# I've identified the reason of my shoulder pain.....I think



## Spoked Wheels (25 Jan 2016)

As the thread title indicates, I'm having problems with shoulder pain....

It's only in the last few days that I'm seriously thinking this is due to my cycling.

Until October I rode my summer bike without any issues and then I began to use my winter bike that has never been a problem in the past. Around that time also my daughter asked me to start riding with her, only gentle rides along the promenade..... it was then that I started riding my brother's old hybrid (Carrera Subway with flat bars) and then I did a few 20 milers in November but my winter bike was still the main bike up to that point. During December I began to ride the hybrid with flat bars only and I began to have this shoulder pain that I thought was to do with me sleeping in a poor position. It got worse really quickly than I needed an injection 2 days before Christmas. Since then I've been taking unti-inflammatory tables and I'm still in pain.

I had a rest for about 5 days and although the pain didn't go away, I felt better. Last Sat I went on my usual club ride and I rode the hybrid again.... (I've equipped this bike for touring so I thought I'd practice with loaded panniers, etc). It was just over 50 miles and when I came back I could feel discomfort from the shoulder area.... sitting on the sofa just the weight of the arm made me feel the arm was going to come off from its socket. Moving the arm backward or even trying to reach for something sideways would bring excruciating pain that would spread from the shoulder to the elbow.

On Saturday afternoon I seriously suspected the bike as the source of my shoulder problem.... I compared measurements with other bikes and they were all about the same... so on Sunday I went out on a ride just to analyse my position on the bike..... my position feels comfortable, there is a very slight bend at the elbow when my hands are on the corner of the handlebars and bar extensions which is where I keep my hands mostly. I thought that I could probably do with a 1cm shorter stem (my brother is 2cm taller so that would make sense) but I moved the saddle forward 1cm for now, position still feels good but the biggest difference comes from the width of the bars, my road bikes are 44cm wide and this flat bar bike is 61cm wide and since I hold the bars mostly at the corner of bar and bar extension, I'm actually using the full width. So at this point I'm suspecting the extra width being the source of the problem.......

My MTB has a much shorter stem and wide bars but I've never do more than 10 miles on that and I only use it occasionally, that would explain why I've never had a problem....

Does it make sense to you my findings?

BTW, my doctor, as brilliant as he is  he is not one of those that try to find what the problem is.... he always starts with take these tablets for xyz days and come back to see me if they don't work. So I'm sure if I figure the problem myself I would save a lot of time and pain


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## mjr (25 Jan 2016)

Spoked Wheels said:


> I compared measurements with other bikes and they were all about the same...


OK, that's a bit unusual: hybrids and road bikes can have very different riding positions, so I'm surprised if the right fit on a road bike is the right fit on a hybrid unless it's basically a flat bar road bike. For example, I'm pretty upright on my roadster (I trouble low branches) while by comparison I feel like I'm almost doing a Superman impersonation on my road bike! 



Spoked Wheels said:


> I moved the saddle forward 1cm for now


Rarely a good idea but I understand why.



Spoked Wheels said:


> the biggest difference comes from the width of the bars


Yes, 44cm to 61cm is quite a bit. What's the difference in distance between saddle clamp and usual hand position? Could you get a closer distance by mounting another set of bar ends inside the grips temporarily, or are the controls in the way?



Spoked Wheels said:


> BTW, my doctor, as brilliant as he is  he is not one of those that try to find what the problem is.... he always starts with take these tablets for xyz days and come back to see me if they don't work.


I hate those. Doesn't sound brilliant. Any other doctors in that practice who you could see who might refer you to a specialist if needed?


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## Spoked Wheels (25 Jan 2016)

There's another one that is pretty good but it's harder to with the lottery than to book an appointment with him


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## Oldfentiger (25 Jan 2016)

I am not a doctor, but those symptoms sound like it could be a shoulder impingement. I had this a few years ago on my right shoulder, and now it looks like my left is going the same way.
My point is, I think you should insist on a proper investigation by a specialist.


