Your cycling workouts should provide a respite from the stresses of daily life, not add to them. But elbow pain while bicycle riding can be an unwelcome distraction and could also be a sign of a more serious condition such as lateral epicondylitis, more commonly known as tennis elbow.
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The condition occurs when the tendons that connect the forearm muscles to the elbow become inflamed due to stress and overuse, according to Johns Hopkins Medicine. A poorly fitting bike can contribute to elbow pain, as can the constant twisting of your elbows to switch gears.
Your cycling position may also be to blame. When cycling, your elbows act as shock absorbers, cushioning your upper body as you ride over bumps or uneven terrain. If you cycle with your arms straight and elbows locked, your elbow joints take a beating, which can result in elbow pain.
Proper Cycling Posture and Arm Position
Improper cycling posture can contribute to elbow aches and pains. When you stand over your bike, you should have about 1 inch of space between your body and the top bar on your bike frame.
You should be able to sit almost fully upright when leisurely pedaling, with a slight bend in your elbows. Holding the handlebars with slightly bent elbows will make it easier to absorb shock as you ride, according to REI, causing less stress on your elbows, shoulders and neck.
Your wrists should be straight and your chin tucked in. Keep your spine in a neutral position while maintaining a straight back. The position of the shifter and brake levers should also be within comfortable reach so your wrists and elbows aren't straining to change gears or brake.
By assuming the proper position on the bike, the forces you encounter during a ride will be evenly distributed over your body.
Bike Fit: Hands, Feet and Seat
Before you hit the streets or trails, make sure the bike fits your body. Seek the help of a qualified bike fitter, who can check the key areas — hands, feet and seat — where your body has contact with the bike.
For example, the handlebars may be too far from or too close to your body. If the handlebars are too high, you increase the risk of lower back pain. If they're too low, you may overextend your arms and lock your elbows while you cycle.
A fitter can help you set the handlebars in proper relationship to the saddle and in such a way that the entire set-up accommodates your physique.
Symptoms of Elbow Tendonitis
Two types of tendonitis can strike your elbow from cycling. If you feel pain on the outside of the elbow when forming a clenched fist or lifting your wrist up, it can be a symptom of lateral epicondylitis, or tennis elbow, according to the American Association of Orthopaedic Surgeons (AAOS).
But tennis elbow doesn't just develop from swinging a racquet. As you cover terrain on your bike, shocks are transmitted up from your handlebars to the tendons of your wrists and elbows. The tendons controlling the muscles for these movements attach at a tiny bump on your outer elbow and become inflamed after repetitive shocks from your handlebars.
According to Utah Mountain Biking, cyclists with tennis elbow will experience pain or burning on the outer side of the elbow when raising the wrist up or making a fist. The bony bump on the outside of the elbow may feel tender to the touch, and your grip may feel weak.
Medial epicondylitis, or golfer's or baseball elbow, is results in pain in the inner elbow when straightening the arm and is caused by inflammation of the tendons there, per Johns Hopkins Medicine. These tendons attach to muscles enabling you to flex your fingers and turn your wrists downward.
If you're turning your wrists up and down on the handlebars when jumping or doing drop-offs — rolling over obstacles on a descent — the sudden yanking motions can lead to injury or elbow pain.
Treating 'Biker's Elbow'
Though it may be tempting to ignore the pain and keep cycling, you need to rest your injured arm, according to the AAOS, even if that means taking a break from cycling and other sports for several weeks.
Ice and anti-inflammatory medication may provide initial pain relief and help reduce any swelling. Continue to ice the elbow for a half-hour every two hours over the course of two days. If necessary, take anti-inflammatory medicine, such as ibuprofen, and rest your elbow in a sling.
Visit a doctor if your condition doesn't improve with rest, your experience severe or worsening pain or if your elbow becomes significantly swollen or discolored. If you find it difficult to perform routine tasks with the injured arm, more serious treatment may be required.
After a few days off (or more if needed), attempt to stretch the elbow joint through its normal range of motion by bending your elbow and fully extending your arm. Stretching the tendons and muscles of the wrist and forearms can also help relieve elbow pain if done periodically throughout the day. Try this stretch:
- Straighten your right arm out in front of you and rotate it so that your forearm faces the ceiling.
- With your left hand, gently push your right fingers back toward your body so that your right hand starts to become perpendicular with the floor.
- When you feel a stretch in your right wrist, hold for 15 seconds.
- Switch sides and repeat 2 or 3 times.
This wrist stretch is also excellent as part of a warm-up before cycling once you've recovered and been cleared by your doctor.
You can also try the Super 7 for tennis elbow, which is a series of seven different stretches to help ease the pain of lateral epicondylitis.
- Robert J. Gregor: "Handbook of Sports Medicine and Science: Road Cycling"
- USA Cycling: "How a Bike Fit Can Address Common Aches and Pains"
- Johns Hopkins Medicine: "Lateral Epicondylitis (Tennis Elbow)"
- Virginia Sportsmedicine Institute: "Elbow Pain"
- Utah Mountain Biking: "Tendonitis"
- American Association of Orthopaedic Surgeons: "Tennis Elbow (Lateral Epicondylitis)"
- BBC Sport: "What is tennis elbow?"
- REI: "Bike Fitting Basics"
- Hughston Clinic: "Tennis Elbow - It's Not Just for Tennis Players: The Super 7"
- Johns Hopkins Medicine: "Medial Epicondylitis (Golfer's and Baseball Elbow)"