oh no carpal tunnel

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Tabby
Participant
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I seem to have developed carpal tunnel and wondering if anyone has any experience or advice to share. Do I just need to stop riding for an extended period of time? :(


88MS88
Participant
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Where and when does it happen?


reddan
Keymaster
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Never had such problems myself, but I’ve heard recommendations for a higher stem, or even switching to a bike with a more upright position (MTB, perhaps?), in order to get more weight off your hands and wrists.

‘Bents are also an alternative when suffering such problems.

I’d hate to see you stop riding completely…


myddrin
Participant
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I’d say start with a bike fitting at UPMC and mention CTS as a specific concern. They’ll take a look at your riding stance and probably suggest some changes.

I’ve not really had any issues except that after my first 75 mile ride, I had numbness in the fingers normally associated w/ CTS for about a week. It was annoying and I can’t even imagine how bad the outright pain would be. Fortunately for me it hasn’t come back, but I don’t think I’ve actually changed anything.

That being said, there is a fair bit you can do in your non-cycling time that can help. (I’m a developer and have seen a lot of people struggle w/ CTS.) For non-cycling activity, if you type a lot stop for 5 minutes every hour and do some wrist exercises: write rolls work well.

Also investing in a mouse pad w/ a wrist rest and a wrist rest in front of your keyboard can do wonders from what I hear.


Tabby
Participant
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I know reddan I’d hate to see that too!

I have mild numbness of my pointer finger and thumb (both hands but my left hand is worse). This has been going on for a couple months. More recently there is also more of a wrist pain/ache and my grip is weaker or sore sometimes. Last night eating with chopsticks, I would have moments of weakness or pain.

I hadn’t been really noticing much while riding, but I think it may have more to do with braking than my regular position. I usually brake with my first two fingers because it’s quite a reach. Maybe that’s a problem.

@myddrin- thanks, I have the wrist rest. I will try taking typing breaks. I wasn’t thinking of myself as a “serious” enough cyclist for the UPMC folks, but it would be cheaper than getting a ‘bent or driving more.


StuInMcCandless
Participant
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I sometimes get some wrist and hand cramping, though I’ve never been formally diagnosed with CTS. When it occurs, I just use a different hand position on my drop bars.


88MS88
Participant
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Tabby, what kind of handlebars do you have (flat/curved)?

Stay away from the ‘bent or otherwise you’ll start sprouting weird facial hair and will only be able to communicate using bad puns.

;-)


Pseudacris
Participant
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Tabby, I have to watch this, too and I probably haven’t been riding for as long or as far as you. I have an upright stance, but I still have to be careful of too much constant pressure on my hands. It’s both thumb joints and the lowest joint on my index fingers that can get a bit numb. Padded gloves have definitely helped, to my surprise. They have little gel inserts on each of those joints.

myddrin: where do you go at UPMC for a bike fitting?


Tabby
Participant
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I like the puns, the facial hair would be upsetting though.

I have drops, you know my bike, Jolene. I spend a lot of time on the hoods, some in the drops, not much on the top bar. I did use the top more on my way to work today which felt good since my wrist and forearm weren’t twisted outward. Most of my rides are short since I live close to everywhere I go, so I don’t really have long stretches of time in just one hand position.


88MS88
Participant
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I would have also mentioned the obligatory Birkenstock usage but I figured it was already too late for you, Butters.


Lolly
Participant
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My regular doctor diagnosed me with carpal tunnel in 2003. My hands and wrists were so weak I could barely pick up ANYTHING for several months. She had me in wrist braces for both hands and that meant that I still couldn’t pick up anything but I also was wearing cumbersome braces that seemed useless. Strengthening exercises and the brace did nothing and there was no improvement for many months and regular doctor was starting to suggest that crappy invasive and ineffective carpal tunnel surgery. (My best friend had it and it didn’t help at all)

Then I went to a chiropractor for neck pain and told her about my wrist problems. So she wrapped them in a mysterious hot paraffin wax while she worked on my neck and back. It felt GREAT at the time and my wrist felt a bit stronger but not dramatically. So I went back the next week too (because I had insurance and loved the way the adjustments left me feeling) and she did the paraffin wax thing again and I don’t know how it worked or why but it did. I left my chiropractor that day and my wrists were like new!

