Hypermobile elbows and shoulder pain
 

I have been experimenting with different positions for a long time 42cm-38cm bar, 100mm to 80mm stem, tried raising/lowering the bars, sliding/lowering the saddle back, adjusting the cleats. I have managed to solve some of my issues and i believe i have decent stability now but i still get shoulder pain. I started to believe that my hyperflexible elbows, which look like knock knees when riding, might be the cause. What change could resolve this inwards bent of my elbows or is my pain related to sth. else?

Hi,Welcome to BF!
hope you enjoy your time here, get some info, and give some...
Re your Q, bold above.
I would interpret your 'condition' is only possible if you straightarm / lock your elbows...an 'A Frame' posture ...
my suggestion - here, from a previous post - about good riding posture and attaining a greater level of comfort... with images ...
https://www.bikeforums.net/22220270-post25.html
Ride On
Yuri

If your arms can't flex at the elbows, then road bumps will be transferred on up the line to your shoulders.

Not quite sure what you mean by hyperflexible hypermobile elbows. If that means they go beyond straight and have a reverse bend, then I'd think that'd be a prime candidate for them being in a locked and stiff position.

Yeah they have a reverse bend

Well I'd say try keeping a good bend in your elbows. In the positive direction and not reverse. Try it out when you ride. Probably won't feel natural and likely your current setup won't make it an easy thing. But you can make a conscious effort and maybe see some indication of what the results might be even if you can't do it for the entire ride.

When I had the most issue with my shoulders, it seems to have been fixed with the narrower 38 mm bars I put on the bike. So that I'm not braced so much to resist side by side swaying motion.

Just being able to keep your elbows bent 70 to 90 degrees might keep your shoulders from bearing too much weight and transferring bumps straight into them. If I'd tried that first before going to the 38mm bars, I wonder if that also will have solved my shoulder issues.

But that much bend might present it's own set of issues for your fit and comfort on the bike till you get other things squared away.

Hypermobility is not THE problem. And resolving aching shoulders is not just about bending the elbows...
Aching shoulders can come from a number of areas. But your mention of 'hypermobile elbows leads me to deduce (for lack of further info)
That you ARE 'straigtharming' (in your hypermobile way...) and locking the elbows. Along with that comes a bunch of other contributing factors, like hunched shoulderrs.
You're not unique. Many riders I see on road bikes and hybrids (which actually cause/exacerbate this issue) have this issue to some degree.
My earlier post/link covers much of how to resolve these poor posture issues - not all.
That they ride the way they do, is totally up to them. Not my crusade. But I lucked out and had some good tutelage when I first became more involved in riding.
Ultimately the issues fall to a lack of using some core muscle and back strength to help in holding up the torso. Either due to poor strength or just poor understanding.
Once there is realization, there can also be adaptation, in a more personal way, for each rider. Of course, some just chose to continue on as is.
Ride On

I forced myself to ride with normal horizontal bent and about 80 degrees vertical bent. My body position was somewhat the same but it was harder to carry the weight.It caused more pressure on my lower back and led to pain. I had to switch back to my old knock-knee-looking elbow position. I will try to ride this way and see if it improves. Thanks for the advice.

I forgot to mention the fact that my shoulders are also hyperflexible and I have a slight biological dent(pectus excavatum) to my left side which shows itself as shortened reach on one side. I solved it by moving the shifter a bit closer. I am indeed straightarming/locking my elbows. My shoulders are pushed up and squeezed around my head. I am mostly bending my elbows weirdly when I am lifting hard or pushing something. I guess that is why I am struggling when I try to hold the bars without bending my elbows weirdly. I have been doing some core work lately. I will re-read your article again. Thanks a lot for your help.


Also, I am trying to find a bikefitter but there is none around, unfortunately. The scarcity of fitters causes me to question their quality of work since there is no competition. I would be happy if you suggest to me any book or reliable source for doing your own DIY bikefits.I read almost all the articles of Steve Hogg and watched all the bike fitting-related stuff on youtube.

I don't know of any books, but you can google for bike fitters and some have some decent stuff to read on their sites. Not all bike fitters go by the same methods. Some get all into measuring every inch of you and doing motion studies with dots stuck on your body and input all that into a computer to come up with something. Some just look at you and how you appear to fit and function on your bike.

