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Hand Numbness

 
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PostPosted: Tue May 11, 2004 6:41 am GMT +0000    Post subject: Hand Numbness Reply with quote

Doc, I am fairly new to MTB(3 months), and getting back into exercising in general(since Nov) so this may just be my lack of all the above. My hands go numb in about the 1st 20-25 min of a ride, if I don't stop and shake it out, it quickly gets to the point I can't shift or brake. I have had my bike"fitted" twice, added bar ends which I switch to when not in a technical areas and it helps, I've also moved my seat up, down front back.

I also get numbness when I'm on the elliptical (sp) at the fitness center and use the moving arms after about 20 min. Question

I'm a Clyde at 5'8" 230, who workout (weights and cardio) 3-5 days a week and ride 4-5 days a week(5 to25 miles each).
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The Bike Doc
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Joined: 08 May 2003
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Location: Corpus Christi and Warda, Texas

PostPosted: Tue May 11, 2004 7:18 am GMT +0000    Post subject: Reply with quote

Tate, I have copied to responses to similar questions below. One deals with hand numbness from carpal tunnel syndrome and the other from ulner nerve compression.

CARPAL TUNNEL SYNDROME

The median nerve runs through the carpal tunnel, the base is formed by the wrist (carpal) bones and the roof is formed by the carpal fibrous ligaments that cross over the top of the bones. The median nerve can become compressed by swelling to the carpal tunnel. Repetitive trauma, diabetes, arthritis, acute injury and other things can cause carpal tunnel syndrome. Symptoms are characterized by numbness, tingling pain and or weakness to the distribution of the median nerve: the thumb, index finger, middle finger and the aspect of the ring finger next to the middle finger. Occasionally the pain can go retrograde back up the median nerve to the elbow and shoulder.

Treatment consists of resting the wrist form repetitive use injury (yikes off the bikes!), using a wrist splint to prevent hyper- flexion or extension of the wrist, a course of anti-inflammatory medications, occasional steroid injection within the carpal tunnel and in reticent cases, surgery to release the fibrous band of the carpal roof. If there are signs of muscle weakness such as decreased size of the muscle in the thumb side of the heal of the hand or weakness in the hand grip or uncontrollable pain, then surgery is indicated.

Things that you can do to help your carpal tunnel in relation to your bike are the following:

1. Raise your handle bars and bring them back with a shorter taller stem or switching to riser bars with more back sweep
2. Set up your front suspension on your MTB to a softer setting to isolate your hands from high frequency low impact vibration
3. On a road bike look at getting a suspension stem or even a suspension fork
4. Switch from Grip Shifters to thumb shifter (those of you who read my columns regularly know I am a great fan of the durable, simple twist shifters but there are times when I cannot recommend them)
5. Get rid of your conventional road bike and switch to a recumbent (check out www.bentrideronline.com for a start on recumbency literacy and enlightenment). I had been afflicted from carpal tunnel syndrome from my conventional road bike. I was looking to go under the knife but spent the money on a recumbent instead. What a relief it was! Now I am 'bent happy!
6. Put bar ends on your mountain bike and switch hand positions frequently.
7. Get a large volume pump that has broad grips and easy of pumping. I like the Jo-Blow Pro.
8. Put fatter tires on your road and mountain bike to damp the vibrations.

Now if you have any of the above described serious symptoms do not hesitate to get a medical evaluation by a physician. Delays in treatment of serious carpal tunnel syndrome can lead to irreversible nerve damage and loss of muscle strength.

ULNAR NERVE COMPRESSION

The ulnar nerve runs through the hand on the palmer, pinky side of the heal. During the long road ride with your bearing weight on the hands (which anatomically they are not designed to do) you compressed the nerve and caused loss of blood flow in the nerve, thus, the resulting numbness. How long will it last, you may already be better by now as it has been four days from your post and my reply. If you are still feeling numbness now, that is not good and you may have caused some significant nerve injury. The periperpheral nerves can regenerate (unlike the Central Nervous System nerves); they re-grow at a rate of about 1 mm/day. If you crushed the nerve enough to have effectively choked it to death, it will take about 2 weeks, at the rate of 1mm/day growth, to regenerate nerve down to your finger tips. If significant scar tissue develops, this can block the regeneration of the nerve and the numbness can be permanent. Time will provide the answer here.

How can you prevent this problem in the future? Try gloves with padding over the ulnar nerve area. Specialize Body Geometry gloves has padding specifically in this area to help prevent compression of the ulnar nerve. I have visited with individuals who found excellent relief with these gloves. They may or may not work for you depending on the anatomy of your hand.

Use bar ends on your mountain bike and switch hand positions often. Try using a set of clip on aerobars on you bike when road riding to give you additional hand positions. Raise your handle bars up some (use a riser stem or move spacers under the stem if they are on top) to decrease the amount of weight you are putting on your hands.

Consider a recumbent bike for road riding (they are lousey off road). You will completely eliminate the problem going to a recumbent. This link http://bicycling.about.com/gi/dynamic/offsite.htm?site=http%3A%2F%2Fwww.bikeroute.com%2FBentMedBenefits.html will take you to an article I wrote on the medical benifits of recumbents. There are several fast recumbents out there. The world land speed record for human powered vehicles is held by a streamlined recumbent 80+mph on a flat without wind assist. Much like there are different types of road bikes, racers, tourers, cruisers, hybirds etc, there are several different types of recumbent bikes to consider. Check out www.bentrideronline.com for several reviews and discussions about recumbent bikes. They have several models reviewed that you can access to their link to bikes reviewed.

I hope this information helps.

Thanks,
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Paul K. Nolan, MD
AKA: The Bike Doc
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