Cyclists Hands: Handlebar Palsy

[box type=”shadow” align=”aligncenter” width=”750″ ]Exercise therapy is a program of physical activities carried out in an effort to reach specific health goals. Its purpose is to return to normal musculoskeletal function or to decrease pain caused by injuries or other health problems. The exercise therapy online column is written by Raasay Waters.[/box]

[author image=” ” ]Raasay Waters is a graduate Sports Therapist from the University of Central Lancashire, North England. She has lived and studied in the UK for 6 years and has been back in South Africa since 2012 to pursue her passion and career as a Sports Therapist. She works at a Private practice in Claremont, specializing in Sports Massage, Exercise Therapy, Fitness training, Injury rehabilitation and strength and conditioning. Raasay spends her time outside of work trail running, cycling and hiking! You can find out more by visiting[/author]

Handlebar palsy is also known as ulnar neuritis or ulnar neuropathy. This condition is generally experienced by long-distance cyclists. In handlebar palsy, the ulnar nerve in the wrist gets compressed due to long periods of direct pressure on the nerve when the weight of the upper body is resting on the handlebars thus the term handlebar palsy.

Cycling injuries are either overuse injuries which develop gradually over time because of repeated movement patterns or pressures, or acute, traumatic injuries due to a fall. These are extremely variable and so not really covered here. The most common cycling injuries tend to be knee pain such as Iliotibial band syndrome, lower back pain from being hunched over, or wrist injuries from pressure on the handlebars.

Causes of Handlebar Palsy

Handlebar palsy is caused due to compression of the ulnar nerve in the wrist.

Handlebar palsy, as the name suggests, is most frequent in cyclists due to compression of the ulnar nerve because of positioning of the wrists on the handlebars. Handlebar palsy could also be caused by disruption or compression of the ulnar nerve at the elbow because of bone spurs, trauma, cysts and arthritis. Handlebar palsy may occur by repetitive movements at the wrist or elbow. Sports activities which involve weight lifting and throwing may also cause handlebar palsy.

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Signs and Symptoms of Handlebar Palsy

  • Difficulty while performing typical hand functions like using pen, using surgical equipment, or playing piano.
  • Clawing of the hand.
  • Affected fingers may fail to work properly.
  • Outer half of the ring finger and little finger along with outer portion of the hand typically get affected.
  • Pain while performing wrist activities.
  • Difficulty straightening out the ring and pinkie finger of the affected hand.
  • Numbness, weakness and tingling could be experienced.
  • Lack of coordination or clumsiness in the hand is felt.

Treatment of Handlebar palsy

The most important feature of treating this condition is to correct the cause of the problem. In cyclists, this may mean checking the bike set up such as the height of the saddle and handlebars and the wrist position when riding and ensuring the right size bicycle and proper position of the handlebars is used. Correcting these problems will usually stop the symptoms.

In cases where this does not work, seek advice from a professional sports injury therapist. They will be able to assess the injury. These symptoms could be due to compression of the nerve at any point along its course, not just at the wrist. The neck may be a problem and so posture should be checked, as well as other activities which may put a strain or pressure on the nerve higher up.

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Physical Therapy

Physical therapy is important in speeding up the healing process and to get optimal results. Physical Therapy also decreases the chance of recurrences in the future. Physical therapy may include:

  • Soft tissue massage.
  • Heat and ice treatments.
  • Exercises to improve strength and flexibility.
  • Activity modification and training.
  • Appropriate plan for return to activity.

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