DaveLeeNC

I have recently developed a most inconvenient problem. Suddenly (no known 'event' associated with this) shifting to a lower gear (2014 Campy Chorus mechanical gearing) creates 'not ignorable' discomfort in my right wrist. The action causing this (obviously) is the 2-3 outside fingers on my right hand pushing inward when the hand is in a 'weak position' (wrist pointing mostly down when the forearm is pointing mostly horizontal). The pain is focused "kind of shallow" just below that knobby bone on the outside of your wrist where the wrist joins the forearm. This would seem to be a tendon thing, I am guessing.

When I ride it feels OK for 10 to 15 minutes and then the pain starts. I do lots of rear cog shifting as I ride in very rolling countryside. A few days of rest and ice does not seem to solve the problem, so now I am half way through a 10 day period of rest and ice. I will then contact a doctor if there is no improvement. But I thought I would would troll for other opinions/experiences here while I wait.

BTW, this pain does not show up in other 'normal' activities and that would include golf, surprisingly.

Thanks.

dave

joejack951

Talk to a physical therapist. A good one who understands that focused therapy can result in improvement even if it's slow. And one that understands that surgery is generally not the answer.

datlas 

Sounds like a good excuse to upgrade to electronic shifting!

Campag4life

Aside from switching to electronic shifting as datlas suggested, I too ride Campy Chorus with no such infirmity. Oh, I have other physical challenges, just not that one.

It maybe an ergonomic issue. For best help, you need to post your shifter position on the handlebar..how you have it located relative to vertical. This affects hand leverage.

Also, explain which lever...you said shifting to lower gears so I assume you mean the lever behind the brake lever.
How do you implement the shift? Should be with the index finger, i.e the trigger finger next to the outer fingers you reference.

That would be a start. Also shifting multiple gears with a single lever push will tax the hand more. Keep in mind, some guys ride fixies and single speeds. Yes, we tend to want to dial in our cadence and pedal force precisely for a given effort but some guys shift more than others.

Posting a pic or two will tell us a bit more...if you can with your hand also in position about to effectuate a shift.

DaveLeeNC

Electronic shifting has occurred to me (re: datlas). But it really isn't where I want to spend my money at the moment, although I could make this choice without a serious alternation in my life.

What is a bit disturbing to me is that this happened during a period of much reducing riding (other factors). There was no 'big ride' or 'lots of riding' or 'an event that I recall' associated with this. Something is injured here, and if it heals then outta' my mind. If not then I'd like to understand it. I'm having other wrist issues (that don't present themselves on a bike), so this one is more important than it might be otherwise as I really need to understand just how bad my wrists are here.

My shifting tends toward 2nd finger (next to index). My shifters look about vertical (as best as I can determine what vertical is on a Campy 'curvey shifter'). I have done a ton of riding like this without an issue, so I am concerned that this is yet another arrow in the quiver of my arthritic wrists (and knees and shoulders and ..... ).

dave

Campag4life

What I would suggest is...and I am not a wrist doctor is...try shifting the lever behind the brake with your index finger as I suggested. A shift is executed not with a index finger push but rather with tension in the index finger and a 'hand rotation'. I believe you are stressing the ligaments and nerves within the wrist tunnel by the way you are doing it. Only a hunch. Many are prone to carpal tunnel issues by the way they use their hands repetitively.
Good luck

DaveLeeNC

Thanks - I will give that a try. I did try a whole bunch of positions and approaches to shifting without success. But honestly I cannot say that I tried this one. It could be quite helpful.

dave

popeye

Ultegra DI2 is dirt cheap at PBK and works as well as my DA.

DaveLeeNC

Oh - the HORROR. Polluting my 1996 EL/SO Bianchi frame with Shimano parts. The Italian cycling mafia would descend upon my home and family and ...



dave

ps. This is not intended to be offensive.

canklecat

While you're working out the ergonomic issues, try some good topical analgesics. I've tried 'em all since a neck injury in a 2001 wreck, and a shoulder injury earlier this year. Most topical analgesic balms, creams, ointments, etc., are a waste of money. It's the massaging action that provides most of the relief, if any.

