Cyclist’s Palsy

Even though cycling is considered a very healthy and fun exercise, various factors might lead to certain health problems, majorly pains in particular areas. If you have a poor cycling posture, lack of training, or overtraining, the chances are that you will experience severe pain in your hand. Cyclist palsy also referred to as handlebar palsy, is a common injury in cyclists which results in similar conditions mentioned above. In this type of injury, there can be a pain in the hands and fingers because of the frequent nerve stress in the region. The most common reason for cyclist palsy is the overuse of the handlebar or cycle. 

Hand pain is quite a common issue among cyclists, especially those who practice long-distance cycling. The studies have proven that almost 31% of cyclists experience overuse hand pain. If you have a severe nerve injury that has led you to handlebar palsy, you will have to take various measures to get rid of the pain or subside it. Medications and rest can provide short-term recovery for hand pain in cyclists. But if you want to get rid of the pain permanently, you will have to change your cycling habits, perform various exercises, and use specific gloves to remove the pain completely. 

Suppose you are a cyclist experiencing cyclist palsy or want to have adequate information on the topic that can help you efficiently. So, let’s dig into this guide that has everything you might need to know about this type of injury and its effective cures.

Understanding Cyclist’s Palsy

Cyclist palsy can be defined as a certain pain, numbness, or tingling sensation in various regions of a hand and fingers. A cyclist might experience this pain in the wrist, the thumb side of the hand, or the ulnar side of the hand. This type of pain usually occurs when there is a nerve compression in a cyclist’s wrist or pinky side of the palm, which might be due to repetitive stress and extended position. 

There are various names of cyclist palsy that are listed below;

• Handlebar palsy
• Ulnar nerve compression or Ulnar nerve injuries
• Ulnar tunnel syndrome
• Bicycler’s neuropathy
• Guyon Canal Syndrome (GCS)
• Tardy ulnar palsy

Both sensory symptoms and motor symptoms can be caused by handlebar palsy. The motor symptoms, in this case, include having difficulty using your fingers for minor tasks or having a weak or loosened hand grip. While in the case of sensory symptoms, you will experience pain, tingling sensation, and numbness. 

The nerve conduction study has shown that there are more cases of cyclist palsy than are reported. For example, when practical studies were held, the researchers noticed that every seven out of ten cyclists experienced some overuse injury. It was also noticed that most of these injury symptoms could be recovered through proper medication, rest, and some exercise, but some injuries did not tend to go away. However, in some severe nerve damage conditions, it also results in paralysis or irreversible loss of sensations in the particular hand. 

Causes of Cyclist Palsy

Some of the main causes of cyclist palsy are described below;

1. Compression of the blood vessels or extensively pressurizing the hands or nerves

2. Stretching of soft tissues in hand in case of extending the hand or the wrist in a specific position. 

3. Insufficient core muscle that might result in excessive weight on hands or pelvis rocking. 

4. Excessive weight on upper limbs can be due to low handlebars or high saddle.

5. Continuous vibration in hand due to small wheels, skinny tires, and over-inflated tires.

Handlebar palsy can occur in every type of biking, whether mountain biking or road one—the risk of such overuse injuries increases in prolonged periods of stationary bike rides. 

What are the Hand Injuries Experienced by Cyclists?

Now, we will discuss various hand injuries experienced by cyclists one by one;

1. Cyclist’s Palsy or Ulnar Nerve

While holding a handlebar, your hand might experience a great level of stress, resulting in irritation and compression of the ulna nerve. This compression in the wrist can be within or away from the Guyon’s Canal. This type of situation is more than likely to occur in rough terrains, increasing the risk of injury. The hyperextended position of the wrist while riding a bike is the most common bike position that also results in such cycling injuries. 

Some of these types of injury symptoms include numbness, clumsiness, cramps, pain, tingling, weakness, motor limitation, etc.

