How to prevent ulnar nerve palsy

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If you’ve ever been in a long distance run or endurance run, you’ve probably experienced some extraneous aches and pains that appear over the hours. Numbness and tingling are common sensations that cyclists complain about when stuck in a fairly stationary position for hours. In fact, ulnar nerve palsy is so common among cyclists that it is often referred to as “cyclist’s palsy”. Chances are there have been plenty of riders on the roads of Emporia, Kansas experiencing that exact feeling as they held the handlebars on bumpy gravel roads.

What is ulnar nerve palsy?

The ulnar nerve begins in the neck, travels down the shoulder, down the arm, and into the wrist and fingers. When the ulnar nerve reaches the hand, it passes through the “Guyon tunnel” of the hamata bone. The hamatous bone is one of the eight bones on your wrist and it can be located by looking at the palm of your hand, about an inch from your wrist and articulating with the fourth and fifth metacarpals (on the side of the l little finger and ring finger of the hand). The hamate has a small hook that forms a channel called the Guyon Tunnel. When the ulnar nerve passes through this tunnel, it is particularly vulnerable. Prolonged compression can cause numbness or paralysis of the ulnar nerve. Compression of the ulnar nerve at Guyon’s Tunnel, in particular, will manifest itself as numbness in the little finger and part of the ring finger.

Why is ulnar nerve palsy common in cycling?

Ulnar nerve palsy is especially common in cycling because we spend a lot of time holding the handlebars. Prolonged periods spent with pressure on the hand cause compression on this ulnar nerve. Repeated jackhammer sensations, such as riding on gravel washboard roads, can also exasperate the ulnar nerve. While generally this numbness is not a cause for concern, it can be quite uncomfortable and annoying when trying to enjoy your trip.

Changing the position of your grip and / or your hands can help prevent “cyclist paralysis”. (Photo by Christian Kaspar-Bartke / Getty Images)

Here are some ways to help minimize or completely eliminate ulnar nerve palsy:

1. Loosen your grip

When the going gets tough, we all tend to tighten our grip on our handlebars. Sometimes we actually have to do the opposite. This tendency to ‘grip deathly’ on the bars increases the pressure on your palms and ulnar nerve. If you are able to consciously loosen your grip on the bars, you will notice that you can still maintain control on the bike, while still allowing the bars to vibrate separately from your hands. This can provide some respite from the compression of the nerve.

2. Change the position of the hand

If loosening your grip isn’t enough, try changing your hand position at the same time. Even if you feel the most comfortable or powerful in a position on the bike, spend brief periods changing the position of your hand to apply pressure to different points of the hand, rather than just to through the ulnar nerve. Spend time in the hoods, roofs, and drops of your bike to change the pressure on your hands. Something as simple as standing and sitting can be enough to change where you put pressure on your hands.

3. Additional padding

Since we know that the cause of ulnar nerve palsy is pressure on the ulnar nerve, we know that we can also help alleviate the problem with additional padding in the form of padding in the gloves or on the bars. You can look for gloves with extra gel padding or wrap your handlebars with padded tape.

If the nose of your saddle is pointing down, you may need your hands to prevent sliding forward. This can cause ulnar nerve palsy. Photo: Jochen Haar

4. Flatten your saddle

If the nose of your saddle points towards the ground, it is likely that you are sliding forward in the saddle as you ride. As you slide down the nose of the saddle, your arms and hands support you. That extra pressure on your hands as you work to push yourself back into the seat can be the pressure that makes your hands feel numb. Try to level your saddle so that it is flat.

5. Raise your bars

Finally, if none of these other strategies have worked for you, you may want to try raising your bars to relieve yourself a bit. By raising your bars, you will lean less forward on the bike and there will be less weight passing through your hands. You can try adding spacers under the rod or try using a shorter rod.

Comfort is the key

Remember that on many of those long rides and runs, your comfort will ultimately be your biggest driving factor. The longer you stay comfortable on your bike, the longer you can focus exclusively on the power of the pedals. Once you start to feel pain or discomfort, you start to expend energy on something other than pedaling.

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