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How to avoid hand & wrist pain when mountain biking

Hand and wrist-based pain associated with mountain biking makes up what might be a surprisingly large portion of our caseload as hand therapists and there are a few big reasons as to why.

First, let’s take a look at how our hands and wrists are positioned while on the mountain bike.

Often when riding, our wrists are bent back into extension and the handlebar places pressure into the centre of the palm and over into the ulnar side of the palm. During mountain biking, you are generally gripping the handles more tightly than in road or more casual cycling and can often be in this position for hours at a time. Staying in this position for a prolonged period of time places pressure and stretch over a number of important structures in our hands and wrist which are related to all of the common mountain biking symptoms listed below.

1. Numbness/tingling

Why? First things first – sensation-based symptoms. As a result of the pressure in our palms and the position of our wrists while riding, two major nerves are being stretched and compressed – the ulnar and median nerves. If you are an avid mountain biker, over time these nerves can become damaged, and symptoms can occur both on and off the bike leading to pain, numbness and difficulty with everyday fine and gross motor tasks. The median nerves runs through the wrist more centrally through the carpal tunnel and provides sensation to the thumb, index, middle and half of the ring finger. The ulnar nerve runs through a tunnel toward the ulnar side of the palm called Guyon’s canal and provides sensation to the ring and little fingers. Ulnar nerve compression is more common in mountain biking and is also known as handlebar palsy.

What can I do? Head outside and have a look at your bike. Is there a way to pad your handlebars to decrease the pressure in your palm? Are there gloves with more padding you could wear to have the same effect? It is worth seeing what can be adjusted that will allow you to continue riding at your hearts content while also protecting you from longer term nerve related issues.

2. Wrist Pain

Why? General wrist pain with or without numbness/tingling can also be associated with nerve stretch and pressure as discussed above. Wrist pain over the little finger side of your hand can also be a result of long-term strain of a major ligament complex that sits over this side of your wrist. This might be a sharper pain that you feel more when lifting, twisting or weight bearing through your hands. What can I do? If you are getting wrist pain on the side of your little finger, it is worth getting this investigated. This type of pain can easily become chronic and if it is something that is ongoing can become more and more difficult to repair either with therapy or potentially through surgery.

3. Trigger finger

Why? Another common symptom/condition associated with prolonged tight grip is something called trigger finger – which you may be familiar with. This can occur as a result of excessive tension on the flexor tendons of your fingers which cause nodules to develop. When you bend and straighten your fingers, one or multiple fingers can become stuck or locked in a bent position and be more difficult to straighten.

What can I do? As above, this is a condition that is best to be properly investigated if it has been going on for any length of time. Heat and massage over the base of the finger can help, and avoiding excessive tight gripping while the inflammation has a chance to settle.

If you are anywhere from an avid mountain biker to someone that likes the occasional thrill, these symptoms can occur. If you are experiencing anything mentioned above it is always best to have it checked out to prevent longer term damage. We can also help to brainstorm ways to adjust the bike set up so that you can continue to or get back to riding as soon as possible!

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