In my physical therapy practice I treat hundreds of patients a year for headaches. Many of these have recurring neck pain and stiffness, as well as headaches. I teach horse riding and many cyclists admit to having headaches. Cyclists tend to have neck pain and headaches after riding at the end of the day. Unless there is a medical cause, most headaches are what we call ‘cervicogenic’ (cervico means neck and genetic means origin of) therefore cervicogenic means that the headache starts in the neck and is caused by the joints and muscles of the neck. The two upper joints are the main cause of headaches because the nerves that supply the head, temples and eyes are related to the two upper joints of the neck.
Headaches that originate in the neck are caused by the nerves being compressed or pressed by the joints or muscles in the upper neck. There are many other causes of headaches. This article only talks about cervicogenic headaches (starts in the upper neck), not headaches of any other cause. It is important to be evaluated by a physical therapist or a doctor to determine if your headaches are cervicogenic or other.
Poor neck posture and general poor posture will almost always result in a headache, given enough time. Repetitive behaviors and postures that cause the neck to be in poor posture will lead to headaches. These postures are the positions that we use in our daily work and in our driving posture.
So what is the relationship between rider and headaches?
The best bad neck posture comes from the round shoulder posture. A person with round shoulders on the ground will have round shoulders in the saddle. When the shoulders are forward and so called round, the neck will be in a forward chin posture. This pose places the upper neck in an extended position and tightens the joints, nerves, and muscles. Over time, the joints become stiff and painful, the muscles shorten, and the nerves become inflamed. The nerve then refers the pain to the head as a headache. Increased pressure when riding in a round shoulder stance will increase pressure and therefore nerve pain. Horse riding is one of the main causes of headaches. All other activities associated with horses can also put pressure on the neck.
The posture of many teenagers is unfortunately the norm. His shoulders are drooping, his chin is tilted forward, and his upper neck is in a locked, stuck position. Many do not use any of their postural muscles and simply hang from their joints. Many people spend many hours in a similar posture. Driving, working with the computer, working at home, are just some of the activities that reproduce this position. As riders, we adapt the same posture in the saddle. Riders are told to sit up and roll their shoulders back.
How do you fix it?
The quick and easy answer is to straighten up, correct your posture, and control your mobility. The long answer is to educate yourself and eat knowingly. First, see a physical therapist and get a professional evaluation. Learn how and why you adopt the postures you do, and then learn how to groom yourself and manage your pain with posture management. Not many therapists will be able to associate their headaches with riding unless they know the riding posture. Very few therapists can relate to the muscles used in riding or the amount of skill required to ride well. Remember that for non-riders it seems so easy. Just sit there!
Managing cycling headaches can be easy.
The control of headaches in riders is the same as for all people; however, I place greater emphasis on the particular characteristics of the treatment, because I am a rider. If you have been evaluated and your problems are not too severe, but are chronic in nature, that is, they keep coming back, then these simple exercises will help. This should be considered only basic advice. To control headaches, the joints in the upper neck must be mobile. Your muscles must have strength and endurance. It must also have strong core stability. The strength of the deep core muscles will reinforce correct upper neck posture. I start with the core muscles of each patient I treat for headaches. Management success without this knowledge and strength is always limited. That is why chiropractic (or other) treatment is very regressive.
I give simple but effective stretching exercises and educate patients on their posture. I advise all my riding students to follow the Applied Posture Riding program.
Simple stretches to gain mobility in the neck
Stretch 1
Stand tall, clasp your hands behind your back, and tilt your head so that your ear moves toward your shoulder. This stretch can hurt, so be careful.
Stretch 2
Stand tall, close your eyes, and turn your head so that your chin moves toward your shoulder.
Stretch 3
Push your chin in with the opposite hand to force the stretch further. Feel the stretch or some pain in your neck. Do not add to the headache with this stretch. Obviously do it on both sides and if it makes you worse go to a physiotherapist. Hold for 10-20 seconds and repeat. Do these stretches little and often and do them when you feel good, don’t wait for the stiffness and headache to return. Manage good mobility and keep pain away.
