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Shoulder issue
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I have a client that complains about horrible right shoulder pain. This is primarily due to her job as a computer programmer and sitting in front of a screen moving a mouse all day. However, I would like to rule out anything bike or fitting with her pain. Her pain is primarily behind her shoulder in her rear deltoid. Her pads are pretty wide (I believe 28 cm center to center) but definitely under her shoulders and her drop is even with her saddle. Any suggestion on what my next move should be?
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Re: Shoulder issue [Speedo24] [ In reply to ]
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Moving her center of gravity back slightly takes weight off the arms and shoulders, and sometimes helps a bad shoulder as long as it doesn't negatively affect the rest of the fit. If she's already super far forward and you can move the whole cockpit (seat and bars) back by a small amount, it may be worth trying. Also, if you move seat back you can often have the rider stretch out a bit more (i.e. - leave the bars where they are), improving aerodynamics and alleviating the need for a super short stem (often an issue with smaller women).
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Re: Shoulder issue [Speedo24] [ In reply to ]
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Any History of Trauma?
How is Core Strength?
Any curves in the spine?
The actual cause may be comming from some where else.


Happy Freedman
Orthotic Consultant
Bike Fitting Specialist
Prosthetics and Orthotics/DME
Hospital for Special Surgery
510 East 73rd Street, Suite 201
New York, NY 10021


Happy
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Re: Shoulder issue [Speedo24] [ In reply to ]
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Speedo24 wrote:
I have a client that complains about horrible right shoulder pain. This is primarily due to her job as a computer programmer and sitting in front of a screen moving a mouse all day. However, I would like to rule out anything bike or fitting with her pain. Her pain is primarily behind her shoulder in her rear deltoid. Her pads are pretty wide (I believe 28 cm center to center) but definitely under her shoulders and her drop is even with her saddle. Any suggestion on what my next move should be?

Test her glenohumeral range of motion and rotator cuff muscle strength to pinpoint the exact muscle. She likely has a rotator cuff tear, especially if she's not doing any corrective exercises to fix the posture and muscle imbalances associated with prolonged sitting. If she has "rounded shoulders" and rotator cuff weakness, she can easily tear her rotator cuff just from pulling quickly on the handlebars to hop over a tiny bump in the road.

If her current fit is causing shoulder pain, adjust the bike to eliminate the pain by taking the weight off her hands (shorten reach and/or raise handlebar height). Avoid the aero/TT position. If she feels the slightest amount of pain with her current fit, it needs to be adjusted until there's no pain. If nothing you do eliminates the pain and she's unwilling to buy new components, recommend a safer alternate for her shoulder like walking. Basically just follow these steps:
  1. Find the cause - Is it posterior deltoid, supraspinatus, infraspinatus or teres minor?
  2. Let it heal - Avoid movements that require use of the affected muscle above and rest it. Once she feels no pain, wait another week before returning the bike to it's original fit.
  3. Be proactive - Strengthen her shoulder to fix posture/ muscle imbalances and prevent reinjury.


Vincent Vergara
Eat.Sleep.Train Smart - Personal Training & Coaching
EatSleepTrainSmart.com
Twitter: @ESTrainSmart
Strava: app.strava.com/athletes/444535
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