Hand and wrist pain can be a common issue when cycling, but it doesn’t have to be.

Meg Beckett, a certified hand therapist with UCHealth SportsMed Clinic in Steamboat Springs, outlines strategies to prevent hand and wrist issues this biking season.

What can happen

Both the median and ulnar nerves, which run through the wrist and provide sensation and movement to muscles in the hand and fingers, may get compressed when cycling, resulting in a lack of blood flow.

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“It’s good to get out and bike, but the length of time you spend in that position may irritate the nerves that go through your wrists,” Beckett said. “A good analogy is a garden hose. If it’s pinched somewhere along the line, the amount of water flow you get out the end is going to be compromised.”

Symptoms may be felt in different parts of the hands and even in different fingers, depending on which nerve is impacted. For instance, if the ulnar nerve is compressed, tingling and numbness may be felt in the small finger and small-finger side of the ring finger. If the median nerve is compressed, symptoms may be felt in the palm, thumb, index and middle fingers and the thumb side of the ring finger.

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Get a proper bike fit

Leaning too far forward on the bike or riding with too much weight on the hands can cause problems. With a good bike fit, a more neutral hand position can be established.

“If people are having issues with their wrist and experiencing numbness or tingling, the main thing is to have your bike properly fitted,” Beckett said.

Decrease pressure and vibration

Using padded gloves, bulking up handlebars for a thicker, softer platform and shifting positions during your ride can all help.

Also practice riding with a softer grip. 

“It’s like driving a car — if you’re going through an intense situation and grip hard, your hands may hurt after the ride,” Beckett said.

Increase overall strength

Core, back and shoulder strength can help riders maintain good position without putting too much pressure on their hands.

“Go to the gym and stay active at home to build good back strength, core strength and shoulder strength,” Beckett said. “Those things go a long way. People don’t always realize how connected the whole body is.”

Address symptoms as they arise

“A lot of cyclists say wrist pain is just part of the ride, that you need to get used to it, but it’s not,” Beckett said. “If you try these things and it doesn’t alleviate symptoms, you need to see a specialist.”

Without intervention, issues such as muscle atrophy may result.

Symptoms that persist after the bike ride is over or make it difficult to sleep are signs that the issue should be addressed sooner rather than later.

Treatment options

If preventative measures have been taken and a rider is still experiencing pain, further treatment may be helpful.

Working with a certified hand therapist is often helpful. Massage and stretching may help free up tissue around the affected nerves. Nerve gliding exercises may help decrease adhesions, so nerves move more smoothly through nerve canals.

Anti-inflammatory medications may help reduce pain, while using a splint at night can keep the wrist in a neutral position, relieving symptoms.

In some cases, surgery may be necessary to release a compressed nerve.

Beckett encourages patients to take steps to prevent injuries and treat issues as they arise, and then to get back out on the bike.

“Cycling is a great exercise. The more cardiovascular exercise you can do, the more bloodflow your body gets, and the better off you are in a lot of health standings,” Beckett said. “Go for it, but be willing to learn and be safe.”

Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at cunninghamsbc@gmail.com.