Well to be exact, behind handlebars and aerobars. As with all your contact points on the bike it’s important that your bike fit is optimised to enable a great position but not at the cost of comfort. If comfort is not there, then efficiency is affected and so, therefore, is speed.
I am sure most of us who ride a bike have experienced that feeling of pins and needles in the hands, often along the ring and little finger. You take your hand off the bars, make a fist, wave your hand around and the sensation reduces and disappears. Hands back on the bars, back up to speed, and a while later it is time to repeat the process. On each occasion, whilst you do this, you reduce your speed (not to mention the one-handed cycling and changes in ride posture/pressure on other contact points).
Clinically, this is known as Handlebar or Cyclist’s palsy. It is commonly associated with compression of the ulnar nerve. The median and ulnar nerves provide sensory innervation to the hand. Compression most frequently is in an anatomical space in the wrist called the Guyon’s Canal. Depending on your choice(s) of hand position on the bars and the setup of the front end of your bike, the numbness may also be experienced around the thumb, index, or middle finger. This will be compression of the median nerve and may be diagnosed as Carpal Tunnel syndrome. This is more common among mountain bikers and the cross -triathlon community due to the different handlebar configuration and hand position.
For triathletes, from novice to experienced, there then there comes the question of aerobars. Incorrectly set up aerobars increase the risk of ulnar nerve impingement at the Cubital Tunnel at the elbow. As the ulnar nerve travels from the neck to the hand, compression of the nerve may show symptoms along this path. Most often symptoms are numbness and tingling in the hand or finger of the affected side and difficulty in the application of finer motor skills i.e. changing gear in an aero position.
Handlebar Palsy can be split into four categories, with a fifth category to consider in relation to aerobars, according to where the compression occurs. Each has its own characteristics of sensory loss and/or motor weakness. While it is unusual for age group triathletes and cyclists to suffer motor impairments, any symptoms and their causes should be managed to avoid the risk of long-term chronic damage.
Research in this area over a number of studies indicates that this is an important issue for growing numbers of athletes riding on aerobars. Cross-referenced studies have shown increases between pre-event and post-event symptoms; and end of season symptoms have shown a further increase. Triathletes and Time Trialists should research or take advice on the best shape of aerobar design and configuration for their individual biomechanics.
There may be a range of reasons for the symptoms across all groups of riders including:
- Being too far forward on the bike – uneven weight distribution;
- Too much pressure through the hands;
- Incorrect grip on the bar;
- Incorrect athlete position on aerobars;
- Aerobar pads with insufficient or worn padding;
- Saddle too high/bars too low;
- Worn down handlebar tape;
- Poor saddle choice/position;
- Lack of padding in gloves;
- Incorrect bar width;
- Incorrect aerobar design for particular athlete;
- Incorrect aerobar set up – angle, width;
- Overinflated or narrow tyres.
Due to the changes in how we train with the advent of turbo and smart trainers, a growing variety of platforms to train and race on plus virtual racing events, the prevalence amongst the triathlon and cycling community may be on the increase. Historically there is an increase in people experiencing symptoms over the winter months. This is most likely due to decreased changes in hand position; less movement of the hands generally and reduced fine motor movement demands. Training indoors may bring on symptoms due to factors such as wearing different gloves or moving less on an indoor trainer.
This condition can be caused by a poor bike set up/fit. I often see riders with stems slammed low to emulate a perceived quality aero position when the rider just is not capable of maintaining it comfortably, safely, or efficiently. As a result, weight shifts in different proportions around the contact points. The most common hand positions for symptoms are hands on the hoods or drops or by the gear shifters. Also, for those on aerobars, the general considerations for handlebars apply to the base bar but also consideration of the design of the aerobars and set up plus individual biomechanical limitations.
What can you do to relieve or stop the symptoms?
- Get a proper fit. Talk with your fitter and ask their rationale about changes to your set up.
- Optimise your handlebar width for your physical size.
- Optimise your aerobar design and shape for you.
- Make small changes in angle to your handlebar position to reduce pressure on the hands.
- Make sure to change hand position every 5-10 mins – especially when on the trainer.
- Avoid over-gripping the bar – an overly tight grip does not improve your handling or security.
- Reflect on your ride position and grip.
- Ride a wider tyre or adjust tyre pressure.
- MTB riders / Cross athletes should keep your front suspension serviced.
- Gloves with foam/silicone inserts. Research indicates 3mm of foam to be effective.
Most of us who cycle will experience this from time to time. It is about noticing it, reflecting on it, and making those changes to improve your position or riding habits to maximise your health and the riding experience.
Ian is a qualified cycle-fitter with over 10 years of experience working with age group and elite level riders/triathletes of all ages. He believes he is fortunate enough to have been trained by some of the best fitters in the business. His fitting knowledge is supported by his understanding as a Level 3 High Performing Triathlon Coach and a British Cycling Level 3 coach for Road, Time Trial, and MTB. He is always happy to discuss your needs in relation to fit and training.