Help with hand pain (nerve?)



TrailTramp

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May 22, 2023
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Long time lurker here, first time poster.

I hereby summon the Sages.

I need your advice on a hand injury, maybe you've experienced a similar situation, or know someone/read about it. I'll really appreciate any leads on the diagnose, the right professional to approach, tests, etc.

For the past week I've been suffering from pain in my right hand. It started while cycling up a mountain trail (light gravel), as a shooting pain starting in the bottom of my wrist (center) and going right to my thumb/index/middle fingers (I suspect nerve-related as it shoots up like through a pipeline). It was triggered by weight/pressure/effort on my hand, as soon as I was on the hoods or hit the brakes, it would kick in (9/10 pain). If pain wasn't triggered, there was a constant pain in a specific spot (middle of the union between the wrist and the forearm) but at a lower intensity (3/10). I aborted the ride and at one point on my walk home, all my fingertips went numb (I can't pinpoint what triggered it), it stayed like that for 5-10 min and then it went away (haven't had numbness since). While off the bike, weight, pressure and effort on the right hand triggered the pain. One week after the incident, pain hasn't gone away, though triggering sensitivity has decreased.

I'm 38, 100kg, I've been cycling for 10-15 years now, but long-ish distances (40-70km) for only the past year, and I had wrist pain in the past year on those long rides (numbness), but they went away after a bike fit setup optimization. There was no gradual pain leading to last weak.

Post bike fit, I did mess with the hood position and I'm probably throwing my weight on my hands as I haven't been using my core; both could be our main suspects, I guess ;)

I'd like to get a diagnose to figure out what the damage is and what the recovery options are, and then back to a bike fit (no messin' around this time) and training to have the right position on the bike.

I live in Quebec, Canada, and while (most) health care is public, waiting times are insane and getting referrals from a GP are a pain. Unless I want to spend 3-4 months to get all the correct forms and authorizations, I really need to know the full roadmap to the right test/specialist by the time I meet my GP.

Any leads on what this thing could be?
Focalized tests? (EMG/Ultrasound/MRI?)
Does this sound like I'd need to check the spine? Other areas?
Would diagnose for this be something for a neurologist to assess? Physiatrist? Other?
 
" Unless I want to spend 3-4 months to get all the correct forms and authorizations, I really need to know the full roadmap to the right test/specialist by the time I meet my GP."

That short of time would be easy- peasy . Hands are complicated and something I dealt with many decade , particularly CTS. From UIT many years impact tools Had to give up stringed instruments . So play piano now .

Oh, this is a bike forum . So right away I'd say get hand specific nerve conduction tests. A doc who does CTS release might be that right person . Perhaps the neurologist as well.

The hands issue was just one of the many reasons my new sled was not outfitted with Di2.
I've got to baby them hands , every movement must be careful. Not a whole lot of sensation there.
If I can see it I can do it...

But thats just me , have no doctorate . Just a lot of suffering , some of it needless.
I'd consider hand symptoms can often be issues in the cervical vertebra . A brainstem malformation can cause breach of the skull and and myriad of neurological symptoms .

So throw in an MRI or two. And good luck .
 
To save the pain of ID of the acronyms that would be Carpal Tunnel Syndrome and the might still call it Accumulative Impact Trauma but I think these days might be called repetitive motion injury
 
Post bike fit, I did mess with the hood position and I'm probably throwing my weight on my hands as I haven't been using my core; both could be our main suspects, I guess ;)

I developed pain on my right wrist joint. Not exactly the hand but close. It was caused by three things, poor quality roads, bad dropbar angle, and insufficient use of core.

The poor quality roads could never be fixed and to deal with it, I adjusted the dropbar to an angle that gave the least wrist angle while riding. I also wrapped extra layers of tape on the dropbar, particularly on the dropbar ends and tops to help deal with poor quality roads. It helped a lot.

And finally, I trained to pedal pushing big gears instead of spinning easy gears. Riding hard, big gears (doesn't really matter if you mash or spin it, as long as it's hard and big - no pun intended!) This style of riding will naturally recruit your core muscles to a greater magnitude IF you're also recruiting your glutes and hamstrings on the downstroke. It's actually quite difficult to get this right if you never did it while cycling. You may need to do special workouts off the bike to get this right.

Simply tensing your core muscles to unload your arms may only cause you to waste energy. It would much better if you're actually using the core muscles in such a way that it's also recruited to power the downstroke to help delay leg fatigue and maximize endurance. It's the same technique many, if not most elite TdF racers use from the classical era to the modern era with clipless pedals and the technique works just as well with flat pedals without any foot retention.