Topical analgesics must contain a transdermal carrier to be effective. Most use MSM, which is much gentler than DMSO and seems to be more effective. I get itchy rashes from DMSO, but not from MSM. It helps the other ingredients penetrate just enough to affect the nerves transmitting pain signals. I'm doubtful about how effectively topical analgesics can relieve inflammation, although reportedly the topical version of diclofenac can. I've used only oral diclofenac, which has enabled me to cut way back on the massive doses of ibuprofen suggested by one clinic.

Here are two I swear by rather than at. Both use MSM as a transdermal carrier; and either menthol or methyl salicylate (wintergreen oil) as the primary analgesic:
Stopain -- the roll-on version. Works within minutes. Strong menthol and some glucosamine (no idea whether the glucosamine really helps).
Ted's Pain Cream -- I've tried only the original wintergreen scented cream, which took several days to be effective. Reportedly the newer roll-on works more quickly.

I use both, first the Stopain, then the Ted's while the skin is still wet from the solvent. I use the Stopain as needed throughout the day, less often the past couple of weeks as the shoulder has improved. I use the Ted's once a day now that it's built up some effect. It seems to last longer and the effect isn't simply washed out with bathing, so it's not just skin surface level numbing. However I doubt any topical analgesic penetrates enough for deep muscle pain. These seem to be intended for joint relief just under the skin.

It's hard to explain how Ted's works better than the developer already does, so check his website. He's a neuroscientist specializing in pain therapy and faculty at UT-Dallas. If not for his credentials I'd have dismissed the hype as quackery, but darned if it doesn't work as described. Ted's also uses resveratrol extracted from red grapes, which supposedly "reset" hyper-sensitized nerves carrying phantom pain signals from old injuries that should have healed by now. I was skeptical but it seems to work as claimed.

And I'm not particularly susceptible to placebo effect. I've tried all kinds of alternative remedies over the decades, for severe headaches and chronic pain from old injuries. Most are junk. And while I had "high" hopes for CBD, it does little or nothing for my chronic pain (although I think it is a subtle but effective mood enhancer without any psychoactive effects, and did help with my nausea earlier this summer when my thyroid suddenly worsened and I had a hyperactive gag reflex, interfering with swallowing solid food). And I don't believe CBD does anything special as a topical balm. Most cannabis topical analgesics contain the same stuff as every topical analgesic, so the CBD is superfluous, just taking advantage of the marketing hype. It appears that CBD must be ingested to be effective.

If pain relief is the goal, right now CBD seems overpriced for what you get (although Lazarus and Green Mountain in Vermont have the best prices in the CBD industry, and good products). While Ted's seems expensive at nearly $20 a tube, it works well enough to be worthwhile.

Stopain has recently redone its website and packaging, so current stock in stores and online will still show the original packaging with bold colored blue, green and red and cheesy graphics that look like something the owner designed with "Grafix R Us" software. The newer packages have somewhat improved graphics. The ingredients appear to be the same. Costs $8-$10, and all the money went into the ingredients, not the design.

Ted's did their marketing homework and apparently hired a professional graphics designer. It looks like expensive stuff. And the cream is non-greasy, doesn't stain clothing and feels like fine skin cream, although with a noticeable wintergreen odor. Reportedly the newer formulation has little or no scent.

Campag4life

Canklecat,
For the two topical ointments you recommend, is odor detectable to not only yourself but others around you?

Nachoman

I had a similar issue and tried to solve it with this thing, which did not work.
I ended up switching gears for a while with my middle finger and then over time it eventually went away.

canklecat

I'll have to admit up front that I like methol and mint flavors and scents, so I'm biased. I drink mint tea. I love menthol cough drops and carry 'em on bike rides as an alternative to huffing on my asthma inhaler. Decades ago when I smoked I preferred menthol cigarettes. I like chocolate/mint ice cream. I'm about to order some chocolate mint flavored CBD oil. I need help with my mint habit.

