Cyclist’s Palsy: Addressing Hand Numbness in Cyclists

By Cory Szostowski, PT, DPT, DN-C

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Biking requires constant gripping and pressure through the arms to control the bike. This can lead to increased compression through nerves and vascular leading to riders experiencing numbness/tingling into their hand. Symptoms usually only happen intermittently, resolving once pressure is relieved, but there are some riders who experience persistent/recurring tingling and numbness that limits their ability to ride long distances and enjoy riding. 

Symptoms commonly stem from excessive stress on the ulnar nerve at guyon’s canal or median nerve in the carpel tunnel. The nerve that is affected can be determined by the distribution of numbness/weakness. Ulnar nerve compression causes numbness/tingling into the pinkie/ring finger and median nerve leads to symptoms into the thumb as well as middle/pinkie finger. Determining what is causing the excessive pressure is key for resolution of symptoms. 

There are typically two things that lead to a rider bearing more weight through their arms: a poorly fitted bike to the rider and rider inherent limitations that affect their position on the bike. If a rider has core/scapular weakness and thoracic kyphosis they will have a tendency to fall forward putting more pressure through their arms/hand, especially as they fatigue with longer rides, causing more pressure to be put on the nerves of the hands. There are several exercises cyclists can perform to prevent and address these impairments. 

Quadruped Thoracic Extension

(5-10 sec x 10 reps)

Kneel with elbows on a bench and holding a stick in both hands. Bend elbows backward and slowly rock hips onto heels while allowing mid-back to fall inward until you feel a stretch in the back of the arms, sides and upper back. Hold.

Open Books

(3-5 sec x 15 reps each side)

Lie on your side with one knee bent on top of the foam roller, bottom leg straight and flat to the floor, and hands together, directly in front of you. Slowly lift your top arm toward the ceiling, rotating through your chest in order to reach as far behind you as possible. Hold and repeat on the opposite side.

Pallof with Shoulder Flexion

(20 reps)

Begin standing perpendicular to a band anchored at chest height. Stand in slight hip and knee flexion, core engaged, holding the end of the band with both hands at the middle of your chest as shown. While maintaining core activation, slowly straighten your arms. While keeping your arms straight, lift your arms up over your head to a 45-degree angle. Be sure to not let your hands drift towards the anchor point of the band throughout the movement, nor to allow your back to extend. Reverse the movement and repeat.

Plank Body Saw

(20-30 reps)

Begin in a plank position on your elbows. Engage abdominals and glutes to tuck your pelvis, then push your chest as far from the floor as you can to feel shoulder blades wrap around the rib cage. With your feet on furniture sliders or towels, slide them back as far as you can while still maintaining the stability of your spine, then slide them back up to the starting plank position.

Prone Scapular Retraction

(3 sets x 10 reps)

Begin by kneeling in front of a physioball. Lie over the top of the ball so it is underneath your stomach. Point your thumbs toward the ceiling. Lift your arms toward the ceiling, at shoulder height. As you lift, squeeze your shoulder blades together making sure not to shrug your shoulders.

At Evolution, we work with athletes and sports hobbyists every day. Many of our therapists have a passion for cycling and love to help others in the sport. If you have questions or want to work with one of our physical therapists, you can request an appointment here. We also have more great exercises for cyclists to read up on, including some great core exercises and ways to manage knee pain while cycling.

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