I still have some pain on my right wrist but it's no longer getting worse but in the process of healing! Also, try to loose weight if possible.
 
Long time lurker here, first time poster.

I hereby summon the Sages.

I need your advice on a hand injury, maybe you've experienced a similar situation, or know someone/read about it. I'll really appreciate any leads on the diagnose, the right professional to approach, tests, etc.

For the past week I've been suffering from pain in my right hand. It started while cycling up a mountain trail (light gravel), as a shooting pain starting in the bottom of my wrist (center) and going right to my thumb/index/middle fingers (I suspect nerve-related as it shoots up like through a pipeline). It was triggered by weight/pressure/effort on my hand, as soon as I was on the hoods or hit the brakes, it would kick in (9/10 pain). If pain wasn't triggered, there was a constant pain in a specific spot (middle of the union between the wrist and the forearm) but at a lower intensity (3/10). I aborted the ride and at one point on my walk home, all my fingertips went numb (I can't pinpoint what triggered it), it stayed like that for 5-10 min and then it went away (haven't had numbness since). While off the bike, weight, pressure and effort on the right hand triggered the pain. One week after the incident, pain hasn't gone away, though triggering sensitivity has decreased.

I'm 38, 100kg, I've been cycling for 10-15 years now, but long-ish distances (40-70km) for only the past year, and I had wrist pain in the past year on those long rides (numbness), but they went away after a bike fit setup optimization. There was no gradual pain leading to last weak.

Post bike fit, I did mess with the hood position and I'm probably throwing my weight on my hands as I haven't been using my core; both could be our main suspects, I guess ;)

I'd like to get a diagnose to figure out what the damage is and what the recovery options are, and then back to a bike fit (no messin' around this time) and training to have the right position on the bike.

I live in Quebec, Canada, and while (most) health care is public, waiting times are insane and getting referrals from a GP are a pain. Unless I want to spend 3-4 months to get all the correct forms and authorizations, I really need to know the full roadmap to the right test/specialist by the time I meet my GP.

Any leads on what this thing could be?
Focalized tests? (EMG/Ultrasound/MRI?)
Does this sound like I'd need to check the spine? Other areas?
Would diagnose for this be something for a neurologist to assess? Physiatrist? Other?

Might be some sort of tendon issue(i.e same as people who run with bad shoes have in their ankles. Those are fixed with proper mens running footwear at least, not sure about hand).
By the sound of it sounds like carpal syndrome to me, but might be some pinching/inflamation of the nerve in your wrist. Does it go higher to your elbow?

I've had carpal in my left wrist from playing drums for like 10 years without proper form+bike riding on top and desk job. It's not the end of the world if treated right so here's that :D
Back when I got diagnosed I think they did ultrasound and X-ray, so here's that regarding your question. I'd check elbow too just incase 'cause that's where a lot of people get issues too. Might be some sort of tendon issue too, especially if it's wrist.
 
I'm not a medical professional, but based on the symptoms you described, it's possible that you may have injured a nerve or developed a condition like carpal tunnel syndrome or cubital tunnel syndrome. However, it's important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment options. Here are some general suggestions to consider:
  1. Consult with a healthcare provider: While you mentioned the waiting times and referral process can be challenging, it's important to see a medical professional to get a proper diagnosis. You could start by scheduling an appointment with your primary care physician (GP) and explaining your symptoms.
  2. Specialists to consider: Depending on the initial evaluation, your GP might refer you to a specialist such as a neurologist, orthopedic surgeon, or physiatrist (a physician specializing in physical medicine and rehabilitation). These specialists can help assess nerve-related issues or musculoskeletal problems.
  3. Diagnostic tests: The specific tests needed would be determined by the healthcare professional, but they might include electromyography (EMG), nerve conduction studies, ultrasound, or possibly an MRI to evaluate the affected area and determine the extent of the injury.
  4. Bike fit and ergonomics: As you mentioned, it's crucial to ensure proper bike fit and ergonomics to prevent further injury. Once you have a diagnosis and treatment plan, you can discuss this with your healthcare provider and consider consulting a professional bike fitter or physical therapist specializing in cycling injuries. They can help optimize your bike setup and provide advice on posture, technique, and strengthening exercises to prevent future issues.
Remember, it's important to consult with a healthcare professional who can evaluate your specific situation and provide appropriate guidance. They will have the expertise to diagnose your condition accurately and recommend the most suitable treatment options for you.
 
