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  1. #1
    Junior Member mdlynam's Avatar
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    Carpal Tunnel / Hand Pain & Numbness

    Hello;

    I have what's been rated as severe carpal tunnel syndrome (CTS) on one hand and moderate on the other. It's been a problem on the bikes (road & mountain) as the hands get numb and/or hurt. I've tried varying hand positions while on the bike and that gets temporary relief, but, well, long story short: still a problem.

    Does anyone have similar experiences? Have you been able to ride with wrist braces or support of some sort?

    I'm wary of CTS surgery for now since I've got two toddlers....I think the lifting & hand use restrictions would make life pretty difficult for a time for my wife & family.

    Anyway...would welcome to hear others' experience, work-arounds, or remedies.

    Thanks,
    Mark

  2. #2
    2nd Amendment Cyclist RichardGlover's Avatar
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    Have you had your bike professionally fit?

    Reason I ask, is that a lot of hand numbness can be attributed to poor bike fit; you end up putting more weight on your hands than you should.

    Obviously, with CTS, you're not going to completely eliminate your hand pain, but getting a good fit on your bike would be the first thing I did.
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  3. #3
    Senior Member meanwhile's Avatar
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    Braces have a poor - perhaps even negative - record for RSI treatment. In a choice between risking riding with braces and giving up riding, I'dd give up. RSI can ruin your life.

    However, there is a lot you can do:

    - Flat bars are almost designed to compress the carpals. Fit Ergon grips and your flat bar will be much better.

    - The best position for your drop bar bike is on the hoods with your wrist neutrally aligned. Clydes are often riding bars that are too narrow for them: buy bars that have your wrists at least as wide as your shoulders when you are on the hoods. Nitto Noodles and Salsa Bell Laps come in extra wide.

    - Consider putting a shorter and higher stem on each bike.

    The key to everything is getting your carpal bones aligned so that the carpal tunnel isn't compressed and keeping your neck in a natural
    position.

    Be wary of professional bike fittings. Many aren't very professional, and many of the rest are focussed on getting an efficient racing position at the cost of overall stress to the body. Find someone who knows how to fit touring bikes if you are going to do this.

    Obviously, wear gloves and fit some kind of padding to the drops - eg Fizik Bar Gel. And most people think that Campag and SRAM hoods are much cushier than Shimano's.

  4. #4
    Junior Member mdlynam's Avatar
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    Thanks guys.... yeah, I learned the hard way on the bike fitting. The experiences (2) I've had with reputable fitters in the Nashville area were, well, educational. They're experience base was mostly for efficiency, not comfort. I'll see about finding someone with touring bike fitting experience.

    I'll look into the Ergon grips on the flat bar bike. The road bike is a Specialized Sequoia...as road bikes go, a pretty ergo-friendly set-up....more upright that the previous road bike, with more weight distributed to the saddle than the arms & hands. I'll also see about additional padding on the bars (and looking into the Nitto Bars) & hoods. That sounds like good advice!

  5. #5
    Come here often? <wink> exile's Avatar
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    You also may be gripping the bars to tightly and not noticing it. Try to be cognizant of how tightly you are gripping the bars. It should be a light touch for most situations while riding.

    Try different types of gloves if you go that route. Some may exacerbate the problem with padding that is to thick or thin, or possibly in the wrong places.

    I have ergon grips on my hardtail and love them. They help keep the wrist in a neutral position and are overall more comfortable.
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  6. #6
    Senior Member late's Avatar
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    When you ride, you should be using your back to support your weight.
    Everyone leans on the bars a bit, but it sounds like you
    are simply relaxing and letting your hands take a pounding.

    Because we are so heavy, you need to strengthen the back and core so
    you don't have to put all your weight on your hands.

    You can look up and try various core exercises ( sit ups and crunches are too old school).
    For the back, you could do some hyperextensions on an exercise ball (or a hyperextension
    station at a gym).

    Or deadlifts. You really should have someone teach you how to do a straight leg deadlift
    (and the standard version) properly. It's quite easy to injure yourself if you do it wrong.

    But there is really nothing better for strengthening the back.

    The big trick is to keep your head up and never, ever slouch. When you get tired, that
    can happen.

    As to the CTS, start learning about inflammation. A variety of things like Omega 3 help control inflammation.
    But you should go on a anti-inflammatory diet for a month.

