a neck problem, you must spend time riding this way, keeping your abdominal muscles relaxed and your upper back relatively flat. When you get on your bike let your belly hang toward the ground – let your stomach relax. Take in a deep breath and let your ribs pull away from your waist. As you ride, think of maintaining this relaxation in your abdominals – don’t suck them upward like a greyhound. Relax and try to let your belly flop towards the ground.

This “floppy belly” way of riding is for muscle length retraining purposes, it is not a permanent “new” riding style. To ride a bicycle with any level of aggressiveness, the abdominals must contract to some degree, and sometimes with great force, like when sprinting or during hard TT or climbing efforts. But many riders overcompensate at all times, and it’s important to practice full relaxation in order to learn to use the correct amount of tension at the correct time.

before and after, rider with looser abs and flatter back
The same cyclist “before” on the left, compared to his new “automatic” position on the bike after working for several months to learn to relax and lengthen his abs, leading to a flatter back and easier neck (click to expand).

2. Strengthening exercises for muscles that oppose the abdominals

Magazines, books, and blogs are full of exercise routines that seek to strengthen the “core” muscles of the body, including the abs and the back muscles. These are often a decent starting point for cyclists who are looking to improve stabilizing strength, however, it is critical to understand that if you already have relatively short and stiff abdominals, you will do yourself no favors by doing exercises to “strengthen” the abs.

I cannot emphasize enough that if you already have short and stiff abdominals, you should NOT do any exercises like situps or crunches that will only encourage your abdominal muscles to remain short and stiff.

Instead, for the time being you should only do exercises that strengthen and shorten the upper back muscles that oppose the pulling action of the abdominals, at least until you have elongated the abs and have developed the opposing muscles satisfactorily. There are plenty of options, I’ll mention three here that are easy to do at home.

First, standing wall slides are a great exercise for both stretching the abs and strengthening opposing muscles in the upper back. The exercise is similar to the standing arm raise used as a test above, but instead of placing your back against the wall you will face the wall instead. Then, by setting your arms against the wall you will get extra leverage that will allow you to raise them higher to stretch to abs and work the muscles of the back. As you stand facing the wall, keep your feet below your shoulders so you’re not leaning in, and again be sure not to arch your back. Start with your elbows bent at about ninety degrees, then slide your arms up the wall as high as you can, letting your back muscles do the work and letting your abs stretch. As with the stretching exercises above, take the opportunity to inhale at the top of each repetition, and take care not to arch your lower back.

wall arm slides exercise demonstration
Wall arm slides. Keep your feet under your shoulders  and lift your arms high above your head, using the wall to support your arms and get a good stretch in the abdominals  (click to expand).

Second, you can do stomach lying arm raises, either with bent arms (easier) or straight arms. Put one or two large pillows on the floor to support your torso and to keep your lower back from arching, and place a support such as another pillow or towel under your forehead to support your head and keep your neck from arching. Set your arms on the floor, either with the elbows bent or with your arms straight out and your hands on the floor, then lift your arms using the muscles in the center of your back. The bent arm position is a bit easier if you need to start slow then work up to the straight arm version.

You can set this exercise up on the floor. The torso and neck pillows lift you off the floor to give you more range of motion, as well as support you to prevent arching of the neck and lower back (click to expand).

Finally, you can use the same setup to do forty-five degree arm raises. Set your arms out forward of your head at at a forty-five degree angle. Start with your hands on the floor, then lift your arms, keeping them straight and feeling the muscles of your back do the work.

45 degree stomach lying arm raises example
Forty-five degree stomach arm raises. Start with your hands on the floor and arms out at a forty-five degree angle forward of your head. Raise your arms off the floor, feeling your back muscles doing the work.

3. Adjust your bike fit temporarily during the process of retraining your muscles

You can also take temporary, immediate action on the bike to reduce your current neck pain. Consider raising your stem and bars a bit if possible. You may also tolerate moving your saddle forward and down a bit to allow you a more upright position. Making your bike position a little more upright will help relieve your neck of the stress from pulling against the scalene muscles while you retrain your abdominal muscles to lengthen.

