[TDI Hoo]

I just bought my 2012Felt Z6 2 months ago and switched from riding my Bridgestone City Bike for the last 21 years. I am up to 160 miles a week, and 50 mile rides once a week on weekends. About a month ago I developed intermittent numbness in my left hand. About 2 weeks ago I developed weakness in the left hand. My neighbor is a hand surgeon and a bike enthusiast. He noticed the muscle atrophy. I had an EMG yesterday and I have a severe compression neuropathy of the ulnar nerve just above the wrist, not in the palm. I will have MRI of my wrist in two days. For now, no more bike riding for at least 6 weeks. And if I need decompressive surgery (likely, since healing could take 18 months or more without surgery and 4-6 months with), no bike riding for 3 months, at the least. My case is severe, and I have a Z series bike, not the most aggressive setup, and I still have the handlebar spacers, though I did have the shop invert the stem 2 weeks after I purchased the bike. So, I am disappointed that my exuberance for my new bike and the increased mileage (up from 70 miles a week on the old bike) has led to this problem. Just wanted the "Beginners" to know that you can develop severe atrophy and weakness very quickly. Everyone's anatomy is different. Some may be more susceptible to this than others. My right hand is absolutely fine. I have been wearing gel padded gloves and changing hand positions. Just bad luck.

Have fun. I hope I don't have to go a reclining bike. For now, it's back to the elliptical machine. Ride on.

 

[PJ352]

I just bought my 2012Felt Z6 2 months ago and switched from riding my Bridgestone City Bike for the last 21 years. I am up to 160 miles a week, and 50 mile rides once a week on weekends. About a month ago I developed intermittent numbness in my left hand. About 2 weeks ago I developed weakness in the left hand. My neighbor is a hand surgeon and a bike enthusiast. He noticed the muscle atrophy. I had an EMG yesterday and I have a severe compression neuropathy of the ulnar nerve just above the wrist, not in the palm. I will have MRI of my wrist in two days. For now, no more bike riding for at least 6 weeks. And if I need decompressive surgery (likely, since healing could take 18 months or more without surgery and 4-6 months with), no bike riding for 3 months, at the least. My case is severe, and I have a Z series bike, not the most aggressive setup, and I still have the handlebar spacers, though I did have the shop invert the stem 2 weeks after I purchased the bike. So, I am disappointed that my exuberance for my new bike and the increased mileage (up from 70 miles a week on the old bike) has led to this problem. Just wanted the "Beginners" to know that you can develop severe atrophy and weakness very quickly. Everyone's anatomy is different. Some may be more susceptible to this than others. My right hand is absolutely fine. I have been wearing gel padded gloves and changing hand positions. Just bad luck.

Have fun. I hope I don't have to go a reclining bike. For now, it's back to the elliptical machine. Ride on.

I'm not a doctor so I won't play one here and tell you the cause of your injury. As you say, everyone's anatomy is different. I will offer that IME this isn't a common problem among cyclists - at least not at the level of severity you describe.

Given your mileage/ time frame, if I had to guess (and it is a guess), I'd say it's a typical overuse injury (too much, too soon) possibly coupled with fit/ form issues left unaddressed. The lesson I walk away with is slightly different that yours, being, everyone should be attentive to any fit issues they experience and have them identified/ remedied in a timely manner - and definitely before becoming acute.

Good luck with your recovery, no matter it's form. Hopefully you'll rejoin our ranks - back stronger than before. :thumbsup:

 

[TDI Hoo]

Update: I had my MRI of my wrist, and my Guyon's canal is just very, very small, so pressure is easily transmitted to the nerve. I have been using Pearl Izumi gloves and Specialized BG gloves, both of which are advertised to prevent ulnar nerve injuries. I have just ordered a pair of Qwi gloves for the future.
http://www.qwinerveprotector.com/BicycleGlove.html (not affiliated with them.)

Surgery to decompress Guyon's canal is scheduled in 2 1/2 weeks. My surgeon said I could ride the bike in the interim with some limitations (He is a cyclist, too.) So, I went on a short ride today.

I lowered the front tire pressure to 80 psi from 100. I flipped the bar stem back up. I rode mostly with my left hand behind my back, a la Apollo Ohno, the speed skater. I went on a 15 mile ride today, mostly one handed. My left hand muscles are so weak it was tough to push the shifter to get to the large ring. Obviously, I am slower since I am more upright and one handed, and clearly I am going to take it easy, especially on down hills.