I could hold anything, it was like they never hurt at all. No surgery for me, just two co-pays, some soothing experiences, and I haven’t had any pain in the last seven years.

I highly highly highly recommend trying this.


Tabby
Participant
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@ MS

?


Tabby
Participant
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wow, Lolly that’s amazing. So glad that worked for you. I go to my acupuncturist for everything, so I’ll start there for sure. Good to know there are other possible options.


Lolly
Participant
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who do you go to for acupuncture? i just went for the first time recently to pittsburgh community acupuncture.


88MS88
Participant
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Tabby, reference on FB to your Hot Topic dreads. (hugs)


Tabby
Participant
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here’s the thing MS, I’ve never watched south park so it’s all going right over my head.

lolly, I’ll PM you.


Mick
Participant
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Oh! Rough stuff.

Getting your doc to refer you to either a physical therapist or an occupational therapist coould be a good idea, if you have the insurance for it.

On my first GAP trip, I had some hand numbness. I had enough cash that I cold do a high-budget solution – I bought higher handlebars and had the shop install them while I was at a nearby diner. That worked.

If the problem is equal on both sides, it might be a problem with your neck, not with the carpal tunnel itself at all.


bikeygirl
Participant
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@Tabby: I had this problem too when I started riding, and my fingers would get quiet numb and painful. But after I got riding gloves (with cushions), and set my bike saddle higher, it all went away.

Do check your overall riding/angle wrist style. For me rising my saddle has done wonders…


88MS88
Participant
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LOL, I miss giving you grief in person D. You riding with the Flock on Nov 5th?

http://www.southparkstudios.com/clips/210820/the-south-park-society-of-vampires

Michael


Tabby
Participant
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@mick and bikey- you both are giving me somethings to think about and check. thanks. glad you were able to resolve your numbness issues.

@MS- yes, I plan to flock in november. see you then and you can make fun of me more.


88MS88
Participant
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Nah, I’ll go easy on you since you’re a wounded bird. Just try to get your CTS resolved and keep riding.

Healing vibes sent your way,

M


Lyle
Participant
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Bad: too much time in the same hand position

Good: Finding good neutral wrist positions without flexion or rotation.

You have some options up front. You might want a shorter stem or one with more rise. You might want narrower or wider bars. If you have small hands, you can get brakes with a shorter reach to the levers. You can also move the levers up or down the bars a bit, you can rotate the bars forward and back, and you can rotate the brake hoods in or out a bit. I rode for years with the hoods lined up straight and parallel to the curve in my bars before a bike fitter pointed out that I could rotate them in a bit. Duh!

I’d rather spend the money on prevention than on therapies…


ejwme
Participant
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when I get tired, I find that I rest on my hands more. When I’m fresh, I feel like I’m not on my hands at all, though I apparently have a “surprisingly agressive posture preference” (per bike fitting @ DH’s)

The only thing I’d add, aside from what everybody’s said here, are two things – braces will probably hurt more than they help, and watch what you do with your hands. By the latter, I mean that you want to stay away from trying to use the limits of your wrist positions (bent all the way forward or all the way backward) as positions of strength, and also sitting for long periods in those positions.

I had a coworker who was having carpal tunnel issues until she had an epiphany while falling asleep at night – she was tucking her hands in under her chin and bending her wrists all the way just before sleep, limiting circulation for a few hours until she moved. She stopped that habit and healed, no more issues. Not saying it’ll work for you, but it’s something to check? If you’re using your bike with your hands pushed all the way back, then operating your brakes, that could be just the wrong position for that kind of movement.

and, as always, the ever necessary Sheldon Brown link: http://sheldonbrown.com/pain.html#fingers


ejwme
Participant
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and most of the attempted content of my post was said much better by Lyle :D Thanks Lyle :D


Tabby
Participant
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nah, it’s good stuff ejwme, thanks for adding.

It seems that I have several things to look at. I think the most likely though is that the handlebars are too low. I just went out to the hall to check on my position and when I’m braking my wrists are in this completely flexed position and I can feel the pinchy-ness. In order to have my wrist more straightened out and be able to get more than 2 fingers on the brake, I have to be completely laid out. I’m just not likely to get that low riding in stop and go traffic most of the time.