Between the two extremes and all the various methods between, I'd have more faith in the latter.


I do find a lot of interesting stuff on this guys site. https://www.stevehoggbikefitting.com/

He has some people all over the world that have trained with him to learn his methods. Maybe one near you.

On the internet, it v-difficult to get a good sense of everything involved. Limited info, no real sense of the bike and current setup, no real feel for rider, etc...
SO might be best to suggest areas to review. Also good to remember Newton's 3 laws (of cycling...)
1. Don;t screw with something that isn't broke
2. Dig deep to uncover all the factors involved in an issue.
3. Don't make large changes - make adjustments in reasonable increments and only make ONE change at a time. Give enough time and mileage to allow best evaluation of a change.

You've already violated Law 3 - the cumulative of all the laws - you went from a 'straightarm' to almost a 90 deg bend - and what would be expected to happen? Backache being a high probable result. Resulting in 'retreat'. Is there 'in-between' ? A bend of 10-15 deg to start might have already shown some improvement, without the adverse result.
Small incremental changes. It's almost assumed. But so many times (as recently happened in a similar 'position' post) some major, drastic change by the OP caused a full retreat because the change was 'worse'... The body doesn't like 'change'... at least change it's not had time to adapt to. Small, incremental changes.
Law 2 - so what else might be at work? Not just Hypermobility, but possibly some lack of structural strength ? 'Core' is and oft used term... but often visualized as 'abdomen', not considering the upper torso as much. Maybe it refers to the entire torso package? Shoulders definitely often ignored.
here are 2 links for good info on 'core', as it relates to the entire package - especially the shoulders, scapular structure and back.
Back pain from Cycling, how it happens and how to Prevent - a good synopsis
Exercises for the shoulders, scapular structure and back - really good exercises which most everyone can do to gain strength, stability and balance for these areas, without the need for extensive gym work. These are great because they can be modified and done in INCREMENTALLY increase efforts - i.e. Planks can be done from the toes or started by doing from the knees for someone concerned with joint stability, until the muscles gain some further strength.
Start 'light' and evaluate the 'effort' and result after a few sessions. Get confidence that some higher level of exertion won;t be damaging. Be regular, do them at least every day.
Once the scapular structuring is stronger and more stabilized. one can easily 'pull' the scapulas 'down' and be more comfortable for longer rides - Less chance of shoulder pain, better overall comfort, and less stress to the lower back.
Oh, lower back... Flexibility is as important as muscle strength. Since the Thoracic spine is generally immoblie, the only place which allows a comfortable forward bend is the lumbar spine.
If that area lacks flexibility - then comes aches and pains. Flexibility for the hamstrings, lower back, hips and reaching to upper back and shoulders.
I suggest 'Sun Salutation' - the modfied/simplified forward fold version without the additional elements....
- keys to observe - DON'T force the amount of folding, go as far as you can without stressing the back or hamstrings - ok to get to that point and then RELAX and allow your body to 'SOFTEN' into however much further forward it might go. DON'T be concerned to touching your toes - that may happen or will eventually happen.
After holding the 'Fold' for a short period, come back up a bit - EXHALE and fold again - this allows more 'space' for the body to fold a bit further. IF you get a little light-headed, come back up, recover, and try again.
I also add the yoga arm movement before folding - from the start position (called - feet placed comfortably hip width apart, weight even to each leg/side) - then bringing straight arms upward in a outward side swing motion until they met overhead, reaching to the sky, maintaining the 'mountain pose' strength through the feet.
Then slowly bringing straight arms back down in side swing while moving into forward fold. Don't forget to come up a bit, exhale, and fold again...
When coming up from forward fold, I swing straight arms again outward and up, which adds a v-small balance and strength component to upper arms and back...
All vey smooth, done at a pace comfortable for you. Do whenever you can - a great way to release tension and start a period of relaxation.
The there's stretching... LOL! we can leave that for another time... LOL!
Ride On
Yuri

Wow, thank you so much! You are right on every point. When I move a part on my bike, I do it slightly. But, I forgot to apply the rule to myself, lol. My core is mainly focused on the upper back and scapular stability but I don't do them daily, will commit to them this time and add the ones you listed to my core. I will post my progress here. Thanks again :)

