When you ride your bike do you experience tingling, numbness or pain in your arm, wrist, hand or fingers? It is estimated that one third of repetitive stress injuries in cycling involve the hands. Carpal tunnel syndrome (compression of the median nerve at the wrist) is one of the most common. Proper positioning and wearing the correct gear may prevent these injuries from occurring.
A very common problem I see in my chiropractic practice is carpal tunnel syndrome (CTS). It wouldn't surprise me if you know someone yourself that suffers from CTS. Several thousand people annually undergo carpal tunnel surgery. Even though CTS is a very common disorder, doctors still have very little understanding about what causes CTS and what can be done to prevent it.
Carpal tunnel syndrome has been associated with certain metabolic conditions such as diabetes, gout and thyroid disease. It is a commonly held belief that repetitive manual occupations or activities can cause CTS, but there have not been any scientific studies conclusively proving a link between occupational activity and CTS.
Although cycling has not been identified as a direct cause of CTS, riding with the hands on top of the handlebar creates direct pressure onto the median nerve. The result of this direct pressure on the median nerve can result in symptoms of numbness and tingling in the fingers and thumb, and sometimes weakness of the hand can occur also. In mild circumstances, the symptoms usually resolve quickly once the ride has ended or in more serious conditions if you stop cycling altogether for a week or two.
Although hand position and median nerve pressure contributes to these symptoms there are usually multifactorial causes for neurological symptoms such as pain, tingling and numbness. It is important no matter the level of competition or recreational cycling that if you are experiencing these types of symptoms to be evaluated by a qualified health care professional. For the serious amateur or professional cyclist who spend hours training and racing, this repetitive stress can take its toll. CTS is a condition that can be prevented and avoided and hopefully not interfere or end a promising cycling career.
Injury to the median nerve results in symptoms of pins, needles, numbness, tingling and weakness. The median nerve passes from the forearm to the wrist through the carpal tunnel. The tunnel is made up of carpal bones which form the floor, and the roof is formed by a thick ligament. The flexor tendons of the fingers are also packed tightly into the tunnel. When the nerve is irritated inflammation and swelling occur, and the increased pressure on the nerve causes it to malfunction and the CTS symptoms.
Being properly fit to your bike frame, seat and handlebar heights and angles, and pedals can be the first step in preventing CTS. Proper fit is a major step to not only performance and comfort, but preventing overuse injuries while cycling. Being in an upright position, taking direct pressure of your hands, wrists and the median nerve will reduce the likelihood of irritating or damaging the carpal tunnel structures. When out on long rides, make sure you constantly shift positions on the handlebars and not keep to one position for an extended length of time. Cycling gloves usually have padding that helps protect the hands, and some people even like to use padded handlebars to give them extra comfort. The extra padding helps to absorb the shock from a rough road also. Make sure the weight on your hands is not directly centered on the palms of the hand, and is evenly distributed to the outside of the hands as well. Stretch your hands and wrists before and after each ride. This will help prepare the tissues and also recover better if you take a few minutes to do a short stretching session before hitting the road.
A lot of cycling overuse injuries are the result of poor preparation and improper positioning on the bike. Taking the extra time to address these issues may minimise the possibility of injuries occurring.
If you are already suffering the symptoms of carpal tunnel syndrome resting, wrist splinting, and chiropractic care are frequently the initial treatments for CTS. Addressing the proper positioning, pedal fit, handlebar and seat height, and padded gloves may reduce the stress on the wrists and hands and minimise the severity and symptoms of CTS. In a severe situation cutting back on the riding time may help an injured nerve to recover.
The conservative approach to treating carpal tunnel syndrome listed above is most successful for early and mild cases. Studies indicate that approximately thirty percent of people will respond to this type of treatment. In more severe cases other more aggressive measures may be required, but this is rare if addressed properly from the onset.
Corrective chiropractic care is a conservative, safe, effective and gentle approach to improving function to the injured areas. Specific mobilisation of the involved joints and tissues enables tissue repair, fluid exchange and nutrition to enable the body to begin to repair itself. The conservative approach is an effective and safe alternative to surgery in mild to moderate conditions of CTS.
If you or someone you know is experiencing the symptoms of CTS, They should be assessed by a qualified health professional. Once a thorough history and consultation has been done, along with a complete physical, neurological and orthopedic examination, a diagnosis can be made along with the correct treatment recommendations. Delaying treatment could result in long term nerve damage or other chronic symptoms.
