Preventive strategies, exercises and rehabilitation of hand neuropathy in cyclists: a systematic review

Key Points

1. Prevention strategies should consider bike ergonomics with a combination of bespoke bike fitting and frequently changing the position of the neck, shoulder girdle and hands whilst cycling.

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BACKGROUND & OBJECTIVE

The incidence of hand neuropathy in the sport population is not well reported. However, an old study reported 24.7 cases per 100,000 in the general population (1). Repetitive and sustained cycling can lead to musculoskeletal injuries including direct or indirect trauma and nerve compression caused by the extrinsic compression force (2,3). Incorrect position of the hands on the handlebar potentially increases compression on the nerves in the wrist, which in combination with vibrations from the road can lead to injuries to the nerve (3). The nerves most involved in the hand during cycling are the ulnar and median nerve.

Several factors such as experience and cycling posture have been described as linked to these neuropathies (4). Preventative measures are therefore important for reducing the incidence. However, when symptoms occur, symptom management is important as neuropathies can potentially lead to sensory loss (5). Given the importance of this area, a systematic review was used to examine strategies to prevent and treat hand neuropathies in cyclists, with a focus on the ulnar and median nerves.

The incidence of hand neuropathy in the sport population is not well reported. However, an old study reported 24.7 cases per 100,000 in the general population.

Having the correct bespoke equipment for the intended purpose is probably the best form of prevention of hand neuropathy in the cycling population.

METHODS

• 15,731 records were identified through database searching.

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