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I've been riding for about 7 years now and am approaching 10,000 road miles. I also do some light "mountain" bike riding and am at the gym 4 - 5 days a week. I'm in decent shape, no gut, good weight.

I've have two bikes, neither with especially aggressive geometry. One I had professionally fit using the Specialized method.

My problem is that after a couple of hours of riding my right shoulder blade, under my neck and towards my spine starts to ache. I mean real serious pain. One time after stopping I got off the bike and let out a yell after a bolt of pain shot through my back. Sometimes the ache will last a day or two.

My question is what can I do to address this? I've tried different seat and handlebar angles with no effect. The stems on both bikes are angled up.

Any suggestions would be greatly appreciated. Thanks in advance.
 

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Steaming piles of opinion
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It's very likely a postural problem. Chances are you are riding with elbows locked and your head and neck 'hammocked' between your shoulders.

Try bending your elbows. Doesn't take much, just enough to force the support to be in the muscular system rather than the skeletal. You'll also likely feel your pecs activate, though only slightly.

Some other, more detailed thoughts:

http://sheldonbrown.com/pain.html#posture
 

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concentrate on paying attention to your general posture and tension as danl1 said. Also, periodically, just think about briefly loosening your neck, shrugging, wiggling, and relaxing your shoulders and back, flexing/unflexing your arms, etc. Unless you're racing, just sit up a bit, move all movable parts, actually think about relaxing and easing tension. Also, change positions on the bars regularly, maybe even frequently. Sit up and put your hands on the tops. Go to the hoods, go do the drops, etc. etc.

After a few rides, all of this will become pretty subtle and a part of your routine.

When you start paying attention, you'll probaby notice that your default position is pretty rigid, and that you're holding your shoulders in an unnaturally hunched position (very common), maybe arms and hands tense. You're not supposed to sit there tense and rigid. Think about relaxing and moving around regularly.
 

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Still On Steel
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Posture is my guess, as well. In my case, the guess is based on current personal experience. This year, I've been experiencing shoulder pain that sounds like EXACTLY what you describe. I have realized that I'm tensing up, locking my elbows ... just as danl1 and Camilo wrote.

And it's a mystery because I've been riding since 1992 and this has never happened before; I don't know why I'm doing it now. What I do know is that by making sure I stay loose and relaxed, I stay pain-free.
 

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Slightly Opinionated
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Sounds like you could possibly be irritating a nerve root to get that shooting medial shoulder blade pain. Stretching and on bike relaxation would be a good start.
 

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See a doc or a chiropractor and tell them what's going on. They'll likely have more knowledge and better suggestions than you might get here. We sympathize and empathize with your pain, but IMO a doc will do better.
 

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Possibly a fit issue

I have been suffering from the same problem. I just returned from a fit adjustment, and the problem was that I purchased a new saddle. Despite the bike shop guys trying to match the measurements, my entire fit was completely thrown off. So, if you have purchased something new or changed something, have your fit reassessed. Good luck.
 

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Besides all of the mechanical and bike fit issues, shoulder blade pain can be from C6/C7 nerve root irritation, as someone has previously mentioned. I rode with that for 6 - 9 mos before needing a medical procedure. Mine was also on the rights, and was somewhat relieved by leaning my head to the left, while putting my right arm behind my back.

Charlie
 

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Pain in your right scapula could also be referred pain from your gallbladder.. but if its only when you bike and and your not going yellow its probably not gallstone. Just throwing it out there.. sorry if that scared you, but it shouldnt.
 

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I have pain in the same area, although not quite as intense as what you are describing. A couple different massage therapists have told me my shoulders are rotated forward from "normal", causing my rhomboid to be over-stretched. Pectoral stretching to allow my shoulder position to rotate back has helped, along with massage therapy.
 

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Had a similar pain, which I sourced to come from stem length being too short. Catch is, this is about me mostly when standing on the pedals, off the saddle. Somewhat was a cured case when seated as well.

One quick experiment I'd try is getting in a plank position on the floor, and then shifting back and forth relative to your hand placement. Take note of things and see if it draws back to your on-bike position.
 

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olr1 said:
Bars too wide?

I changed from a 42 to a 40; problem gone away..
I think bar width has a lot to do with comfort, and IME, if you get it wrong, it could hurt. My case was just the opposite. The bars were too narrow. When I was riding anything over 40 miles, I'd get pain in my shoulders that was like a tooth ache. It was bed enough foe me to take a couple of aspirins before the ride, then a couple more at lunch or the half way point. I changed the bars from 42 to 44. Ta-daa. Problem fixed.
 
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