Hand & Wrist Conditions Cyclists Can Avoid
As cyclists across Texas ready for the upcoming BP MS 150, a two-day bike ride from Houston to Austin, we thought we’d talk about some of the most common overuse, or repetitive stress, hand and wrist conditions affecting cyclists and ways to avoid them to ensure a pain-free ride.
How Repetitive Stress Occurs
Nearly one-third of the overuse strains associated with avid cyclists competing year-round in weekend rides and races affect the hand and upper extremity. These types of injuries can also affect those who have not adequately trained yet embark upon a 150-mile ride between Houston and our state’s capital.
Despite the best equipment and preventative measures, the constant vibration, griped hand position for hours at a time or tense ride into the wind, up a hill and alongside Interstate traffic can result in such repetitive stress conditions as carpal tunnel syndrome or handlebar palsy, also known as ulnar neuropathy. Cold weather also makes tissue more distensible and may slightly increase risk for carpal tunnel syndrome as well.
Carpal Tunnel Syndrome
One of the most common tendinopathic conditions associated with overuse activity and repetitive stress in the hand and wrist is Carpal Tunnel Syndrome (CTS). The result of irritation and swelling, CTS causes compression within the narrow carpal tunnel located at the wrist – through which one of the major nerves in the arm, the median nerve, passes. CTS is one of the most common overuse hand and wrist conditions affecting cyclists. When the median nerve becomes irritated in this inflamed and compressed tunnel, numbness, pain, tingling and weakness may result in the thumb, index and middle fingers – causing discomfort and affecting a cyclist’s ability to even shift gears with the affected hand. Resting periodically and stretching the hands, changing grip to reduce hyperextension and hyper flexion may help during the ride, but ongoing pain may require treatment – which is generally nonsurgical and may entail night bracing and/or injection therapy. CTS pain remaining unresolved following nonsurgical treatment may require a minimally invasive Endoscopic Carpal Tunnel Release.
Handlebar Palsy (Ulnar Neuropathy)
Handlebar palsy, known medically as ulnar neuritis or neuropathy, is another common overuse or repetitive stress condition affecting cyclists. This results when direct pressure is placed on the ulnar nerve at the hand and wrist – from the grip of a cyclist’s hands on handlebars, causing stretching or hyperextension of the nerve. The ulnar nerve controls sensation in the ring and little fingers as well as the muscular function of the hand. Compression of this nerve can cause numbness and tingling in the ring and little fingers and/or hand weakness. Nonsurgical treatment such as rest, stretching exercises, and anti-inflammatory medications generally resolves this condition.
Hyperflexed Wrist
These overuse, repetitive stress conditions affecting bicyclists also often affect motorcyclists as well – as the continuous vibration of the motorcycle causes the same type of conditions that long rides and regular bicycling can cause.
Hyperextended Wrist
Cycling Tips for Reducing Your Risks
Professional cyclists and medical experts have contributed to an array of preventative cycling gear and recommendations for reducing risks for such conditions.
These include:
- Cycling gloves – both basic or specialized gel cycling gloves to reduce pressure on the ulnar nerve.
- Additional handlebar padding.
- Custom adjustments in handlebar height and overall bike fit specific to each rider.
- Applying less pressure or weight to the handlebars and avoiding hyperextension and hyper flexion.
- Frequent adjustments to grip and position on the handlebars during a ride.
- Hand exercises between rides, such as squeezing an Iso-Ball.
Figures source: http://www.hughston.com/hha/a_15_3_2.htm
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