Known clinically as ulnar nerve neuropathy, “handlebar” or “cyclists palsy,” is an inflammation of the ulnar nerve at some point along it’s course from the shoulder to the hand. Because this nerve provides both sensory and motor innervation in primarily the inside aspect of the arm, people suffering from this condition can potentially experience numbness, tingling and weakness in the medial forearm, pinkie and ring finger.

Why is this complaint common to cyclists?

As the ulnar nerve enters the hand it passes through a small passage created by the Pisiform (a small bone on the outside aspect of the hand) called the Tunnel of Guyon.

When a rider grips the handlebars, especially in the drop position, the nerve can become compressed in the Tunnel of Guyon under the weight of the upper body.

Couple this compression with the effects of constant vibration from the road and conditions are ripe for the development of scar tissue and adhesions in and around the tunnel creating an entrapment syndrome.

Soft-tissue treatments to restore the proper function to the tissues in the area is the first line of defense in treatment.

In some cases, anti-inflammatory medications may be needed to interrupt acute inflammatory irritation in the nerve.

Proper bike fitting to make sure the rider is neither riding too “high” or “low” on the seat creating extra stress on the tissues is an integral part of both recovery and prevention of this potentially debilitating problem.

Most cases of Cyclist Palsy can be effectively managed with relative rest, therapy and inflammation control as long as they are caught early on.

Stubborn cases can require further diagnostic testing (NCV/EMG to evaluate the health of the nerve) and more drastic interventions.

What’s that mean? A pinkie and/or ring finger that is falling “asleep” or aching after you ride is nothing to ignore.

Unless of course you’re a big fan of the food in the hospitals surgical recovery suites.