article by: Dr. Debbie Wright, Thrive Chiropractic & Wellness Centre, Vancouver
An often overlooked, but fairly common cycling injury is something called “handlebar palsy”. Also known as “ulnar neuropathy”, it is irritation and inflammation of your ulnar nerve, which runs from your armpit, through your inside elbow, to your hand. This nerve serves to give you strength in various forearm and hand muscles, and provides feeling to a portion of the arm and hand.
The mechanics involved in cycling can easily inflame this nerve, both at the elbow and at the wrist. Your arms absorb a lot of shock that is transmitted through your handlebars. In addition, the nerve is easily irritated when you hold your writs and arms in a fixed position for too long. A combination of both can generally be overwhelming for the nerve.
The bumpy roads and trails involved in off road riding are a main culprit of this problem. However, it can also be linked to improper bike set-up or the rider’s own body type and build. For example, if your handlebars are too low compared to your seat, or if the seat is tilted too far forward, it puts too much weight and pressure on your hands and wrists. Another common problem is riding on a frame that is too big for your body.
Symptoms of this injury include pain, numbness or tingling along the outside of your hand or forearm, and can even progress to the fingers. Often in the early stages it will simply feel like pins and needles, which can be relieved by switching hand positions. However, if left unchecked, it can progress to numbness and intense pain that is present even when not riding. Prolonged irritation of the nerve can even lead to loss of strength and co-ordination of the hand.
If you have the early stages of handlebar palsy, or occasionally feel pins and needles when you ride, you are still at the point where you can manage the condition yourself. This is primary an overuse injury, and so you should focus on the factors you can control in your riding environment. Firstly, get your bike set-up and riding posture checked by a professional to ensure you are not shifting your weight too far forward. Secondly, padded gloves are recommended to decrease the amount of shock transmitted to your arms. Thirdly, be sure to change around your hand positioning while riding and don’t spend too much time in positions you know are more stressful. Lastly, preventative stretching and strengthening will help to increase your arm’s tolerance to riding.
It is important to stretch both the front and back of the wrist. Stretching should be done 3 times daily while symptoms are present, and after each ride preventatively.
Strengthening the wrist and forearm muscles will also help to build tolerance. It is important to start with a very low weight (1-2 lbs) and increase with tolerance. The pictured exercises should be done in 3 sets of 8, at least twice a day. When the symptoms resolve, it is also prudent to keep this exercise in your regular routine to maintain strength.
If your symptoms are severe and regular, or if you are unable to resolve the problem with home exercises, consult a chiropractor. A chiropractic doctor can diagnose the specific cause of your pain, provide treatment to manage the condition, and prescribe sport specific and injury specific rehabilitation exercises.