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Cyclists – are you suffering with any of these common conditions?

Hand and Wrist Pain in Cyclists

 Whether you cycle as part of your daily commute or take part in 100 mile sportive’s over the weekend, cyclists of all abilities typically suffer from some type of pain or numbness in their hands or wrists – impacting both their riding pleasure and performance.

In this article I wanted to highlight the two most common causes of the discomfort, pain, tingling or numbness in your hands or wrists; Ulnar palsy (handlebar palsy) and Carpal tunnel syndrome. We will also give you methods of how to treat them and how to prevent the condition.
 

Whether you cycle as part of your daily commute or take part in 100 mile sportive’s over the weekend, cyclists of all abilities typically suffer from some type of pain or numbness in their hands or wrists – impacting both their riding pleasure and performance. In this article I wanted to highlight the two most common causes of the discomfort, pain, tingling or numbness in your hands or wrists; Ulnar palsy (handlebar palsy) and Carpal tunnel syndrome. We will also give you methods of how to treat them and how to prevent the condition.

Ulnar Palsy (Handlebar Palsy)

The ulnar nerve originates from your neck, tracks down the arm to supply the 4th and 5th (ring and little) fingers and like all nerves, its purpose is to provide sensation and muscular contraction. Whilst cycling, either a prolonged grip position or poor biomechanics on the handlebars can lead to compression or stretching of the ulnar nerve. This can subsequently result in tingling, pins and needles or an altered sensation in the fingers making it uncomfortable and potentially difficult to brake or change gear. Using the ‘drop down’ position on the handlebars can greatly increase the risk of developing this condition due to the biomechanical demands on the wrist.  

Carpal Tunnel Syndrome

Similar to the previous condition, carpal tunnel syndrome is a compression of the median nerve at the wrist which also originates in the neck and runs through the middle of the wrist. Compression on this nerve can again lead to altered sensation, pins and needles or loss of strength in the thumb, index, middle and ring fingers. Cyclists are more prone to experiencing these symptoms whilst using the ‘flat’ grip on the handlebars whilst in a more upright riding position.

Methods of preventing these conditions

Having a professional bike Fit This is a really important step to take if you are starting to take your cycling more seriously or increasing your distance.  A common mistake is having an uneven distribution of weight on the bike. Having too much weight on the front of the bike i.e your saddle too high and handlebars too low, will increase the forces going through the wrists and hands placing increased pressure on the nerve supply to the hands and wrists. There are different levels of bike fit ranging from basic to advanced depending on how serious you are wanting to take your cycling.

Regularly changing grip position

–      Try and get into the habit of changing between all 3 handlebar positions whilst cycling. Even when you are in the aerodynamic tucked position trying to maintain a high level of speed, just ensuring that you regularly change your grip will prevent prolonged compression on the nerves which intern will impact your performance and decrease the risk of discomfort.

Ensuring that have correct spinal mobility

–      Stiffness or restricted mobility anywhere in your spine will dramatically decrease your cycling efficiency and prevent you being able to hold demanding positions over long periods of time. This can lead to excessive forces through other areas of your body to compensate i.e the hands and wrists. As the nerve supply to the upper limb originates from the neck, restrictions here will affect the mobility of the nerves being able to slide correctly along their pathways. This in-turn will increase the pressure on the neural supply to the hand and fingers causing discomfort. By having your chiropractor assess your spine to help correct any restrictions or postural issues, the mobility in your joints and nerves will be optimised enabling you to cycle for longer and even increase your performance. In addition to this your sports therapist can give you some nerve exercises to perform (known as “flossing”), which help to slide the nerve in and out of the neck (hence the term), relieving  pressure on it and therefore decreasing the discomfort you experience.
 

Having flexibility and strength in your muscular system–      Cycling for extended periods of time in prolonged positions will place high levels of stress through your muscles and joints. Ensuring that you maintain a good degree of flexibility will help aid your biomechanics on the bike thus increasing efficiency. By having appropriate levels of strength and endurance in both your stabilising and force producing muscles will enable you to maintain the correct posture on the bike reducing the risk of injury. Having your sports therapist assess you and prescribe the correct mobility and strength exercises will enable you to get the most out of your cycling what ever level you may be.

Adam Harrison
Sports Therapist

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