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Writer's pictureKeith Fernandes, PT

BICYCLE HEADACHE

Updated: Jan 22, 2022


In these times of COVID-19, some of you are cycling more and more. It’s nice to be outside, keeping physical distance, getting some fresh air and exercise!


But did you know that cycling can lead to a headache?


The reason is that our neck is vulnerable to the effects of sustained end range strain.

What that means is, the pressure and posture in our lower and middle back can lead to upper cervical extension and the chin forward position (see the right side picture below). When your head is forward, the back of the neck gets compressed and pinched into upper cervical spine extension (right around the hairline).



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This leads to an overpressure of joints and eventual excitation of the brainstem via the trigeminocervical nucleus. Research by Dr. Dean Watson Physiotherapist, suggests that this noxious afferent nerve input (nerve signals moving TOWARDS the brain) can reach a threshold thereafter manifesting as head pain or what we know as, “headache”!

The good news is, it’s entirely preventable! Micro-adjust your posture as I say to my clients. Cycling postures vary depending on if you are cycling for recreation or racing, on an upright bike or road bike. If you are having neck tension and/or headache, something has to change with the posture.


Consider leaning forward from the hips, not just cycling with an upright back.  


Ensure you are bending your elbows so that the jarring forces are not directed straight to your neck but absorbed by your arms.


Consider a more upright position (if currently hunched forward) even periodically, to allow the head to retract back as it is now sitting on a more neutral thoracic spine (upper back region).


Consider actively retracting your head during cycling, partially, to stay closer to a neutral spine posture. Do some reps immediately before and after prolonged times of cycling to reset.


Consider if you have corrective eye wear, positioning them higher on the bridge of your nose to ensure that you are not inadvertently cranking your neck upward to see clearly.


Ensure that the straps of the helmet under the jaw are not so tight that they are restricting neck flexion, sometimes this leads to the neck being cranked into extension and a head forward position. So keep that helmet secure but comfortable!

There are various other bike fit and personal anthropometric points to look at in some cases.

If you have any specific questions about cycling and back of the head and/or temporal region pain after cycling, please contact me!



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