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## ayceejay (25 Jan 2016)

There are two items here - the cause and the cure - to help with both try the self diagnosis in the link below since your GP is useless as most are in this field. If you know what the problem is a bit more specifically the just 'shoulder pain' you will be better able to fix it and the cause may be more evident.
http://breakingmuscle.com/strength-conditioning/how-to-self-diagnose-your-shoulder-pain


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## Spoked Wheels (25 Jan 2016)

ayceejay said:


> There are two items here - the cause and the cure - to help with both try the self diagnosis in the link below since your GP is useless as most are in this field. If you know what the problem is a bit more specifically the just 'shoulder pain' you will be better able to fix it and the cause may be more evident.
> http://breakingmuscle.com/strength-conditioning/how-to-self-diagnose-your-shoulder-pain



Thanks for the link, that looks good. I'll the wife to play doctors  and see what we find....

Thanks again


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## Kajjal (25 Jan 2016)

Oldfentiger said:


> I am not a doctor, but those symptoms sound like it could be a shoulder impingement. I had this a few years ago on my right shoulder, and now it looks like my left is going the same way.
> My point is, I think you should insist on a proper investigation by a specialist.



Simple test for this is with your arm straight raise it in an arc to the side towards your head. If it is painful once you get above shoulder height that is a likely cause, especially if it clicks. Also reaching to a high up shelf to lift something in front of you will be painful.

This will not be corrected by a bike fit as it is an internal inflammation that needs proper medical treatment. Either way if it petsists you need proper medical investigation.


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## vickster (25 Jan 2016)

I have similar symptoms, painful arc and clicking. I have a posterior labral tear, seen clearly in MRI and being fixed mid March. For me, the instability causes biceps tendonitis, which leads to arm pain

See a sports physio, followed by a referral to a shoulder orthopod if required


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## Spoked Wheels (26 Jan 2016)

mjray said:


> OK, that's a bit unusual: hybrids and road bikes can have very different riding positions, so I'm surprised if the right fit on a road bike is the right fit on a hybrid unless it's basically a flat bar road bike.



The effective top tube length on all bikes is between 56.6 to 59. The position on the bikes is different because the saddle position is different and the stem length is also a bit different.

I still think the bike bar setup is a suspect. I've been off the bike for nearly 48 hours and I feel better. I can bring the pain back by stretching my arm in the direction where I know it would hurt. 

I have an appointment to see the physio and in the main time I will adjust the bar setting a bit


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## Scoosh (26 Jan 2016)

I'm with @vickster on this one - see a *sports* physio. You will probably need to go private for it but the difference I have found is that an NHS physio will restore you to 'working' condition ie you can raise your arm, do all the basic movements without pain, so all is well .....

... except you want to be able to ride your different bikes for x many hours and they are frankly too busy to be able to get you to that level. For your goals, you need the sports physio, who knows how to get you back to what you want to do and who can give you deep sports massage - which most NHS physios either don't do or don't have time to do - and lots of seriously hard work exercises. 

NHS physios did wonderfully for Mrs Scoosh when she seriously smashed up her shoulder a few years ago but couldn't take her to the level she wanted to get to - and is now at.  Sports physio is definitely a step up in results, IMHO.


This is in absolutely no way a denigration of the NHS physio service - they do amazingly well with what they have and who they have.


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## bonsaibilly (27 Jan 2016)

First step would be get advice from professionals not cycling bluffers on here. But my advice would parallel wheel buying advice. Start with the grips which are cheap to get a good pair, and get someone to saw off the handlebar to say 540 mm.


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## vickster (27 Jan 2016)

bonsaibilly said:


> First step would be get advice from professionals not cycling bluffers on here.


That's what people have advised


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## bonsaibilly (27 Jan 2016)

Yes. Yes it is.


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## ayceejay (27 Jan 2016)

bonsaibilly said:


> First step would be get advice from professionals not cycling bluffers on here. But my advice would parallel wheel buying advice. Start with the grips which are cheap to get a good pair, and get someone to saw off the handlebar to say 540 mm.