Stopain has a potent menthol odor. It seems overpowering but nobody else has commented on it. I suspect it diffuses quickly because it is not greasy and doesn't get into my clothing. I wait a few minutes after applying it before putting on a shirt, so my skin is dry and not oily. When I wash my shirts later I don't notice any particular odor. I can't say the same of other greasy menthol creams I've used -- those stained my shirts and left lingering odors so I've discarded a lot of cotton t-shirts I reserved specifically for days when I needed those balms.

Ted's has a new odorless gel roll-on. Ted's Pain Cream original formula uses a much milder wintergreen oil scent (methyl salicylate). Some folks objected, and even the co-developer, Dr. Ted Price, didn't care for the scent. The new formulation in roll-on gel uses trolamine salicylate, another popular topical analgesic used in many odorless topical analgesic creams. But unlike those, Ted's uses MSM as a transdermal carrier. It also includes arnica and resveratrol, popular alternative ingredients in some topical analgesics but seldom emphasized due to regulatory restrictions about claims for these ingredients.

Campag4life

Ted's odorless roll-on sure is expensive. Thanks

https://tedsbrainscience.com/product...ain-gel-3-pack

canklecat

Yeah, Ted's isn't the cheapest topical analgesic around. It's premium priced like Biofreeze and Blue Emu. But it sure seems to work and they have the credentials and research to back up their claims.

Seems to last awhile too. I'm still on the same tube of Ted's original that I bought in June and I use it once a day almost every day. At first I applied it 2-3 times a day. But I use it fairly sparingly and rub it in thoroughly on a fairly small area -- just my right shoulder and back of the neck.

Stopain roll-on is the best bang for the buck. Works very quickly, costs only $8-$10, almost no waste because none of it goes on the hands to apply it elsewhere. I use a rubber headlight strap to attach it to one of those telescoping grabber doodads so I can reach my injured shoulder blade too without straining my good shoulder.

Campag4life

Thanks for your comments canklecat. I have never tried any ointment for pain relief. Instead, I just live in pain.
Very informative. Thanks again.

fietsbob

An electronic shifter system, EPS in Campag,
will take the effort out of pushing the mechanical shift levers..

canklecat

Glad to help.

Chronic pain is not good. Gets in the way of stuff we want to do to enjoy life. I'm for anything that helps and doesn't make me sleepy all the time.

I slop on the Stopain and Teds cream and I'm ready to ride my bike, do my physical therapy, household chores, whatever needs to be done. That's a good thing. Getting my blood flowing and riding my bike is an effective pain reliever by itself.

Interesting thing about Ted's approach is that the intent is not to mask serious pain, since serious pain is telling us something is wrong and needs to be fixed or rested until it heals. When I re-injured my shoulder back in the summer after pushing myself too hard doing my own PT at home, the ortho doc basically said "Stop that." I took a couple of weeks off, doing only very gentle stuff, and, sure 'nuff, the shoulder was significantly better and has continued to do better since mid-September.

The idea with Ted's formula is to relieve chronic pain that the body developed out of habit as a result of old injuries. I was intrigued by his theory of resetting or rebooting nerves that had developed chronic pain in response to old injuries that had already healed. Seems to have worked on my chronic neck and shoulder pain from the 2001 injuries, which should have stopped hurting long ago.

That also seems to be a theory with CBD, but I'm not quite as convinced about that. And it's awfully expensive, even the lower priced stuff. So I'm not quite on that bandwagon, although I'm open minded about it.

77Eric

sjh953

Your post sounds exactly like what I dealt with about a year ago. Felt like carpal tunnel or something, came on VERY suddenly for no known reason. Happened with right hand when shifting and braking. The one major difference between our situations is that I live in a flat valley, so shifting is largely optional in that I can shift less often and not really suffer for it. I ride about 3500 miles per year. In the year since, I've largely recovered by doing the following.