Hey there,

I'm not a medical expert, but it sounds like you could be dealing with some nerve-related issues. Rather than relying on guesswork, I'd highly recommend consulting with a healthcare professional. Waiting times can be a pain, I know, but it's crucial to get an accurate diagnosis. Start by booking an appointment with your primary care physician. They should be able to guide you in the right direction.

Take care,
TrailTracker
 
Ah, the life of a cyclist! I've seen it all, from broken bones to banged-up bodies. While I can't diagnose you, I can certainly share some insights from my years of following the sport. Nerve issues in cyclists are not uncommon, especially with the repetitive motion and pressure on the hands. It could be something as simple as handlebar palsy, or even more complex like carpal tunnel syndrome.

Now, I'm not a doctor, but I've seen enough cycling injuries to know that it's important to get it checked out by a professional. I'd recommend starting with a general practitioner, but don't be surprised if they refer you to a neurologist or a hand specialist. They might want to run some tests, like an EMG or a nerve conduction study, to get a better understanding of what's going on.

And hey, while you're at it, maybe consider investing in some ergonomic handlebars or gloves. They might not cure your injury, but they can certainly help prevent future ones. Just remember, it's always better to be safe than sorry. Happy cycling, and I hope you find the solution to your hand pain soon!
 
Sorry to hear about your hand injury. I've had my fair share of mishaps on the trail, but nothing quite like that. Nerve issues can be tricky, and it's great you're seeking advice. I'd recommend consulting a sports medicine specialist or a hand/nerve specialist. They might suggest nerve conduction studies or an MRI to get a better understanding of the issue. In the meantime, try to rest your hand and avoid activities that exacerbate the pain. Stay strong, and I hope you find the help you need. Keep us posted on your progress! :)
 
I'm no doctor, but I've had hand issues from cycling. Consider seeing a hand specialist and getting a nerve conduction study. Good luck.
 
Sorry to hear about your injury. Have you considered seeing a sports medicine specialist or a hand therapist? They could diagnose and suggest appropriate treatments. Keep us posted on your progress! :)
 
Consider consulting a sports medicine specialist or a hand therapist to address your injury. They possess the expertise to diagnose your condition accurately and recommend suitable treatments. It's crucial to prioritize your recovery and keep us updated on your progress. Remember, taking care of our bodies is essential, especially in activities like cycling. Have you explored any alternative therapies or exercises that could aid in your rehabilitation? ‍♀️
 
Have you considered incorporating yoga or pilates into your rehab plan? Cyclists often overlook the benefits of flexibility and core strength, but they can significantly improve pedaling efficiency and reduce the risk of injury. Moreover, techniques like Graston or Active Release Therapy (ART) could potentially break up scar tissue and adhesions in the affected area. It's essential to remember that recovery is a multi-faceted process, and a comprehensive approach might yield better results. Delving into various alternative therapies may not only accelerate healing but also bring about a newfound appreciation for your body's capabilities. ‍♀️♀️♀️

For further reading, I suggest exploring the following resources:

* (https://www.bicycling.com/training/advanced-techniques/yoga-for-cyclists) - Yoga for Cyclists: 5 Poses to Improve Performance and Prevent Injuries
* (https://www.activerelease.com/what-is-ART.asp) - What is ART®?
* (https://www.pelotonmagazine.com/sections/training/strength-training-for-cyclists/) - Strength Training for Cyclists: A Comprehensive Guide
 
Building on the previous post, I'd like to emphasize the value of incorporating yoga and Pilates into a cyclist's rehab plan. Both disciplines focus on flexibility, core strength, and balance, which are crucial for cyclists. Yoga, in particular, can help counteract the forward-leaning posture on the bike, reducing the risk of overuse injuries.

Moreover, exploring alternative therapies like Graston or Active Release Therapy (ART) can indeed be beneficial in breaking up scar tissue and adhesions. These techniques can potentially enhance range of motion and alleviate pain, further supporting recovery.

Lastly, I'd like to highlight the significance of strength training for cyclists, as it can significantly improve pedaling efficiency and power output. Compound movements like squats, deadlifts, and lunges can help build a strong foundation, while isolated exercises can target specific muscle imbalances.

Incorporating these elements into a comprehensive rehab plan can lead to improved performance, reduced risk of injury, and a deeper understanding of one's body capabilities. ‍♂️♀️️‍♂️
 

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