These bike fit adjustments are not intended to be substitutes for retraining your muscles. They are simply immediate actions you can take to reduce your neck pain and any damage you may be causing to the vertebrae and other structures. You should still be taking action on and off the bike to loosen and lengthen your abdominal muscles as well as address any other contributing factors.

4. Correcting daily postures

There are also important steps you can take as you go about your day. These aren’t “exercises” in the classic sense, but you may have get the best results if you treat them as such. As we’ve seen, the postures you maintain during your daily routine can carry over to bad posture while on the bike, and can actually become so “set” that it is difficult or impossible to correct any posture issues while working directly on the bike.

The first step is to simply become aware of what it feels like to relax the abdominals, and what it feels like to lift the rib cage. You will learn these sensations by doing the exercises listed above, and then practicing feeling them as you go through your day, while sitting, standing, walking, etc.

Second, you should become aware of the positions you hold during the day, particularly any “hunched” positions that you default to when sitting or standing. Then, instead of holding those positions, you’ll want to actively replace them by lifting the rib cage and placing the hips directly under the shoulders.

If you have short, stiff abdominals you may find this very challenging at first. I have had clients who initially had difficulty holding these “lifted” postures for even thirty seconds at a time! But your goal should be to treat these postures as “exercises”. Do them as repetitions, starting with periods as short as thirty seconds, and gradually seek to hold them for longer and longer periods as you practice maintaining a lifted rib cage and keeping your hips under your shoulders. “Trying” to maintain good posture during the day rarely produces results, but by making the postures “exercises” that you do throughout the day, you will gradually strengthen the muscles that support the correct postures, and make it possible for them to become natural to you.

Another good “daily routine exercise” is to try to walk and stand with your chest just slightly forward of the vertical line of gravity, so that the back muscles rather than the abdominals are used as the “anti-gravity” muscles, and will be strengthened and shortened while elongating the abs at the same time. By slightly changing your posture in this way, you will shift the role of the muscles that support your body against the force of gravity to the back muscles instead of the abdominal muscles.

By correcting your poor postures during your daily routine, you will eliminate or prevent short/stiff abs in your “daily posture”, and will then be more able to eliminate or prevent them in your “riding posture” as well.

CONCLUSION

Neck pain while cycling is not something that should be ignored. The muscles and vertebrae of the neck are relatively small and easily injured through tension and compression. Neck pain is not just an irritant, it is a signal that something is wrong, and a long-term injury could be in your future if it is not addressed.

And trying to address it through bike fit alone is rarely a complete answer, as the cause is often partly if not completely the result of muscle imbalances or other biomechanical issues that need to be assessed both on and off the bike.

As we’ve seen, one potential biomechanical issue is the often-overlooked connection between the abs and the scalene muscles in the neck. If the abs are too stiff and short – whether on the bike or at your desk – they can cause tension, compression, pain, and injury in the neck.

If you are experience neck pain while riding, you will want to consider seeing a skilled physical therapist who is knowledgeable about the cycling, or at a minimum do some of the self-assessments I have provided in this article. And if you do find that you have short/stiff abs that could be affecting your neck, be diligent in practicing the solutions I have laid out. Your body will thank you!

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3 Comments

  1. Please comment and let Fundamental Velo know if this information helped you or someone you shared it with!

  2. As someone who deals everyday with the residuals of radiculopathy and herniated discs as result of RAAM efforts I appreciate the importance of these exercises and stretches. I have shared on my Facebook page “POSIVELO” for my bike fitting clients to better understand.
    I would be happy to share other posts you might have in future.
    Geoff

    • Thanks for sharing this post, Geoff. You can follow my Facebook page, where I will always announce when I post a new article here on the website. Eventually I plan to be posting regularly enough to justify a monthly newsletter. Thanks again!

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