Walter Ponten, Aachen, asks: I've been cycling for 19 years and climbing for a year and a half. I have had problems with my right shoulder for eight months. Various doctors have diagnosed recurring bursitis, the onset of osteoarthritis and a calcified shoulder that is breaking down. I mainly have problems when cycling - after a quarter of an hour my shoulder practically stiffens. Climbing, on the other hand, is less of a problem. However, I would like to continue cycling. Could modifications to the bike help, such as higher handlebars, a Tria attachment or a shorter stem?
The expert advice: Your shoulder has been diagnosed with so-called "impingement syndrome". This means that the muscles of the rotator cuff between the humeral head and the acromion are squeezed, which in the long term damages the muscle balance and structure and therefore the shoulder function as a whole.
As you state that you have no complaints when climbing, I don't believe that the pain really comes from the shoulder joint. I attribute it more to discomfort in the cervical and thoracic spine and the upper thoracic opening. It is possible that the nerve exit points on the cervical spine are irritated and the function of the ribs is disturbed. A high position of the first rib in particular can project pain into the shoulder. This is also indicated by pain when the body is in a fixed position, for example when cycling.
As a therapy, I recommend osteopathic mobilisation of the ribs and spine. This can relieve the cervical and arm nerves and relax the muscles of the neck and shoulder girdle. On the bike, you should position the handlebars and saddle at almost the same height and shorten the stem. Frequent changes of grip and pedalling in the saddle are also beneficial. I would rather not use a triathlon attachment, as this forces the cervical spine into an even more reclined position, which could aggravate the symptoms.