For a few weeks, I switched to riding a mountain bike. Flat handlebars for a different wrist position, trigger shifters which use totally different muscles from a road bike. Using the mtn bike, I proved to myself that the condition wasn't getting worse. I rode that bike exclusively for maybe three months.

When I got back on my road bike, I started braking with my left hand/front wheel. Not ideal, but I'm on flat ground and don't go particularly fast. I also ride at five in the morning on mostly country roads, so I have the roads to myself, which cuts down on braking.

This may not apply to you if you have a better bike, but mine is a Specialized Secteur with the lower-end Sora STI and Tiagra levers. After visiting a LBS and playing with better bikes, I realized how much more pressure my levers required to shift. I'm sure this added to the wrist problem. What I noticed when riding is that to shift, I was fully extending my fingers and pushing the lever. That put a lot of pressure on my wrist. That's when it hurt. I found that if I bunched up my fingers and pushed in more from wrist with fingers moving in from 90 degrees, that didn't really feel the pain. Get rid of the leverage.

It's taken about a year for my wrists to get back to normal. It was just a matter of giving those muscles a rest and also adjusting how I handled braking and shifting. Good luck to you.

To add: I just remembered that I also lubed up by cables, to cut down on friction and make the levers easier to work. I did notice a difference in pressure required once I did that.

Carbonfiberboy 

I've been doing these exercises for many years: Carpal Tunnel Syndrome Exercises

Maybe no immediate help, but good maintenance work.

In situations like this, my first response is to diagnose via ibuprofen: Do 600 mg ibuprofen every 6 hours (or take 200 every 2 hours) for maybe 3 days. If that fixes it right up, it's inflammation, so at least you know that. If it doesn't, it's something structural. The weird thing here is that it would seem to be an RSI, i.e. inflammation, though it's certainly possible that you tore something with an extra effort. I've had my hands get so tired from shifting that it was very difficult to perform a shift, but that's not pain, just inability to operate the hand.

Second new cables and housings, but that's a bit late.

DaveLeeNC

We'll know this week as the plan is to give this a try tomorrow after almost 2 weeks of rest and ice. Shifting was the only thing that seemed to cause a problem, so the fact that it doesn't hurt now doesn't mean a whole lot.

I had to replace my right side brifter mechanism (and cable) because I am a sweat machine that aims sweat right at that brifter and the build up had caused a problem (did that a few months back). So that is probably about as good as it will get. Sweat on the left side gets intercepted by a watch so isn't a big issue.

I also take a daily dose of Meloxicam (generic Mobic)- more for knees and thumb area issues (thumb thing is guitar related). It is probably helpful here but no experiments have been done.

dave

Campag4life

Dave,
Feel ya on the Campy Chorus Ultrashift salt attack on the shifters. A real problem riding in the South during the summer months.
I make a point to pull back the rubber hoods and scrub the tops of the shifter body with a toothbrush and dishsoap...and then blow it out with compressed air.
I end up having the replace the shifter retention clamps with pretty high frequency...Al Torx bolt basically corrodes and rots. Can't get it apart without drilling out the softened bolt head.

If you don't wear gloves...I personally don't, the sweat just wicks into the shifter. Btw, this maybe contributing to higher shifter effort as well as the shifter binds more as it becomes contaminated.

DaveLeeNC

I wear half gloves and they even come close to intercepting that river of sweat. What I have been doing is at every chain lube (at least in the summer) I spray in a bunch of WD40 and then blow it out with compressed air. Then I add some chain oil into the mechanism.

I don't know if that will work or not as I only started doing that with my relatively new brifter.

dave

79pmooney

Or (and far cheaper!) down tube shifters. Operated witht he wrist comfortably straight and using thumb, index and middle fingers. Drawback - compatibility, The OP will be limited to every cassette, freewheel, derailleurs, chains and spacings ever made.

Ben