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This leads to an even higher load on Guyon’s canal in the wrist or in the carpal tunnel. Especially when cycling downhill, a large part of the body weight is supported by the hands-on the corner of the handlebar. This pressure of holding the handlebar in combination with vibrations from the road or trails can be enough to damage the nerve due to compression. The position of the hands while holding the handlebar puts pressure on the nerves in the wrist.
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From there, it is divided into recurrent muscular branch and digital cutaneous branch, supplying the thumb, part of flexor pollicis brevis and skin of region shown thumb and digits 2,3 and half of 4.Įpidemiology/Etiology Ĭyclist's palsy typically develops during long-distance or prolonged cycling and occurs with both mountain bike and road cyclists. The median nerve enters the hand through the carpal tunnel, deep to the flexor retinaculum along with the tendons of flexor digitorum superficialis, flexor digitorum profundus, and flexor pollicis longus. In the cyclist, it is at or just before Guyon’s Canal where compressive injury to the ulnar nerve most commonly occurs. Either within or just beyond Guyon's Canal, the ulnar nerve divides again in two motor branches. This tight tunnel is formed between the hamate, the pisiform, and the piso-hamate ligament which helps keep these carpal bones together. At the wrist, the ulnar nerve enters the hand by passing through Guyon’s Canal. The nerve gives off two sensory branches which supplies sensation to the dorsomedial hand, the 5th digit, and half the 4th digit. The ulnar nerve is a branch of the medial cord of the brachial plexus, which travels distally along the medial side of the arm. The prevalence of hand and wrist non-traumatic ulnar or median nerve compression described in the literature (manifesting itself in sensory or motor disturbance) ranges from 10% to 70%.Ĭlinically Relevant Anatomy This means that patient records are not always available. It is difficult to determine the exact incidence rate for these 2 types of non-traumatic overuse injury, as individuals often consider this injury not severe enough to seek medical care. The area then becomes inflamed and narrowed, compressing the structures and it can cause pain, tingling or weakness in the thumb, fingers, and hand. Carpal tunnel syndrome (CTS), which is an overuse injury, occurs when the median nerve on the palm side of the wrist is compressed affecting the median nerve and flexor tendons of the fingers passing through the carpal tunnel. The carpel tunnel (a compact region at the wrist) is surrounded by the carpal bones on the dorsum of the wrist and tough connective tissue on the ventral aspect. The video below gives a good summary of Cyclist's HandĬompression of the median nerve – which causes tingling in the thumb, index, middle and ring finger – is called carpal tunnel syndrome.
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Pain and/or tingling and numbness can occur in various locations such as: the wrist the ulnar side of the hand the thumb side of the hand. (See also cyclist's back, cyclist's neck, cyclist's knee) Hand pain can become an issue, one study reporting that 31% of cyclists experienced some form of overuse hand pain. However, it can take its toll on the body with inadequate or over-training, poor cycling posture or an incorrect bike fit.