Whether you are a new cyclist or a seasoned rider, pain in the shoulder blade can occur. Many times, this is due to poor bike set up, a training error or poor posture. Pain in the shoulder blade is very common with cycling and is usually called Scapulocostal Syndrome. This syndrome is due to abnormal function between the scapula, or shoulder blade, and the posterior wall of the thorax. Pain is felt in the upper and posterior part of the shoulder and can radiate to the neck, head, arm and chest.
Causes
The causes of pain in the shoulder blade are usually from muscles, ligaments and tendons. This can be attributed to poor riding positioning, imbalanced muscles and a weak core. Gripping the handlebars tightly while hunching shoulders can also cause pain and discomfort, especially if this position is held without movement for a long period of time. A training error when first starting cycling can occur, as well as wear and tear on the body for more seasoned cyclists. The heart and gallbladder can refer pain to the shoulder and should be checked by a physician.
Treatment
Treatment of pain under the shoulder blade begins with rest for the irritating movements and activities until the pain is gone. Ice and anti-inflammatories might also help decrease the pain and speed healing time. Massage, ultrasound and trigger-point therapy can decrease the trigger points and muscle tensions.
Proper Bike Fit
Changing positioning of the bike for a proper fit will help to decrease pain in the shoulder blade. When standing, the frame should be able to be easily straddled with the feet flat on the ground. The pedals should have 1- to 2-inch clearance for a hybrid bike or 4 inches for a mountain bike. The saddle should be level to the ground to decrease stress on the shoulders and arms, and it should be at the correct height to have the knee only slightly bent when seated with the ball of the foot of the corresponding pedal at its lowest.
Prevention
To prevent further injuries, slowly increase mileage and time on the bike when reintroducing the activity. Stretch the shoulders, back and neck before cycling. Fit the bike to your body and double-check periodically to make sure no alterations are needed. Improve core strength to allow the body to easily support itself during cycling. Continue massage or ultrasound to avoid flare-ups or a return of the trigger point.