I don't see any contradiction there at all.
I assume you are calling me a bluffer and then offer advice that is totally ridiculous I hope that you take your own advice and seek professional advice and take your sawn off handlebars with you - robber


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## bonsaibilly (27 Jan 2016)

ayceejay said:


> I don't see any contradiction there at all.
> I assume you are calling me a bluffer and then offer advice that is totally ridiculous I hope that you take your own advice and seek professional advice and take your sawn off handlebars with you - robber



Aaaand... there goes another one completely missing the irony and self-deprecation. What *has* happened to the British sense of humour? BB


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## bonsaibilly (27 Jan 2016)

BTW can you explain what you mean by "advice that is totally ridiculous"? because as far as I can tell, since there isn't any medical report in the thread apart from "take these pills and see what happens", we don't know what the actual cause of the pain is, so my technical advice is just as likely to be effective as any other, and moreover, I can't see a massive problem with suggesting a change of grip and a narrower width bar anyway, as first steps in terms of adjusting the rider's bike. BB


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## Spoked Wheels (28 Jan 2016)

bonsaibilly said:


> I can't see a massive problem with suggesting a change of grip and a narrower width bar anyway, as first steps in terms of adjusting the rider's bike. BB



Thanks for the ad advise. I'm seeing the doctor again next week. I'll ask more questions.... he is generous with his time when there is a problem.

I have already made some adjustments to the bars, moved the controls closer together and the bar extenders or bar ends stand at 60cm apart now. Tomorrow I'm riding to Swanage and I have 4 miles of hill climbing so I'll how I get on  

Twice before I've been in trouble with pains and aching body parts that have turned out to be from cycling..... a few years ago, when I bought a new bike and the effective top tube length was about 2cm shorter than what I had been riding comfortably.... so I fitted a stem 1cm longer stem.... big mistake. I began to get discomfort and pain from the neck area and below the neck too. Fitted a 1cm shorter stem and the problem went away in a week or 2. Another time I rode bullhorns for a few weeks and I developed wrist pain. Pain went away when I went back to drop bars. So maybe this time I solve the problem by adjusting the bars


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## bonsaibilly (28 Jan 2016)

Ouch. I feel your pain, I kinda know what setup works for me with no pains at all but it seems like I want it to be different. But my best set-up bikes that I've had have been almost identical.

Sounds like you're a confirmed drops-ist... so maybe look to converting one of your drop bikes for the jobs you're trying the Subway out on...

Or... hmm... N+1 is always a possibility..!! BB


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## Spoked Wheels (28 Jan 2016)

bonsaibilly said:


> Ouch. I feel your pain, I kinda know what setup works for me with no pains at all but it seems like I want it to be different. But my best set-up bikes that I've had have been almost identical.
> 
> Sounds like you're a confirmed drops-ist... so maybe look to converting one of your drop bikes for the jobs you're trying the Subway out on...
> 
> Or... hmm... N+1 is always a possibility..!! BB



N+1 sounds good to me 

Today I had my first ride with the bars narrower, at 60cm and after 3 hours on the bike I don't feel any worse than I felt this morning (2.5 days after my last ride) so I see that as a success.... so far. I found it very estrange the handling of the bike in the first 20 minutes but then I got used to it..... much better I'd say.... probably not ideal for proper off road cycling though.

The other thing that I noticed when I narrowed the bars was that the bars were 2cms further to the right which is the shoulder that I have problems with. This is my brother's bike so I'll ask if there was a reason behind that....

I'm working on the idea of a new bike and probably with drop bars


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## Kip67 (30 Jan 2016)

Oldfentiger said:


> I am not a doctor, but those symptoms sound like it could be a shoulder impingement. I had this a few years ago on my right shoulder, and now it looks like my left is going the same way.
> My point is, I think you should insist on a proper investigation by a specialist.



I have a shoulder impingement and on antiinflammatory tablets whilst waiting to see a physio . Could take a while I've been warned through the NHS. So looking to go private.