Glad that you can find some of this useful. I constantly remind myself to consider what I'm contributing to my own issues. Having a slew of body issues myself, dealing with these means I need to consistently pay attention to my overall state. To do that, constant, regular work and attention to keeping the body functioning well, is job #1. I often fall down on doing the job well, but then commit to being a bit better in the future.
I highly recommend Yoga to everyone. It not only allows and helps us improve our overall body condition and function, but it also doesn;t require extreme effort. The benefits happen even when the effort is moderate, especially for those beginning their yoga 'practice'. For beginners, I do recommend starting/doing Yoga with an instructor, in real space - not online. Good instructors will help a person realize the best outcome for that person. Doing Yoga from a video doesn't allow that connection and personalization.
Yoga has become a lifelong element for me. Essential to allowing me to 'age' in the best/optimum state I can be.
And I benefit from some of the 'mental' strengthening and development it encourages and allows, which helps me retain balance in my outlook on life and what affects me/us.
It's helped me differentiate between real 'rational thinking' vs the fallacies of 'rationalization' - "rationalization' being one of humanity's worst characteristics.
Cycling is also one of those things which brings out the best in us...
Best of everything to you
namasté
Ride On
Yuri

Such good advice… yet I totally ignored that this weekend. Made three changes at once (longer stem, switch to bars with longer reach, switch to levers with more extension.)

So, a lotta change. I did two rides, and on the first one I thought “wow the hoods are a lot further forward and probably too much”. Today it was very windy and there were lots of times when the further reach was handy to get into a more aero position.

So, overall I think this is better for the various seated and standing positions. No discomfort, so this could work.

However, I think trying the new levers and longer stem with the shorter reach Nitto 115s I was using is probably worthwhile.

Just don’t do this at home. 😊

Otto

You can get very close to what a good bike fitter would do on your own. I wrote a little bike fit primer a while back. It's here: https://www.bikeforums.net/21296948-post3.html

Pedaling definitely works one's back. Back pain is one of the most common problems we hear about. The thing is, when you pedal you are activating what's called the "posterior chain," which goes all the way from your heels to your shoulder blades. If you watch someone pedaling in a tight jersey, you can see their lower back muscles flexing. There's not a lot of force there, but cycling is an endurance sport and over time it adds up to pain. The pain can be from two different things. First, there is muscle pain from the exhaustion of individual back muscles. But once those muscles get exhausted, they no longer support the spinal column like they should and then one can get real back pain.

While you're doing your bike fit, also look in the mirror at your back. You want to rotate your pelvis somewhat forward so as to straighten your lower back as much as is comfortable.

When people say "core," too many think "abs." I've never encountered a cyclist who complained about sore abs. It's always the back. IME the very best back exercise is bike riding. It takes time to get stronger, just keep at it and don't push it way into the pain zone or take ibuprofen for it. Stop and rest and stretch a bit. Sitting on the curb can feel really good. Probably the best weighted back exercise is to pick something up with a straight back. With knees straight or very slightly bent, never locked, pick something up and go all the way to upright back, keeping your back straight. There's always too much talk-talk in these videos, but this one is better than some:

LOL! so, as much as I try real hard, I'll find myself changing more than 1 thing... When I do, 1/2 the time I end up retreating and starting over again, because I can;t figure out which changed element is mostly responsible for the 'result'... LOL! so I learn the lesson, again, over and over.
But the small incremental change thing is inviolate for me. I tend to 'experience' even the smallest of changes. like, if I'm off the bike for a considerable time (month or more) I find I have to reduce saddle extension by 3-4 mm for it to feel 'right'. Then after a month of riding, I find I have to move the extension back up again, done in 2 mm increments over 4-5 day interval.
I have so many extra Bars and stems, because I seem to constantly want to try some variation. Often, there are good results, but seemingly always with 'drawbacks' in other areas...
Some are fine with 'Set It and Forget It'; I'm not that guy... LOL!
Ride On
Yuri

I rode the bike this way this last week and it was pretty good. The hood position was a bit of a stretch. Today, I swapped in the Nitto bars with a reach of 95mm instead of 110. Same 100 mm stem and new TRP levers. That seemed good on a quick test ride and I’ll ride it this week and see how it goes.

Otto