INJURY PREVENTION AND TREATMENT

Intervention Check bike position, make sure nothing has caused a change to posture on the bike. Stop any upper body exercises (weights), which may cause increase in symptoms, RICE, strengthening of upper back/neck muscles, increase in ROM and flexibility.

Cyclist’s palsy (ulnar neuropathy) There can be a number of signs and symp- toms in relation to this condition which can sometimes be ignored when the symp- toms overlap with carpal tunnel-like symptoms, but both can be related to the two nerves of the forearm (ulna and medi- al). In cyclist’s palsy (ulnar nerve) the heel of the hand along with the little and ring (third) fingers are usually involved, causing pain, tingling, numbness and weakness, it is usually the hand that stays on the bars when drinking. The symptoms are worse whilst riding and for several hours afterwards.

Causes Extended riding time, rough terrain, improper hand positions, too much pres- sure with weight distribution placed onto hands and wrists.

Intervention Alter the position to take pressure of the hands and wrists and use extra padding (mitts/gloves or handlebar tape). Reduce the time spent on the bike if really need- ed. Mobility of the carpal area will help and massage to the forearm musculature, stretching and strengthening also helps along with NSAIDS.

Carpal tunnel syndrome The pain pattern for this complaint con- sists of

tingling, pain, numbness and

weakness in the hand following the path of the medial nerve. Symptoms usually present in the thumb, index, middle and ring fingers, with symptoms travelling above the wrist, elbow or even to the shoulder and are often worse at night. It is common amongst those who bend their wrist at work ie. therapists and keyboard operators.

Causes The medial nerve is compressed at or in the wrist and inflammation caused by the com- pression can be present. Cycling-related causes are once again extended time on the bike, rough terrain, improper wrist positioning or too much weight bearing.

Interventions Treatment on the bike is the same as cyclist's palsy. Off the bike try reducing repetitive motions at work or at home. Use RICE, wrist braces or splints, and work on strengthening of the wrists, shoulders and arms reducing pressure on the carpal area. Cortisone injections may be helpful as may NSAIDS. Surgery should be a last resort.

THE AUTHOR Warren G. Hutson MSc DO gained his masters in sports injuries and therapy in 2001 from Manchester Metropolitan University and was the first osteopath to do so. He has over twenty five years experience in treating cyclists at every level from club to elite riders. He has worked with a number of professional teams as well as the Great Britain Olympic teams since 1982.

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