    This is non-controversial stuff, it WORKS. It's also perfectly safe.
    No one talks about it because it's brutally hard.

    What you do is eliminate everything inflammatory. Which is to say, anything
    you actually want to eat. No sugar, coffee, alcohol, high glycemic foods, fatty foods,
    and meat.

    A small (no more than a single piece of whole grain bread (REAL whole grain, not the store crap) or an equivalent amount (about a cup) of brown rice, etc.
    That's for the whole day.

    Lots and lots of green stuff. Fruit is low glycemic only.

    Breakfast and dinner have a 4 oz portion of fish. Usually salmon but since you will be taking
    an Omega 3 pill at breakfast and dinner, any fish will do.

    Lunch should have some protein, but not more than a 4 oz serving. Unsweetened yogurt with fruit, as an example.
    It's a good time to savor that generous serving of grain (sorry).

    If you do that for a month I promise you that you will look and feel 10 years younger, and that your CTS will be half to three quarters gone.

    Really.

    My personal record on that diet is just under 2 weeks. It ain't easy, but it is flat out amazing.
    We are as gods, we might as well get good at it.
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  7. #7
    Senior Member
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    I found myself experiencing wrist pain and hand numbness on my flat-bar mountain bike. I found that a bar with more "sweep" put my hands in a more neutral position and eliminated the problem. I ended up using a set of Bontrager Race Lite handlebars with 17-degree sweep. Psycle Store also has some bars (Fubar, Fu2bar, Nubar) with varying degrees of sweep and there are quite a few other options (e.g. On-One's Mary handlebar).

  8. #8
    Senior Member late's Avatar
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    We are as gods, we might as well get good at it.
    Stewart Brand

  9. #9
    Senior Member meanwhile's Avatar
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    Quote Originally Posted by late View Post
    When you ride, you should be using your back to support your weight.
    Everyone leans on the bars a bit, but it sounds like you
    are simply relaxing and letting your hands take a pounding.
    Absolutely untrue. And not even possible. If you're going to ride most bikes - especially drop bars - then a good amount of weight will be on your hands. And RSI is rarely the result of weight on the hands; this is almost certainly a carpal tunnel compression problem due to wrist-hand position and angle. (I'm not a doctor, but I do have quite a bit of ergonomics training.)


    You can look up and try various core exercises ( sit ups and crunches are too old school).
    For the back, you could do some hyperextensions on an exercise ball (or a hyperextension
    station at a gym).
    This is superstition. People don't put weight on computer mice and the little beggars are RSI-machines! Carpal tunnel compression requires no weight at all on the hands to occur. Once again: wrist angle is everything. (There are other forms of RSI, but there's no reason to suspect them.)
    Last edited by meanwhile; 03-12-11 at 05:28 PM.

  10. #10
    Senior Member meanwhile's Avatar
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    Quote Originally Posted by sstorkel View Post
    I found myself experiencing wrist pain and hand numbness on my flat-bar mountain bike. I found that a bar with more "sweep" put my hands in a more neutral position and eliminated the problem. I ended up using a set of Bontrager Race Lite handlebars with 17-degree sweep. Psycle Store also has some bars (Fubar, Fu2bar, Nubar) with varying degrees of sweep and there are quite a few other options (e.g. On-One's Mary handlebar).
    Excellent suggestion. Moustache bars are said to work well for this too. The OP needs to google some on carpal tunnel compression so that he can recognize when it is occurring, then choose bars that avoid the problem.

  11. #11
    Senior Member cod.peace's Avatar
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    Quote Originally Posted by mdlynam View Post
    Hello;

    I have what's been rated as severe carpal tunnel syndrome (CTS) on one hand and moderate on the other. It's been a problem on the bikes (road & mountain) as the hands get numb and/or hurt. I've tried varying hand positions while on the bike and that gets temporary relief, but, well, long story short: still a problem.

    Does anyone have similar experiences? Have you been able to ride with wrist braces or support of some sort?
    I first bought a bike in 2008, a nice used Trek 520. Riding was great fun but wrist/arm pain quickly became a major issue. I'd struggled with pain from keyboard and mouse use for years. After messing with bike fit and padded gloves one 10 mile ride finally left me with a crippled right arm for two weeks. I was diagnosed with mild carpal tunnel in the right arm and ulnar nerve problems in the left - the bike was simply exacerbating the existing problems.

