I had an encounter 2 weeks ago with someone who just completed a 20 mile bike ride with a companion. She told me after the bike ride she was having nerve pain from her neck to the left shoulder and asked what she could do to not only alleviate it, but why she had it.
I spend most of my time with clients discussing alignment and core strength. That really is the crux of everything. I spoke with 1 client that now we will get into more core strengthening, and she said when aren’t we doing core.
Yet I had another client who was working on upper body strength and asked when we would do some core. If you aren’t using the core – lower abdominals, pelvic floor, gluteals, diaphragm – in your activities, you become more susceptible to injury.
You have some muscles that are stabilizers and some that are movers. If you use a muscle both as stabilizer and mover, that is when you can cause injury. An easy example to understand is: standing on 1 leg and kicking the other. The standing leg is really the working leg. It is stabilizing so the kicking leg can move.
Once you understand this concept, the exercise becomes so much easier to do.
So back to this person. First thing was for her to understand her alignment on the bike. If she was hunched over the handlebars, this would compress the core so it could not be activated, round her shoulders making it more difficult to breath, and bring her head forward shortening the neck muscles.
Well if your core is not working to stabilize the trunk so the legs can pump, somewhere else in the body has to stabilize. In her case, probably the upper body/chest area.
Now the chest and neck are tight so breathing becomes shallow and the accessory muscles (in the neck) are being used. Remember she was biking 20 miles – an aerobic activity. When you breathe shallowly, your body begins to tense. The diaphragm is another core muscle.
Her head is also forward creating the muscles in the neck to shorten and compress. This can impinge the nerve in the neck because the muscles are tightening around it, which then sends “radiated pain” into the shoulder in her case.
What to do about it? I instructed her in her alignment on the bike. Then gave her exercises to allow space between the vertebrae and to eliminate the forward head posture. Someone was listening to this and then said to me: “well in my yoga class we always do that with our heads (bringing it forward) while sitting.” I hope now you can guess my answer to that! Why would you enhance the posture that creates more problems that most people are already in? And in sitting, which is a flexion activity that can create the forward head.
Well I ran into this person the next day. She followed through on what I said to her and she told me she was now painfree.
But of course, she is not out of the woods yet. She would need to continue working on strengthening to not only be able to maintain the appropriate alignment but also to support the spine.
If your activity is causing you issues, whether it’s biking, hiking, dancing, Pilates, running and you would like one on one individual personal care to eliminate them, contact us at 301-493-9257 or click here to schedule a Free 20 minute Discovery call. Our sessions are 1 hour long and you work the entire hour with 1 Physical Therapist. You are not passed around to other PT’s or aides to follow through on your personal care.
To Your Health,
Cynthia