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## Kajjal (30 Jan 2016)

Kip67 said:


> I have a shoulder impingement and on antiinflammatory tablets whilst waiting to see a physio . Could take a while I've been warned through the NHS. So looking to go private.



I had the same a couple of years ago. Months of pointless, untargetted physio which achieved nothing. I was unable to sleep for months due to the pain. 

Then saw the consultant, had scans and luckily no sign of wear and tear etc. Had an injection to reduce the inflammation and no pain. Followed up by two months of proper targeted physio and all fine since. 

From my experience don't be concerned if the initial physio is ineffective and push to see a consultant.


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## vickster (30 Jan 2016)

Kip67 said:


> I have a shoulder impingement and on antiinflammatory tablets whilst waiting to see a physio . Could take a while I've been warned through the NHS. So looking to go private.


Be around £250 to see a consultant privately. Gets expensive when you need scans etc though. Local hospital here is £100+ for an X-ray, £400+ for MRI etc

Cheaper to have a few physio sessions first as well as the usual rest etc

If taking NSAIDs for any length of time, ask the GP to prescribe a PPI like omeprazole to protect your gut


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## Oldfentiger (30 Jan 2016)

I had a hooked acromium, which was aggravating the problem. I subscribe to BUPA so obviously went private.
From MRI scan to operation took less than 2 weeks.


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## fossyant (30 Jan 2016)

Kip67 said:


> I have a shoulder impingement and on antiinflammatory tablets whilst waiting to see a physio . Could take a while I've been warned through the NHS. So looking to go private.



Shoulder Decompression operation I think. Best decision I made. Took 18 months for it to be 100% after surgery. Don't regret it given the trouble my shoulder caused.


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## vickster (30 Jan 2016)

Oldfentiger said:


> I had a hooked acromium, which was aggravating the problem. I subscribe to BUPA so obviously went private.
> From MRI scan to operation took less than 2 weeks.


Mine could have been almost that quick but 4 month work contract and holiday have delayed. Want it sorted now!


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## Kip67 (31 Jan 2016)

vickster said:


> Be around £250 to see a consultant privately. Gets expensive when you need scans etc though. Local hospital here is £100+ for an X-ray, £400+ for MRI etc
> 
> Cheaper to have a few physio sessions first as well as the usual rest etc
> 
> If taking NSAIDs for any length of time, ask the GP to prescribe a PPI like omeprazole to protect your gut



Jeez that's a shocking amount. I've been told to expect to wait 3-4 months hence the reason for looking at alternatives.


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## vickster (31 Jan 2016)

Which bit? Depending on where you are in the country, physio is probably £40-60 a session, more for the initial one typically. If in pain and restricted function, seeing a private physio rather than waiting 3-4 months would definitely be worthwhile, especially as the private ones often have more facilities at their disposal, especially time

I pay a lot every month for Bupa but I do get my money's worth


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## Spoked Wheels (31 Jan 2016)

If I'm honest, I have very very little faith in physios. Over the years, with sport injuries and other I've seen a few and I don't get over excited that they might help....

My handlebar adjustment seems to be working. I've done 3 rides since and I haven't felt like my arm was going to fall off afterwards  I feel that the injury is on the mend with antiinflammatories. I can't be 100% certain that this is the end of the problem, time will tell, but I already have more movement and I don't wake up through pain at night, which was happening every night. 
So keeping my fingers crossed and toes too, just in case


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## Oldfentiger (31 Jan 2016)

Seem to remember my MRI scan was £1000 ish


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## Kajjal (31 Jan 2016)

Depending on the examination and consultation, xray and ultrasound often show enough. The longer the condition goes on the more likely you are to have muscle wastage due to not using the arm properly which does not help and makes recovery longer.


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## vickster (31 Jan 2016)

Oldfentiger said:


> Seem to remember my MRI scan was £1000 ish


£440 charged to bupa for mine in November

MRI needed to confirm surgeons suspicion of posterior Labral tear. Ultrasound previously showed tendinitis but not the cause


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