I did go back to LBS to make sure the bike fit was OK. There is no problem with the fit, the reach, etc. I just over did it with long rides on some bumpy farm roads. Injury is probably from riding in the drops with my small Guyon's canal.

After surgery it is at least 3 months with NO road cycling.

 

[PJ352]

Well, on the positive side you have your root cause diagnosed and a plan of action to correct it.

Bummer being off the bike for 3 months, but FWIW when I broke my collarbone my Ortho dr told me not to ride for a few weeks, but I snuck trainer rides in to maintain my fitness. Worked out ok, but was a painful process, literally.

I'm not promoting you do the same, but because a stationary bike alleviates the road chatter and you could ride one handed, the dr might be ok with that option.

 

[tracerprix]

I have carpal tunnel in both wrists. I'm guessing it is from when I was a little kid and broke both my wrists. I get numbness and tingling more in my left hand than my right. I deal with it for now. I really cannot afford to be out of work for a week let alone a few months.

I was diagnosed 7 years ago. Wearing wrist braces at night help. I am trying to see how long I can live with it. I hope you have a speedy recovery. Good luck!

 

[mmlee]

Hope you have a quick and successful recovery........ I agree with PJ and possibly try a recumbent style bicycle trainer until everything is well enough for you to get back on the road.

Even though I was fitted the bike just never felt 100% comfortable. I've only been cycling for 3+ months. I tweaked my setup over a two month period .... trying various stems, spacers, seat positions, seats and even handlebar (narrower and shorter reach)..... until where the bike fitted like a soft easy chair where I could ride for 3+ hours without any issues. My fitted setup had me leaning to far forward and hands too much lower that my seat to feel comfortable although it might have been "proper". At 49 it's all about the comfort and not about the look.

Try to stay involved in cycling somehow during your recovery so that you keep that passion for the sport and will want to get back on the road as soon as you get the green light from the doc.

Take Care,
Mark

 

[thatguy57]

I have a Giant Defy 3, am about 220 lbs., have been riding since April of this year, wear PI gel padded gloves, and also get this numbness in my left hand. I figured it was from being out of shape and putting too much weight on my hands or something. I had a fitting done by the LBS I bought the bike but could have bad form. The numbness/hand falling asleep has been going on for about 1-2 months on most of my longer rides (15-25 miles, 1 hour - 1:20 in duration) and only occurs in my left hand. Is this something I should get checked out?

 

[PJ352]

I have a Giant Defy 3, am about 220 lbs., have been riding since April of this year, wear PI gel padded gloves, and also get this numbness in my left hand. I figured it was from being out of shape and putting too much weight on my hands or something. I had a fitting done by the LBS I bought the bike but could have bad form. The numbness/hand falling asleep has been going on for about 1-2 months on most of my longer rides (15-25 miles, 1 hour - 1:20 in duration) and only occurs in my left hand. Is this something I should get checked out?

This issue comes up so often that I started a text file with notes and (with a little personalizing) cut and paste to respond.

It could be a physical issue, a fit issue and/ or form. But given that you've had a fitting, this occurs only on your left hand and on longer rides, I suspect form degrading as you fatigue - and not changing hand positions often enough (very common, IME).

Some things to be aware of...
- keep your upper torso relaxed, arms slightly bent
- change hand position frequently (tops, bends, hoods, drops...)
- keep a slightly loose grip on the bars (avoid the 'death grip')
- keep forearms and hands aligned (don't twist at the wrist - refer to pic below)
- consider good quality gel gloves (you have them)
- I usually recommend good quality bar tape, but your bike being new, it should already be installed.

If after giving this an honest, consistent effort the numbness endures, you may want to go back to your LBS fitter, describe the problem in some detail (when it occurs, where...) and have your fit tweaked. You're right that excessive hand pressure (frontal weight) can contribute to this. so adjusting saddle position (aft) slightly may help. BUT... before considering adjustments to fit, try the steps above.

 

[TDI Hoo]

I have a Giant Defy 3, am about 220 lbs., have been riding since April of this year, wear PI gel padded gloves, and also get this numbness in my left hand. I figured it was from being out of shape and putting too much weight on my hands or something. I had a fitting done by the LBS I bought the bike but could have bad form. The numbness/hand falling asleep has been going on for about 1-2 months on most of my longer rides (15-25 miles, 1 hour - 1:20 in duration) and only occurs in my left hand. Is this something I should get checked out?

