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May 14th, 2018
May 14th, 2018 / Nicki Chick
A common complaint from cyclists after a long cycle is numbness in the hands and/or the feet. Numbness or paraesthesia in layman’s terms is known as ‘tingling or ‘pins and needles’, by Sarah Bentley, Rehab physio @ Chelsea
As Physiotherapists we can help improve this problem by exploring where the problem initiates from:
Numbness in the hands is often found in the ring and little finger and caused by compression of the ulnar nerve in the palm at the hypothenar eminence (fat and muscle pad below the little finger). Hand numbness can also result from hyperextension of the neck if the cycling position is incorrect. The cervical nerves in the neck can become compressed as they exit the vertebra foramina (holes through which the nerves leave the spinal cord). This can occur as a result of gripping the handle bars tightly and/or putting too much weight through the hands and wrists, due to a poor cycling position or from the vibration trauma of cycling, as the impact travels up through the hands and arms to the neck.
Numbness in the feet can be caused by the shoe, the cleat or further up the leg and into the bottom from the saddle and cycling position. The fit and comfort of a cycling shoe is highly individual, a shoe that is too tight and narrow can cause numbness. The cleat is most efficient when in line with the ball of the foot, however some cyclists find the pressure on the bony part of the foot can cause numbness, in this case we can move cleats in increments back towards the heel to prevent too much pressure. If the pressure is coming from further up the leg, the saddle can be adjusted up or down and slid forwards of backwards to prevent hyper-extension of the knee and compression of the sciatic nerve as it leaves the spinal cord and crosses the buttock. This may be an issue in older cyclists if there is underlying degenerative change (wear and tear) in the lumbar spine. Key to prevention of these symptoms are a good saddle and padded shorts and adjustment of cycling position to prevent pressure on the wrong parts of the anatomy.
Physiotherapists along with your local bike shop can look at the bike set up; for example: is the reach too big?, are the handle bars dropped too low creating more pressure in the hands? How does the cyclist position their hands on the bike? We can help optimise positioning by reducing stem length if the reach is too big, we can alter the angle of the handle bars to reduce the pressure through the hands. We would advise padded gloves to prevent too much pressure on the hands and reduce the risk of numbness on long rides to ensure the cyclist is more comfortable.
Bike assessments are important for exploring the bike set up and establishing which adjustments should be made, this is necessary in order to help the individual cyclist have the most comfortable ride and achieve maximum efficiency. If you are planning long rides or have a new bike for the summer a bike assessment is highly recommended to assure you achieve the best riding position.
Personally, comfort is important as I cycle to work daily. My bike was fitted to me when I bought it, to ensure I had the right reach and saddle height. To relieve pressure I wear padded shorts and gloves. I cycle further distances at the weekends and I am now in training for the fourth consecutive year for the London Prudential 100. Which for you keen cyclists if you haven’t done the event yet I would highly recommend! It’s a fab way of seeing London and a very well supported event.
We can help build a training programme for such events here at Six Physio