2. Median Nerve Compression or Carpal Tunnel Syndrome

Median nerve palsy or median compression that results in tingling in the index finger, middle finger, ring finger, or thumb are the symptoms of carpal tunnel syndrome or can be referred to as the syndrome. The carpal bones on the dorsum of the wrist and the tough connective tissue on the ventral aspect surround the carpal tunnel. When the median nerve on the wrist and the flexible tendons of the fingers passing through the carpal tunnel are compressed, resulting in a narrow carpal tunnel, it causes carpal tunnel syndrome. When this area becomes slimmer and compact, it causes pain and a tingling sensation in the hand and fingers and risks carpal tunnel syndrome. 

As both these types of hand injuries can result from frequent cycling or uncomfortable bike adjustments, cyclists assume they would go away easily. If you are experiencing the exact symptoms mentioned above, there is a chance that your injury is quite severe, and you need proper treatment. Even in regular bicycling, bicycling handlebars can be uncomfortable and cause excessive vibration, resulting in injuries. So, it is important not to take it lightly and get yourself checked properly. You can also make adjustments to the grip to make it more comfortable. Get proper medication immediately if there is an uncomfortable sensation or pain in your wrist or fingers.

Treatment of Cyclist’s Palsy

The cyclist palsy treatments vary depending on the extent of the injury or the degree of nerve injury. You can even be prescribed some medication, rest, and exercises to even surgery depending upon how bad your overuse activity injury is and the form of overuse hand. Also, it is recommended to avoid bicycling on the ulnar. Long-distance cyclists tend to have more nerve in biking, thus severe compression syndrome or worse ulnar nerve. 

According to a prospective study, most nerve inflammation due to the nerve in cyclists can be treated with ice and rest. Moreover, ibuprofen and aspirin also help in reducing inflammation. Therefore, if you are experiencing any symptoms of weakness and severe lesion, you can get a checkup and see if the doctor recommends ice and rest or more. 

If these symptoms of cyclist palsy don’t subside, you must not continue cycling until improvement occurs or you are fully recovered and go for a checkup again. The doctor will probably recommend you some powerful NSAIDs. Even decades of cycling enthusiasts might experience such injuries and are also at risk of carpal tunnel no matter how used they are to cycling or the particular cycling position.

Sometimes the tight tunnel or the injury is too bad that surgery is required. This is a rare case and doesn’t happen too often. The recovery from surgery can take time and is usually a slower procedure. Other treatments for cyclists’ palsy or chronic carpal tunnel syndrome include steroids or injection therapy, splints, soft tissue therapy, etc. 

Effective Cyclist Palsy Treatment Exercises

In any nonsurgical treatment for the injuries, you will have to perform some cyclist palsy exercises, whether your pinky finger, finger joints, or thumb. The activity of muscles and stretching exercises are necessary for long-term and more effective treatment of the injury and better muscular function. A comprehensive exercise program can prove helpful in the treatment. Some effective exercises are listed below;

Finger Bending – Keep your fingers of the affected hand at a right angle and hold them in that position for approximately ten seconds. Repeat this bending exercise five times.

Finger Squeezing – In case of poor adjustments to grip, you might experience an injury. To help with the injury, you can squeeze any object between your fingers for almost ten seconds. Repeat it five times with each set of fingers.

Grip Strengthening – Squeeze a rubber ball and hold it in this position for five seconds. Repeat the exercise ten times.

Final Words

You might be aware that a comprehensive evaluation of your injury can prove helpful in the treatment. This is why even if you are experiencing low pain, you must not ignore it and go for a proper checkup. Also, take appropriate measures, refrain from putting excess weight on your wrist, and avoid inadequate padding. Make sure that your bicycle handlebars are comfortable enough and are not causing you any discomfort. Do not let constant vibration affect your wrist, and take a break from cycling in between or use a shock absorber. Once you go to the doctor, he will analyze your debilitating symptoms and suggest treatment accordingly.

Make sure that you do not ignore your wrist conditions or the effects of situations you might be experiencing, as it can develop muscle paralysis. Repetitive stress is a condition amongst people which is quite common, and if treated in time, it doesn’t cause many problems. Whether you include mountain bike riders or road bike riders, you can face certain injuries due to improper bikes and rough terrains. So, if you think you have cyclist palsy, go to a doctor immediately and get a proper checkup.