Depends on where the numbness is. If the numbness is your pinkie and pinkie side of the ring finger, you have ulnar nerve compression which can occur from pressure on the pinkie side of the palm or from excessive extension or flexion of the wrist. If the numbness is in the thumb, index and middle finger, you are compressing the median nerve, and this is carpal tunnel syndrome. The compression of the median nerve is in a different place. The anatomy of the compression is different between median and ulnar nerve compression. You may be "built" differently on the left side.

If you have any weakness or atrophy, you should get checked by a doctor, either a hand specialist (orthopedic or plastic surgeon) or a neurologist. If the numbness goes away quickly, follow the excellent advice above to prevent any significant injury.

I am a neurologist, by the way, and the hand muscle atrophy which occurred over 2 months in my case, is impressive. I may post some pictures of the muscle atrophy.

Though numbness is common in cyclists and motorcyclists, severe ulnar or median nerve injury is not common and when it does occur, it is often associated with some anatomical predilection for nerve compression.

 

[MoonHowl]

I rode mostly with my left hand behind my back, a la Apollo Ohno, the speed skater. I went on a 15 mile ride today, mostly one handed. My left hand muscles are so weak it was tough to push the shifter to get to the large ring. Obviously, I am slower since I am more upright and one handed, and clearly I am going to take it easy, especially on down hills.

This reminded me of a one armed biker I see when I am out riding from time to time. The first times I saw him were on the Blue Ridge Parkway pedaling a four wheeled contraption with a flag for visibility. He now rides what appears to be a conventional bicycle. I saw him again about a week ago, I had just made it up a climb and he was heading into the steep mountain downhill. I waved (yes, I am one of them) he smiled and nodded; then I felt a little bad waving when he had one arm; but in the end I am sure it was not an issue for him. If I ever get the chance to talk to him I would like to ask him about his progression from the human powered go cart to the bicycle. At any rate, it is inspiring to see a one armed person not allowing that to stop him from pursuing his passion for cycling (and doing so in the mountains no less).

 

[jta]

Sorry to hear about your injury, TDI. Just a thought about gloves: I had a pair of gel padded gloves, but found that they caused pressure points due their thickness, much the same way cyclists will tell you an overpadded saddle will cause pressure points. The pads were thick and tended to push into my palms in an irregular way.

After switching to a better designed glove (at least for me), the pressure/weight is distributed on my hands much more evenly and I experience no numbness in my hands, even though the padding is much thinner.

Also, just threw a pair of flat top bars on my bike, which are very comfortable for your hands - 3T Ergonovas in my case. Looking at FSA wing compact pros for my other bike.

Hope you are back on that Felt soon - it's tough having a shiny new toy that you're not allowed to play with.

P.S. thanks for the warning.

 

[canefanmd]

I started doing longer rides lately, and I suffered ulnar compression symptoms as well, though fortunately not as bad as with the OP (no atrophy and weakness). My symptoms resolved within an hour or so after riding. I've always did everything what was suggested above but still with symptoms.
I used gel-padded gloves and thought the padding position might have something to do with my problems hence I did a ride barehanded just to check and guess what, no symptoms!
To jta, I'd like to know what newer glove you used. I still prefer wearing a glove more for protection in case I fall. Looks to me a lesser-padded glove is the way to go. Any glove suggestions from the others would be great as well!
To OP hope you're able to get your full function back and get ridin again

 

[TDI Hoo]

Pics of left hand atrophy of interossei muscles and the adductor pollicus:

Smaller here (atrophy):

Normal muscle bulk here:

Loss of bulk in the "web" between the thumb and index finger:

Atrophy of dorsal interossei muscles and adductor pollicus:

Side by side, the left hand wasting is obvious. My grip and finger extension weakness is still present nearly two weeks after my last two handed ride. I cannot move the left ring finger side to side at all.

 

[PJ352]

Good points made above re: gloves and the placement of gel/ padding possibly causing pressure. Like many other cycling related items (helmets, shorts, bibs, shoes, saddles...) what works for one won't necessarily work for another. So if one make/ model glove doesn't work, I suggest trying a couple of others because (as has been noted) beyond quelling road vibration they offer a level of protection.

Still, worth noting, changing hand positions frequently does serve to bring relief to specific areas of pressure.

