Expert: Gerald Anzalone, D.C. - 8/4/2006

Question
When i cycle for long distances my wrists hurt. They are usually in a flexed angle. I support myself on the bicycle with my arms/wrists.
After 2 hours my little finger and the next door one goes numb and i get pins and needles.
My wrists are not straight either.
How can i prevent this pain?

Answer
Thanks for your question, Helen.

Many athletic-related injuries mirror occupational injuries when sustained positions cause repetitive micro-trauma to a particular body part.

Prolonged wrist flexion or extension, or a sustained arm position, may cause nerve pressure in the arm or wrist. The affected nerve you describe is probably the ulnar nerve distribution.

To avoid nerve compression, you'll have to avoid prolonged wrist flexion or extension. Your grip on the handlebars should be firm enough to maintain adequate control but relaxed enough to prevent rigidity in your muscles. You may find it helpful to change hand positions frequently and avoid overly flexing or extending the wrist. Padded gloves or handlebar tape may help reduce vibration.

Stretching may also be helpful, but it may not be enough to correct the problem. You might consult a book such as the "American Physical Therapy Association Book of Body Repair and Maintenance: Hundreds of Stretches and Exercises for Every Part of the Human Body" by Marylin Moffat.

I would also recommend seeing a chiropractor, physical therapist, or massage therapist who is well-versed in trigger point therapy. Trigger points are localized lesions that develop in skeletal muscle, and are potent producers of pain or numbness/tingling. You may have chronic trigger points in the muscles of the elbow and arms. Acupuncture might also be an excellent choice for addressing trigger points.

You mention that your wrists aren't straight... this may require additional evaluation, either by a chiropractor who is trained in extremity manipulation, or by a medical specialist such as an orthopedic surgeon. Your wrists may be deviated by overly contracted muscles, or there may be an underlying medical condition producing a Carpal Tunnel Syndrome-type problem.

Additional evaluation may also require a neurologist to perfrom electrodiagnostic testing to confirm a nerve problem in the arm or wrist.

I hope that this answers your question.