+1 lyle on prevention. I’d much rather figure out what’s wrong so I can stop doing it and get better.


Lyle
Participant
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The sleeping thing is a good point. I thought I was the only one that sleeps on his hands. I’ll bet a brace might be worth using at night to prevent that, if for no other reason.

Two fingers is standard for braking. You probably shouldn’t be grabbing a whole handful of brake most of the time anyway. If you can’t brake effectively under ordinary (non-emergency) circumstances without using your entire hand, then you might need some different equipment.

Can you brake at all with your hands on the hoods (with your pinky fingers)? Or is that too hard on the wrist mechanics?


Tabby
Participant
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oh, good to know on the standard braking. I thought maybe I was putting too much strain on those 2 fingers. I will experiment on the way home to see if I can get at the brakes without having my wrist all bent or if adjustments need to be made.

I can brake on the hoods, but not as well, so I don’t rely on that for all stopping.


Ahlir
Participant
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I’ve had these problem with my hand. What helped was to concentrate on two things:

1) keep you wrist straight (ie, don’t hyperextend)

2) loosen way up on your grip (almost let you hand chatter on top of the bar)

More generally regularly take your hand of the bar and shake it out to get the blood moving.

Also, padded gloves make a big difference.


cburch
Participant
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you could also consider adding in-line cross brakes (chicken brakes) so that you can still stop while riding with your hands on the top bar. i switched stef’s single speed to bullhorns with cross brakes mounted on either side of the stem and it has made a huge difference for her.

the other thing that may help is flat bars, urban commuter style.


edmonds59
Participant
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While you’re at it check the tilt of your seat, if the nose is tilted down even slightly it can put excessive pressure on your hands. The saddle should be dead level, or the tiniest smidge tilted back, to keep from having to push back with your hands.

Also you might want to look into having those little “interrupter” levers installed on the top position of your bars, to improve that hand position.

edit, oops, cburch beat me, yes, chicken levers.


Tabby
Participant
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I never heard them called chicken levers. I may have to get them, but I’ll try all these other possible adjustments first.

I don’t think the seat is tilted. I had an old bike that I was too stretched out on and I was always pushing myself back. I remember that feeling and I’m definitely not having to do that now.

I’m going to start paying close attention to what I’m doing with my wrists. I don’t think I grip hard at all, but I think I am leaning into the handlebars sometimes, so BINGO wrist overextention.


stefb
Participant
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lolly – you probably didn’t have CTS if wrapping your wrists with some weird things helped it. it was probably whatever was done on your spine that helped. you can have hand weakness from a problem in your spine somewhere. CTS is the result of your median nerve getting pinched by the surrounding tissues. surgery isn’t a huge deal anymore. we used to do them and it usually meant a tiny little incision and a splint for 10 days.

i have dequervain’s in both of my hands. it hurts to do any thumb opposition if i have been riding my bike a whole lot.

both CTS and dequervian’s can be treated with cortisone shots. changing your hand position may help alleviate symptoms, too. using an antiinflammatory or tylenol may be helpful.


robjdlc
Participant
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I have repetitive motion stress in both of my wrists due to several years of typing/geeking//musicianing.

This little guy keeps me in check and without wrist pain or weakness: http://www.powerballs.com/

Happy to lend mine out if you wanted to try it.


AtLeastMyKidsLoveMe
Participant
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So, you’re loaning out your powerballs? (There’s a punch-line in there somewhere…)


cburch
Participant
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balls.


robjdlc
Participant
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All of you are welcome to hold my powerball in your hands.


salty
Participant
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Lance!


ejwme
Participant
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actually, I’d been having neck and hip problems, and this thread made me ponder my own sleeping posture. shoulder pain almost completely gone after trying not to curl up at night then stick my chin out… not sure what about that posture I ever thought was comfy, turns out it’s really not.

I like when I take my own advice, and then it helps me. Makes me feel like less of a nudge ;D Hope your fingers find happiness soon, Tabby.


Tabby
Participant
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@rob- I would be interested in checking out your powerball to see if that would help me out. I’m tentatively planning on flocking this friday, so if you are too that would be cool.

I’m off the bike all this week till then. I really exacerbated it this weekend and now I’m taking it easy. Doorknobs are my new nemesis.

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