    I considered swapping in some new handlebars for a really upright seating position, getting a pro bike fit, etc etc. After contemplating the idea of throwing money at the problem I said screw this, sold the Trek, bought a recumbent, and now ride 100% pain free. My advice to you: your problem is much worse than mine was so quit screwing around and get your weight off of your injured hands before you really screw yourself up. For absolute maximum hand comfort you can even get underseat steering setups. Highracer style 'bents are paceline compatible if that's something you're into.

    If you don't want to go full recumbent there are numerous crank forward designs that will probably do the job - Trek Pure, Electra Townie, Giant Suede type bikes. Rans (www.ransbikes.com) makes a line of crank forward bikes that are higher end than those, including their new Alterra bike that gets you pretty close to a road bike with far less weight on your hands.
    old steel Specialized Hardrock

  12. #12
    Senior Member Homeyba's Avatar
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    Quote Originally Posted by mdlynam View Post
    Thanks guys.... yeah, I learned the hard way on the bike fitting. The experiences (2) I've had with reputable fitters in the Nashville area were, well, educational. They're experience base was mostly for efficiency, not comfort. I'll see about finding someone with touring bike fitting experience...
    My opinion on bike fitters is that it they should be fitting you in the position that is going to be most comfortable for you. If you were upfront and told them about your carpal tunnel they should fit you accordingly. If you get fitted and there is still a problem you should go back and make them do it right. That's what you are paying for!!!! If they can't fit you so you are not in pain then you should get your money back.

    I have carpal tunnel really bad. It's not a problem for me on the bike because I am fitted properly. I also use aerobars quite a bit so that I can ride without any pressure on my hands at all. I lot of long distance riders use them for that vary reason alone.
    It doesn't get harder, you just go slower.

  13. #13
    Senior Member meanwhile's Avatar
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    Quote Originally Posted by Homeyba View Post
    My opinion on bike fitters is that it they should be fitting you in the position that is going to be most comfortable for you. If you were upfront and told them about your carpal tunnel they should fit you accordingly.
    You over-estimate their capacities. Bike fitters don't have physiology or ergonomic degrees; they're not trained to fit people with medical problems. They're bike store staff who have been trained to interpret a set of tables aimed at fitting a typical roadie to his bike. If you found an exception then you were very lucky!

    cod.peace's suggestion would almost certainly work, although you might want to try those bar adjustments first.

  14. #14
    Senior Member Homeyba's Avatar
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    I don't think so. You're paying for a service. If you are not happy with your service you should get your money back. That's pretty simple. If you state your issues up front and the fitter does not have the ability to do the job they should decline the job or return your money. I do agree that there are a lot of "fitters" who don't know what they are doing or are doing it with very little or no training but it's the same thing with everything we buy. You as a consumer have to do some due-diligence first and ask a few questions to make sure that your "fitter" has has the training to do the job right.
    It doesn't get harder, you just go slower.

  15. #15
    Senior Member meanwhile's Avatar
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    Quote Originally Posted by Homeyba View Post
    I don't think so. You're paying for a service. If you are not happy with your service you should get your money back. That's pretty simple. If you state your issues up front and the fitter does not have the ability to do the job they should decline the job or return your money.
    Getting your money back is a different issue. But insisting that a bike fitter who has been trained to fit racers to their bikes deal with your carpal tunnel syndrome isn't going to work - he won't know where to start and his training will often take him in the wrong direction.

  16. #16
    Senior Member Homeyba's Avatar
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    Another option is to go to your Orth and have them make you an appointment with a Physical Therapist who is also a cyclist. Many of them use cycling as a form of therapy and know how to fit you on your bike properly.
    It doesn't get harder, you just go slower.

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    Try raising the nose of your saddle. it probably won't take much. You are probably pushing with your hands to keep your butt in the saddle.
    Try to keep the back of your hands in plane with your forearms when gripping the bars.
    Whether you think you can, or think you can't, you're probably right

  18. #18
    Humvee of bikes =Worksman Nightshade's Avatar
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    When you ride, you should be using your back to support your weight.
    Everyone leans on the bars a bit, but it sounds like you
    are simply relaxing and letting your hands take a pounding.
    I read complaints about hand pain/problems and wonder did these people just crawl out from under a rock on the moon? I also wonder if these people are so in love with drops that they would rather drink urine than look at a more upright posture?

