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Hand Grip - How to deal with Carpal Tunnel Syndrome
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By leaning forward, you benefit from improved control, good weight distribution and aerodynamic form. All is not bliss, though. How about that tingling/burning/numbness you sometimes have in your hand(s) after a long ride? No big deal, you say: Maybe it isn’t. Or maybe you’re just experiencing ulnar nerve compression (UNC) or carpal tunnel syndrome (CTS)....

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By leaning forward, you benefit from improved control, good weight distribution and aerodynamic form.  All is not bliss, though.  How about that tingling/burning/numbness you sometimes have in your hand(s) after a long ride?  No big deal, you say:  Maybe it isn’t. Or maybe you’re just experiencing ulnar nerve compression (UNC) or carpal tunnel syndrome (CTS).

UNC is the compression of the fibers in the ulnar nerve (the area that branches across the palm of the hand).  You’ve been painfully aware of that nerve when you bumped you elbow’s funny bone against something and you felt your arm throb.

When you lean forward on your bike’s hand grips, your upper body weight is pressing against that same ulnar nerve (broken line in figure to the left) as it innervates the small muscles of the hand and you two outer fingers.

How about that tingling/burning/numbness you sometimes have in your hand(s) after a long ride?

When the fibers in the ulnar nerve become compressed enough over time, you experience a buzzing or numbing sensation in your hands that leads to pain and eventual nerve damage.  Ignored, UNC can cause partial paralysis of the hand.

Even before it get that extreme, UNC can become so uncomfortable that indulging in your favorite sport might be unbearable.  And like many other maladies that “catch up” to the body over time, you may not be experiencing it now, but you could be laying the groundwork for UNC later.

There are some things you can do to prevent or at least to alleviate this condition, however.  Having a higher handlebar position is one of the more beneficial things you can do.  You might want to consider a set of handlebar risers.

Look at the way you grip the hand-grips, also.  Sometimes during fast-riding or dense-traffic situation, you may squeeze you hand grips hard, thereby increasing pressure on the ulnar nerve.  Even during normal riding, you may be unconsciously squeezing harder than necessary.

You can borrow some techniques from the pedal pumpers.  How about padding your handgrips?  Aside from using softer grips, wrap some padded bicycle-handlebar tape around your grips.  Don’t overdo it, though, and make the grips too thick.  A few layers of tape, overlapping half of the tape width, should be enough.  Another technique is to wear padded bicycle gloves.  Full-coverage gloves are available from Olympia Sports (800-654-6124, with gel-filled pockets that help to cushion the palms.

Although you don’t have the optional hand positions a bicyclist has with a “dropped” handlebar, you can vary your hand-grip in subtle ways to spread pressure over a wider area of your palm and fingers.  By “rolling” your hands slightly, to and fro on the grips, you can vary hand/hand grip contact, while still keeping your thumb and fingers booked around he grips.

During extended rides, occasionally remove one hand from the grip and shake it vigorously; also, alternately make a fist and extend your fingers several times.

As if UNC wasn’t bad enough, there’s carpal tunnel syndrome (CTS) too.  This painful condition occurs when the median nerve (tsee picture) becomes squeezed in the carpal tunnel – a narrow opening between the wrist bones and their attached transverse carpal ligament.

The median nerve provides sensation for the thumb, index and middle fingers and part of the ring finger.  Tendons leading to the carpal bone tunnel with the median nerve.  Having the front-brake and clutch levers positioned so you have to rotate your hands sharply to operate them stresses the wrists.

And depending on the structure of the hand and wrist, bending them in one direction (up and down) may not be a problem, while bending them in the opposite way may be painful.  To place the least stress on the hand and wrist, position a lever so that it forms a straight line with your hand and forearm.

Another are that can be troublesome for aggravating CTS is the throttle – especially if it has a stiff action to begin with.  Here you’re working the right hand far more than the left one.  If CTS becomes a problem you might gain some relief by gripping the end of the throttle and twisting it the same way you turn a doorknob.  Oddly, enough, CTS might not make itself felt until yours later.  You might awaken from a sound sleep because of pain in your index and middle fingers, with a loss of sensation in your palm.

If you suspect CTS, you can undertake a simple test by placing your palms together (fingers upward) and pressing them together for several minutes.  Also try pressing your hands together, back-to-back with your fingers pointing downward.  Another test that may indicate CTS is to make a fist and squeeze moderately hard for several seconds.  If you feel pain in your thumbs, index and middle fingers with any of these tests, you could have CTS.  On the other hand, pain in your ring finger (facing your little finger) might indicate the ulnar nerve damage instead.

Should you feel pain in your hands and/or wrists with any of these tests, heck with your doctor immediately.  In fact, recurring or persistent pain in your hands without doing any of the above mentioned tests should behoove you to seek medical help. Waiting for pain to disappear may only aggravate a problem that is remediable if caught in the early stages.

Depending on the severity of CTS, you may be able to get relief with corrective exercises such as stretching your wrist by pulling back on your fingers.  A wrist brace or splint may provide some relief, as well as aspirin.  Steroids similar to what the body produces can be taken also by mouth or injection.  But they may generate some bad side effects.  Oftentimes surgery is the only resort.  The surgical techniques, however, are safe and effective.

Whatever you do to prevent or alleviate ulnar nerve compression can help you to deal with carpal tunnel syndrome also.  Hand shaking and fist-making/finger-flexing help here too, on those long rides.

You can bring on and aggravate CTS and UNC in sports or job-related functions that carry over to your sport riding.  Anything from operating a computer keyboard to playing sports can initiate CTS or other hand-grip miseries, which are further aggravated by working the controls and handlebar on the motorcycle.

Even if you have never experienced UNC or CTS, you may have to contend with other kinds of grip problems dealing with just the fingers.

Consider “trigger finger.”  When a finger must continually work against something, such as a control lever, its tendons and synovial sheath (lubricating covering of tendon) can become irritated and inflamed.  A module may even form on the tendon to restrict finger movement.  Furthermore, when a finger is kept flexed for any length of time, as during sleep, it may “set” in place.  Then when the finger is extended, it may audibly snap into place.  Or it may lock in a flexed position and have to be pulled with the other had to extend it.

Another peculiarity is “dead” finger.  This can occur when a finger is exposed to repeated and intense vibration that damages the blood vessels.  With loss of blood flow to certain areas of the finger, localized necrosis (dead tissue) can develop.  The surface of the finger may develop blanched spots that indicated deadened areas.  Furthermore, you might be predisposed to poor circulation so that your fingers are painfully sensitive – or will be as you get older – to cold weather and ordinary actions, such as operating the controls of a motorcycle.

Because it’s so complex in form and function, the human hand is more vulnerable that we may realize.  What’s more, this vulnerability can be an inherited tendency as well as an acquired one.

So to avoid trouble later, pay attention now to how you use your hands.

-- Bill Hampton


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