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How to prevent ulnar nerve palsy

Five tips to prevent numbness and tingling in your hand, ring finger, and pinky finger.

If you’ve ever done a long-distance ride or an endurance race then you’ve probably experienced a few foreign aches and pains that arise as the hours tick by. Numbness and tingling are common sensations that riders will complain about when they are stuck in a fairly stationary position for hours on end. In fact, ulnar nerve palsy is so common in cyclists that it is often referred to as “cyclist’s palsy.” Chances are that there were many cyclists riding on the roads of Emporia, Kansas experiencing this exact sensation as they gripped the handlebars over some 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 travels through the “Tunnel of Guyon” of the hamate bone. The hamate bone is one of the eight bones in your wrist and it can be located when looking at the palm on your hand, about an inch up from your wrist and articulating with the fourth and fifth metacarpal (on the pinky and ring finger side of the hand). The hamate has a small hook that forms a channel which is called the Tunnel of Guyon. When the ulnar nerve runs through this tunnel, it is particularly vulnerable. Extended compression can lead to numbness or palsy of the ulnar nerve. Compression of the ulnar nerve at the Tunnel of Guyon, in particular, will manifest itself in the form of numbness in the pinky and part of the ring finger.

Why is ulnar nerve palsy common in cycling?

Ulnar Nerve Palsy is particularly common in cycling because we spend so much time gripping the handlebars. The extended periods of time spent with pressure on the hand causes compression on that ulnar nerve. Repeated jackhammering sensations, such as riding over washboard gravel roads, can also exasperate the ulnar nerve. While generally, this numbness isn’t anything to worry about, it can be very uncomfortable and annoying while trying to enjoy your journey.

Changing your grip and/or hand position may help prevent “cyclists palsey”. (Photo by Christian Kaspar-Bartke/Getty Images)

Here are a few ways to help minimize or eliminate ulnar nerve palsy altogether:

1. Loosen your grip

When the going gets rough, we all have a tendency to tighten our grip on our handlebars. Sometimes, we actually need to do the opposite. This tendency to “death-grip” 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 over the bike, while allowing the bars to vibrate separately from your hands. This can supply a little reprieve from compression of the nerve.

2. Change hand position

If loosening your grip isn’t enough, try changing your hand position all together. Even though you may feel the most comfortable or powerful in one position on the bike, spend brief periods changing your hand position so that you have pressure in different points of the hand, rather than only through the ulnar nerve. Spend time in the hoods, tops, and drops of your bike to change where the pressure is on your hands. Something as simple as standing and sitting can be enough to change where you are placing the pressure on your hands.

3. Extra 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 extra padding either 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 pointed down, you may need your hands to keep from sliding forward. This may cause ulnar nerve palsy. Photo: Jochen Haar

4. Flatten your saddle

If the nose of your saddle is pointing down toward the ground, then it is likely that you are sliding forward down the saddle as you ride. As you slide down the nose of the saddle, your arms and hands are holding you up. That extra pressure on your hands as you work to push yourself back onto the seat may be the pressure causing your hands to go numb. Try leveling out your saddle so that it is flat.

5. Raise your bars

Finally, if none of these other strategies worked for you then you can try to raise your bars in order to take some weight off of your hands. By raising your bars, you won’t be leaning as far forward on the bike and there will be less weight going through your hands. You can try adding some spacers under the stem or try using a shorter stem.

Comfort is Key

Remember that on many of these long rides and races, your comfort will ultimately be your biggest driving factor. The longer that you can stay comfortable on your bike, the longer you will be able to focus exclusively on putting power into the pedals. Once you start feeling pain or discomfort you begin to spend energy on things other than pedaling.