    The answer is so obvious I can't believe I have to tell a grown person what it is........
    JUNK the drops and the racing saddle to replace them with north roads bars and Brooks made for upright riding.

    The world is full of racer boys so they won't miss you.
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  19. #19
    Senior Member Wogster's Avatar
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    Quote Originally Posted by Nightshade View Post
    I read complaints about hand pain/problems and wonder did these people just crawl out from under a rock on the moon? I also wonder if these people are so in love with drops that they would rather drink urine than look at a more upright posture?

    The answer is so obvious I can't believe I have to tell a grown person what it is........
    JUNK the drops and the racing saddle to replace them with north roads bars and Brooks made for upright riding.

    The world is full of racer boys so they won't miss you.
    Drops are actually not the problem, it's the distance between the saddle, and the normal riding position on drops. See racers, typically want the bars quite a bit below the saddle, you can see racing bikes that are set up with the bars practically at the level of the top bearing in the headset and the saddle set as high as it will go. The idea is the flat back, or the position where the shoulders are lower then the hips. This pushes a lot of weight forward. If you look at a properly set up touring bike, the bars are even with, or above the saddle, this pushes the riders weight back, so that more of the weight is on the saddle and pedals, rather then on the bars.

    This is one area where older may be better, modern bikes with threadless headsets the steerer is extended through the top of the head tube, then cut off at the required height, then the stem attached, the problem is that bike shops will usually cut the steerer off at the lowest possible point, meaning the only way to fix the problem is either an extender or properly replace the steerer, some steerers can be replaced, some can't. If buying a new bike, you want fitted, ask the shop to leave the steerer as long as possible and to fit spacers under it, makes the most sense. Older quill style stems can be replaced with longer stems, and there are a few longer ones out there, Nitto made some really long ones, I think they still do.

  20. #20
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    Quote Originally Posted by meanwhile View Post
    Getting your money back is a different issue. But insisting that a bike fitter who has been trained to fit racers to their bikes deal with your carpal tunnel syndrome isn't going to work - he won't know where to start and his training will often take him in the wrong direction.
    A fitter who only knows how to fit road racers to race bikes generally doesn't stay in business very long.

    The fitter I used spent 15-20 minutes asking me about the bikes I owned and the types of riding I did. She then spent about 1.5 hours fitting me to my primary road bike, suggested how the fit should change for my touring bike, and instructed me to return after a week if I didn't think the fit was perfect. The tweaks to my position were minor, but they did solve the niggling problems I was having with knee, foot, and neck pain. Of course, this sort of time-intensive process isn't what you're going to get if you pay $50-75 for a "fit" at your LBS...

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    I have a similar problem to the OP, but I don't suffer from carpal tunnel syndrome. I have been trying to ride a Giant TCX cyclo-x bike for a couple years and have been mostly hating it. I went from a flat-bar bike because I wanted more hand positions, hopefully allowing me to put more miles on the bike. After about 45 minutes or so, my hands were so sore, I could hardly stand it anymore. I recently went for a proper fitting and learned quite a lot. The cheap OEM saddle that came on the bike wasn't providing proper support, leading to me sliding into the bars. The response was to push back against the bars, causing my hand pain. I better quality saddle helped with that. I also found that a lack of flexibility in my lower back made it necessary for me to lift the bars a bit so I wasn't putting so much strain on myself. We had to add a steering tube extension and a stem with more rise to get it in a better position. The fitting and adjustments seem to have helped as I can easily ride an hour now without pain.

    My question with regards to this comes now from the type of bike I should really be riding. Am I better off riding a touring bike than my cyclo-x? I guess my thoughts are about the added height to the steerer tube / stem on the cyclo-x versus a touring bike that has that added length in the headtube of the frame. I kind of compare it to owning a Honda Civic and trying to add a bunch of cargo area to it when maybe I should have bought a station wagon in the first place. I hope my question makes sense.

  22. #22
    Senior Member Homeyba's Avatar
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    Quote Originally Posted by D-Fuzz View Post
    ...
    My question with regards to this comes now from the type of bike I should really be riding...
    That's easy, the bike that fits you. What did your fitter steer you towards? Why confine yourself to a touring bike or cyclo-x bike? You can probably be fitted quite comfortably on just about any road bike. The thing you have to watch out for is that most LBS's lop the steerer off at the lowest possible point (for looks) leaving you with handle bars you cannot raise or lower without a funky stem or stem adapter. If you buy a new bike you can make sure the LBS doesn't cut the stem off, then you can have the bars pretty much where you want them.
    It doesn't get harder, you just go slower.

