Handlebar palsy

What can I do?

15 messages
GH0ST    pirate
06/05/2014 at 20:50

On Saturday I rode my first 100 miler. Delight has turned to dismay as I am now suffering what appears to be handlebar palsy (self diagnosed by google).

i first noticed it 10 miles from home, I couldn't change gear but having suffered with raynauds in the cold weather I assumed it would sort itself out quick enough.

Sunday my hands felt a little weak and I noticed my swim stroke was a bit odd but couldn't work out what it was. Yesterday I realised that I couldn't close all my fingers together when the palm is opened up - my little finger splays a centremetre from my ring finger. The weakness persisted so much that I couldn't crush a stock cube.

i went to my GP today but he was baffled at the lack of pain. He said he didn't know what it was but sent me to the infirmary for splints telling me to return if I get any pain.

I've been swimming tonight and gave up pretty quickly as the forked fingers are playing havoc with my stroke.

i've found lots of preventative measures on the internet but not any cures. Lots of sites say this will clear up on its own but timescales vary from 2 weeks to 3 months rest. This is not an option, Bala is a month away.

does anyone have any experience / advice please?

Edited: 06/05/2014 at 20:51
seren nos    pirate
06/05/2014 at 21:23

ghost.I had something similar two years ago.but seemed to start with open water swimming.......weakness in left hand was worse.couldn't do bras straps etc at all.couldn't cross my fingers.......

 

 first time happened lasted a couple of weeks.next time a week and after than just a day........now it only lasts about an hour at most after swimming.......

saw a neurologist who was convinced it was something but had lost of tests including mri on spine and heart tests and all came back fine.....

 still not sure what happened and why it comes on.

makes swimming hard as my hand goes into a claw..........

when it went two years ago on a very wet and windty day i had to do an ironman.......couldn't change gear with my left hand at all and had to reach over with my right hand........scary in the wind.couldn't even use my hand to take my shorts down to pee.......

 

 i thought it might have been the handlebar palsey but then discovered it was cold like OW that set it off.......

07/05/2014 at 09:34

Ghost - 2 questions

do you wear padded cycling gloves?

is your handlebar tape padded?

from what I understand about HP, it's caused by pressure on the ulnar nerve which feeds to the fingers and causes what you have seen.   

get some bike gloves with an ulnar pad to lessen the pressure (there are quite a few around), and if your bar tape isn't padded, get it replaced with some. the combination of the padded tape and gloves should help relieve the pressure.  and by adjusting the way you hold the bars to lessen the pressure will also help

 

cougie    pirate
07/05/2014 at 12:22
Also - what pressure is in your front tyre ? 10 PSI less might give a comfier ride ?

Are the bars quite low ? So extra pressure ?

I think the ulnar nerve is on the outside edge of the hand - do you ride on the tops quite a bit ? Maybe riding on the hoods would put less pressure on it ?
07/05/2014 at 13:15

Ghost, that sound sh*t.  I hope it passes quickly.

 

Most probably irrelevant but just in case … I used to get a degree of numbness in my hands when using aero bars with an s-bend, which required me to tilt my wrists forward excessively (opening gap between wrist and thumb).

 

I’ve since moved to the Profile Design Carbon Strykes which bend up almost like a bull horn bar.  They allow a more natural resting positing when in aero-tuck and (perhaps coincidentally) the occasional numbness has now disappeared altogether.

cougie    pirate
07/05/2014 at 13:18
I definitely prefer tri bars bending up - its a much more natural position. The flat bars might look faster - but they weren't comfy for me.
07/05/2014 at 13:34

you can get hand numbness from using tribars as the ulnar nerve runs from just below the elbow down to the tips of the smaller fingers, so any pressure can lead to numbness but not as bad as pressure on the ulnar nerve at the hand/wrist junction.

and conversely I've switched in recent years from bullhorn type tribars to S-bend.  I found with bullhorns that I wasn't using the upswept section at all so the S shape suits me better.  

GH0ST    pirate
07/05/2014 at 14:09

Thanks for the responses everyone.

Yes I do wear padded gloves, been using sealskinz all winter without problem but then i was only maxing 60 miles. I've just bought the following which i wore on Saturday:

gloves

My bar tape appears to be padded but maybe i can get some better stuff.

I ride 90% on the drops - resting as FB says on the ulnar nerve and yes cougie, i think they're quite low but it feels comfortable everywhere else 

I tried letting some air out of my tyres when you recommended it on a previous post cougie. But on the road surfaces around here it felt like i was cycling through treacle afterwards so i pumped them back up.

 

 

07/05/2014 at 14:34

Ghost - I don't think Sealskinz or those Altura gloves have an ulnar pad so it maybe worth looking at some that have as well.  the Altura glove is a MTB glove and many of them don't have ulnar pads as you hold the bar differently on a MTB

as an example - look at these - http://www.tredz.co.uk/.Specialized-BG-Sport-Glove_41475.htm

if you hover over the image it should enlarge - look at the section surrounded by red stitching on the palm view - that's an ulnar pad.

and there are loads of padded tape suppliers - Fizik, Easton, Spesh etc.  some people put 2 layers on for extra padding or a cork tape as a base and then a more scuff resistant tape over.

GH0ST    pirate
07/05/2014 at 18:43

I feel like a right muppet not knowing about different gloves but i really thought the padding on these Altura ones were good

http://s4.runnersworld.co.uk/members/images/780304/gallery/gloves.jpg?width=350

 

08/05/2014 at 09:13

padding maybe good for MTB use but I don't see an ulnar pad on those (although it's not clear from the pic).   no sweat not knowing about different glove types - many don't!  

the other thing you might also want to bear in mind that for shorter tri distances than 1/2IM, then you save yourself some time in transition not bothering trying to put gloves onto wet hands with cold fingers - I see lots of people struggling with that and personally I don't bother.

08/05/2014 at 10:47

Odd suggestion but have you tried ibuprofen/volatrol gel on the area? I presume it's numb because of pressure on the nerve and surrounding area causing inflammation of both so could be worth a shot? Just off the top of my completely binkers head, I have reyanuds and loose feeling in part of my forearms on long runs but thankfully have been fine on the bike so far. If you're riding on the drops so much perhaps it's time for tri bars?

08/05/2014 at 14:55

AB - I don't believe NSAIDs like ibuprofen have any action on nerve pain which is what this is.  it's not a classic inflammatory reaction to damage that can be dealt with by ibuprofen, but some minor, short lasting, damage to the nerve itself.

flyaway    pirate
09/05/2014 at 07:22

There is an ulnar pad in that photo - must be your eyes, FB, it's an age thing I think

Some reading here: http://www.asbweb.org/conferences/2010/abstracts/177.pdf

suggests that maybe its not as simple as "more padding is better", but that dependant on your riding position, you might need to try a few types of gloves with different positions/thicknesses of padding to find the ones that work for you. Then stock pile them!

Good luck, hope you find a solution.

GH0ST    pirate
15/05/2014 at 19:27

Quick update.

I have a new shorter stem and narrower handlebars. Chap in the shop I popped into today said my bike was built for 6" + person with shoulders like the proverbial outhouse.

 

Edited: 15/05/2014 at 19:28

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