Cycling is an excellent avocation for the body and the mind. Serious cyclists are among the fittest of athletes. Yet cycling is not without risk of injury. Cyclist’s palsy – sometimes called handlebar palsy – is a painful condition of the wrist that is quite common among long-distance cyclists.
In his article renowned Detroit area hand doctor, Dr. Rehman explains the causes, symptoms and treatment of Cyclist’s Palsy.
Causes of Cyclist’s Palsy
Cyclist’s Palsy is typically the result of a cyclist overtraining. It can be aggravated or intensified by prolonged road cycling or mountain biking on rough terrain.
Handlebar Palsy occurs when the ulnar nerve becomes irritated and compressed in the wrist, due to the pressure exerted on the hand as it presses down on the bicycle handlebars. This pressure of holding the handlebar and/or vibrations from the road or trails are often enough to damage the nerve due to compression. During cycling downhill, especially, a large part of the body’s weight is supported by the hands on the corner of the handlebar.
Cyclists who adopt a hyperextended position of the wrist while resting on the handlebars, contributing to likelihood of developing Cyclist’s Palsy, by compressing and stretching the nerve as it passes through the wrist to the hand.
Other contributing factors to Handlebar Palsy are: not changing hand positions on the handlebar frequently, wearing poorly fitting or worn-out gloves or handlebar pads, improper bike size/fit, wrong handlebar shape/size and improperly distributed body weight on the hands.
Symptoms of Cyclist’s Palsy
The symptoms of Handlebar Palsy typically include numbness, tingling, weakness, clumsiness, cramping, and mild to moderate pain. More severe cases of Cyclist’s Palsy can result in possible motor function limitation, or the development of muscle paralysis – depending upon the branch of the ulnar nerve that is affected.
Since many cyclists either “push through the pain” and/or self-treat without seeing a doctor, it is unclear how common Cyclist’s Palsy is. Estimates range from guessing that 10% to 70% of long-distance cyclists suffer from Handlebar Palsy at one time or another.
How Hand Doctors Treat Cyclist’s Palsy
A hand doctor can conduct electrodiagnostic studies and other tests to determine the extent of the nerve compression. Treatment will depending on whether only the sensory branch of the ulnar nerve is impacted, or only the deep motor branch, or both.
Without proper treatment or intervention/prevention strategies, the cyclist can continue to compress the motor branch until a severe lesion develops. Prolonged outage of innervation of the muscles in the hand by the ulnar nerve can also result in a ‘claw’ hand, with flexion of the 4th and 5th finger.
If the cyclist does not receive treatment, the ulnar nerve entrapment can cause atrophy of the hand muscles, as well as permanent paralysis of the hand muscles affected by the ulnar nerve.
For this reason, prompt treatment of Cyclist’s Palsy by a qualified hand doctor is essential. Depending upon the severity the healing process can take from week to months. If severe nerve injury is found, surgical decompression of the nerves may need to be performed by a qualified hand surgeon.
Top Detroit Area Hand Doctor
If you are a Detroit area cyclist suffering from an pain in your fingers, wrist, elbow or arm, contact board certified Detroit area hand surgeon Doctor Rehman for a comprehensive evaluation and consultation. As with most medical conditions, early detection, awareness, and a prevention or treatment plan is the most effective way to combat the effects of conditions such as Cyclist’s Palsy.
Doctor Rehman will assess your individual situation, and prescribe the treatments that are best for your condition.