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    Quote Originally Posted by Homeyba View Post
    That's easy, the bike that fits you. What did your fitter steer you towards? Why confine yourself to a touring bike or cyclo-x bike? You can probably be fitted quite comfortably on just about any road bike. The thing you have to watch out for is that most LBS's lop the steerer off at the lowest possible point (for looks) leaving you with handle bars you cannot raise or lower without a funky stem or stem adapter. If you buy a new bike you can make sure the LBS doesn't cut the stem off, then you can have the bars pretty much where you want them.
    He hasn't tried to steer me towards anything as of yet. He said he wants to see if we can make the bike I have work before we start looking at something different. I just don't want to end up riding a circus bike just for the sake of making it fit. Are frame geometries different enough between a cyclo-x and a touring bike to be worth while looking? I know a full-on road bike is out of the question as and have to remove a couple vertabrae to get down to the bars, but is a touring bike more relaxed than what I have?

  24. #24
    Senior Member meanwhile's Avatar
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    Quote Originally Posted by Mr Danw View Post
    Try raising the nose of your saddle. it probably won't take much. You are probably pushing with your hands to keep your butt in the saddle.
    Sure. Who cares if you get an erectile dysfunction if you can't use your hands anyway???

    Honestly, this is NOT good advice... Saddles are problematic enough without trying to use them to bodge bike fit this way.
    Last edited by meanwhile; 03-15-11 at 04:59 AM.

  25. #25
    Senior Member meanwhile's Avatar
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    Quote Originally Posted by D-Fuzz View Post
    He hasn't tried to steer me towards anything as of yet. He said he wants to see if we can make the bike I have work before we start looking at something different. I just don't want to end up riding a circus bike just for the sake of making it fit. Are frame geometries different enough between a cyclo-x and a touring bike to be worth while looking? I know a full-on road bike is out of the question as and have to remove a couple vertabrae to get down to the bars, but is a touring bike more relaxed than what I have?
    Frame geometries vary with the model of crosser you look at. Obviously you want one of the less stretched out ones! More importantly, you'd then want to put a short and high angle stem on it - often the best way to do this is to look for an invertible time trial stem designed to put you in a super low position when NOT inverted. (I just bought a stem like this to put me in a more upright position on a crosser I use for singletracking.) These guys will give you a 55 degree stem angle:

    http://www.planet-x-bikes.co.uk/i/q/...x-cammish-stem

    Ok, two things are now very important to understand -

    1. As you move to be more upright on a bike your spine becomes more vulnerable to shocks transmitted through the rear wheel, because the vertebrae are stacked on top of each other tightly. This is one reason why using a crosser rather than a road bike is a good idea - the crosser can take fatter tyres which will soften the shock

    2. The key to solving CTS is to get your wrists at the correct angle as much as to take pressure off them. The angle on properly fitted drops - the hoods should be at least as far apart as your shoulders - is excellent. For this reason, if a crosser with a high stem doesn't work for you, then do NOT ride an upright bike with conventional flat bars! Follow the excellent suggestions other posters have made about alternative bars and the semi-recumbent bike. Hmm. Come to think of it, if a crosser with drops doesn't work for you, then moustache bars on the same bike might work:

    http://www.stanford.edu/~dru/moustache.html

    Regretably, whatever you do, you will have to experiment. So buying a used crosser, if you want to stay on drops, is probably a good idea. Even better, start by putting a short and high stem on your current bike and see how it feels. If it isn't at least approaching what you need, consider skipping straight to an upright bike with non-standard bars.

    Oh - and of all the drops I know, Salsa Bell Laps probably give you the highest position while in sane adjustment. They're wide too, and have a small amount of flare.

    Good luck!

    PS This thread shows how much experiment can be needed - what fixes a problem for one rider can cause a problem for another:

    http://forums.mtbr.com/showthread.php?t=287222

    So experiment - and be ruthless about stopping quickly if you experience pain or numbness.
    Last edited by meanwhile; 03-15-11 at 05:05 AM.

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