Cyclist’s Palsy (also commonly referred to as Handlebar Palsy, Guyons Canal Syndrome, Ulnar Tunnel Syndrome or Cyclist’s Hand) is an overuse injury of the fingers and hands affecting both mountain and road cyclists. It is characterized by compression of the ulnar nerve affecting the fourth and fifth digits of the hand and wrist due to repetitive stress which may result from inadequate or over-training, an incorrect bike fit or poor cycling posture. According to studies, at least 31% of cyclists suffer from some type of overuse hand pain. Contact your Chiro based in Pretoria: Joint Health Chiropractic
The common sensory symptoms of Cyclist’s Palsy include pain, numbness and tingling, whereas the common motor effects include difficulty using fingers for fine tasks and weak hand grip as a result of:
- The wrist being held in a hyperextended position resting on the handlebars, therefore causing additional stress (compression and stretch) on the soft tissue structures of the wrist, especially when cycling downhill;
- Inadequate core muscle strength, a low handlebar or high saddle leading to an increase in weight on the hands;
- Additional unnecessary vibrations in hands as a result of a rough terrain, skinny tires, over-inflated tires, or small wheels.
Other factors contributing to the occurrence of Cyclist’s Palsy include:
- Excess weight bearing on the hands caused by fatigue or incorrect saddle setup
- Infrequent changing of the hand position on the handlebar
- Wearing worn-out or ill-fitted gloves
- Having worn-out handlebar padding
- Inappropriate size or shape of the handlebar
In the majority of cases rest, ice and over-the-counter anti-inflammatory medication such as aspirin or ibuprofen are enough for reducing inflammation. Manual therapy such as soft tissue intervention as well as chiropractic manipulation of the wrist, elbow, shoulder and neck provides great benefit. Electrotherapy, laser and/or ultrasound may also be indicated. If necessary, steroid injections can be used to help alleviate the pain.
The following exercises will assist in strengthening the muscles, ligaments and tendons in your hands:
- Start by keeping your forearm, wrist, hand and fingers straight. Now, bend the fingers at a 90º angle and keep them in this position for approximately 10 seconds. Ensure your fingers remain straight while in this position. Repeat this exercise 5 times.
- Place your forearm (palm facing down) on a flat surface in front of you. Your wrist and hand should hang over the flat surface. Now, make a fist and gently bend your wrist up and down. Repeat this exercise 10 times.
- Squeeze a small item such as a coin, pen or a sheet of paper between two fingers and keep for 10 seconds. Repeat this 5 times for each pair of fingers.
- Squeeze a rubber ball with the hand and keep for 10 seconds before releasing it to strengthen your grip. Repeat 10 times (1 set). Aim for 3 sets of 10 as you strengthen your grip gently.
The following neck exercises should also form part of your program:
- Forward tilt: Begin standing upright. Lower your chin to your chest and keep it there for 10 seconds. Slowly return to a neutral position.
- Backward tilt: Slowly lift your chin towards the ceiling and keep it there for 10 seconds. Slowly return to a neutral position.
- Side Tilt: Slowly bend your head (ear) to your shoulder. Avoid overstretching and raising your shoulder. Keep it there for 10 seconds and return to the neutral position. Repeat on the opposite side.
Happy cycling!