Re: suggestions, I like PI's. Fairly thin padding, but well placed and (overall) well designed.

 

[jta]

CaneFan,
Gore Bike Wear Oxygen gloves - after looking them up on the Gore site they do have gel padding, but much thinner compared my other gloves. Considering getting another pair, but also looking at a few other options, i.e. Pearl Izumi Elite Gel Vent Glove.

 

[NJBiker72]

At Tdi. Sorry about that but also curious. I have a slightly similar issue that bothers me sometimes.

Mine is my right hand. Usually. Occasionally both but mostly the right. The thing is that before an accident two years ago it was always equal. Then i broke my left elbow severely.

Mine clears up almost immediately after stepping off the bike.

Helps a bit when i get out of the saddle and not a killer climb.

Curious if any of this sounds familiar.

 

[MoonHowl]

I have also had issues with numbness in the hands in addition to minor issues with muscle tightness and associated strain in the lower back. I went with a much more relaxed geometry on the bike; stem angle about 45 degrees with several spacers to elevate. It has worked well for me and largely resolved both issues. Note; I do not race.

Interesting photos of the atrophy; thanks for posting. Good luck with the surgery and I hope the recovery goes well.

 

[TDI Hoo]

At Tdi. Sorry about that but also curious. I have a slightly similar issue that bothers me sometimes.

Mine is my right hand. Usually. Occasionally both but mostly the right. The thing is that before an accident two years ago it was always equal. Then i broke my left elbow severely.

Mine clears up almost immediately after stepping off the bike.

Helps a bit when i get out of the saddle and not a killer climb.

Curious if any of this sounds familiar.

I only started having numbness and then weakness when I lengthened my rides above 30 miles. In general, if the numbness goes away, you will be OK. Any weakness at all and you need to make changes. More than 50% or race cyclists have some abnormalities on EMG/NCV testing. It's not common to be severe or to have weakness.

In addition to what is posted above:
1. Pretend you are "shaking hands with the bike" and do not flex or extend the wrist, no matter where your hands are on the bars.
2. Stay off of chibbled up country farm roads if you are having numbness.
3. Don't ride on milled or ground up asphalt that is in the process of repaving (a 1/2 mile of road near me was being repaved and I road on it for a week. Not good for your hands, even if only for 1/2 mile on a road bike.)

The Felt Z6 has an incredibly adjustable stem, +/- 16 degrees. My LBS showed me the cam inside that is used with the adjustment. Sure, the bike looks dorky with the stem at +16, but hopefully I will heal. Riding upright with one hand behind my bike I feel like a barn going down the road.

I lost 10 pounds in the 10 weeks I was riding longer distances. Some of that was in my buttocks, so I had to have the saddle raised 1/2 inch. Apparently , this is also common in folks who lose weight cycling. Raising the saddle offsets raising the stem in terms of taking weight/pressure off my hands. I looked at getting a shorter stem, but the reach is not too long with the stock Felt stem. I rode today, and the extra leg extension gives more power, even when using only on hand.
Still, I am taking it really easy.

 

[PJ352]

Raising the saddle offsets raising the stem in terms of taking weight/pressure off my hands.

If that's the (desired) result of your raising your saddle, I'm glad, but it's not the norm. And although a commonly held belief, raising the bars doesn't take much pressure off a riders arms/ hands, because by slightly raising the riders torso (up), it doesn't appreciably change f/r weight distribution.

It sounds counter intuitive, but IME and generally speaking, adjusting saddle aft slightly and making sure it's leveled (or if level, set slightly tip up) tends to move rider weight rearward, lessening weight on the arms/ hands.

 

[NJBiker72]

If that's the (desired) result of your raising your saddle, I'm glad, but it's not the norm. And although a commonly held belief, raising the bars doesn't take much pressure off a riders arms/ hands, because by slightly raising the riders torso (up), it doesn't appreciably change f/r weight distribution.

It sounds counter intuitive, but IME and generally speaking, adjusting saddle aft slightly and making sure it's leveled (or if level, set slightly tip up) tends to move rider weight rearward, lessening weight on the arms/ hands.

Pj. Interesting thought on lifting the saddle tip slightly up. I was thinking of that yesterday. Trying to sit back more on the saddle.

Rode 65 miles and he hands were an issue on the way out but not the way back. Curious if I was sitting back more. Also tried riding with hands on the top more often. Not crazy about that position - too far from brakes. But the combo seemed to work beautifully.