Top 3 Causes of Hand Tingling/Numbness + Pain with Cycling

Fig 1. The thick transverse ligament covers the carpal tunnel and the enclosed Median nerve. In cycling, this nerve becomes compressed when our wrist is extended (back bent) on a handlebar for a prolonged period of time.
Figure 2. Note the distrubition of sensation from the Median, Radial and Ulnar nerves. Image on the Left represents the palm-side of the hand, and the Right image is of the back of the hand. Compression of Median and Ulnar is more common than Radial in cycling.
Fig 3. Note the Ulnar Nerve compression point at ‘Guyon’s Tunnel’ from direct presure through the lower outside part of the palm, such as when riding on a handlebar. This causes tingling/numbness into the ring and pinkie finger of the hand.
Fig 4 Each level of your neck has a nerve that passes between the vertebrae that delivers sensation into thew arm/hand
Fig 5 When the neck back-bends excessively, such as when positioned poorly on the bike, compression at the spinal nerves at the neck can radiate into the arms and hands.
  • Saddle position nose down (dumps majority of weight onto hands)
  • Saddle too high (often accompanied by saddle nose down)
  • Poorly installed brake levers/shifters/hand grips
  • Handlebars too wide vs narrow
  • Elbows locked-out during riding (more stress through wrist/hands)
  • Reaching too far to handlebars (shoulder angle >90degrees when hands on bars)
  • ‘Slouching’ on the bike with excessive rounding of upper back (throacic spine)
  • Excessive Saddle to Bar Drop (saddle vs bar height)
  • Tire pressure high = less dampening of vibration through the hands
  • The faster the symptoms occur, the bigger changes needed in positioning (i.e. symptpms occur in 5 minutes. . . vs 5 hours)
  • Keeping mobile, and change hand positions frequently helps
  • Wearing gloves and Ergonomic (Ergon is a popular one) hand grips/bars can help alleviate direct pressure
  • Goal is neutral wrist of about 20deg extension — not completely straight
  • Try to keep your ‘chest up’ when hands are on bars to keep your ‘head over shoulders’ a bit better, and to avoid excessive back bending at the neck

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Kevin Schmidt

Kevin Schmidt

Owner/Founder of Pedal PT. Passionate Cyclist, Physical Therapist, Clinical Bike Fitter, Dad, and Entrepreneur, living the #BikeLife in Portland, Oregon.