Author Topic: Handlebar Palsy  (Read 4558 times)

Swislon

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Handlebar Palsy
« on: November 03, 2014, 01:45:50 pm »
I have been having problems with my hands aching for a couple of years now.
Just having had 5/6 weeks off (with hands feeling fine) the bike I started riding again.
Almost immediately my hands started the familiar ache. Three rides later it is debilitating.
I have padded bars that are level or just above the seat height and have also had a bike fit.

Anyone else suffered this and what did you do about it?
I don't want to stop cycling but at the moment rest seems to be the only remedy.

Steve

fossala

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Re: Handlebar Palsy
« Reply #1 on: November 03, 2014, 01:53:55 pm »
You tried Thorns comfort bars or Jones H-bar both are very comfortable. I guess you could also go pay for a bike fit to try and help.

honesty

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Re: Handlebar Palsy
« Reply #2 on: November 03, 2014, 02:17:40 pm »
From left field... a recumbent? Takes all pressure off the hand.

Otherwise, bar swaps and playing round with the sweep on the bars you have. I get really bad pins and needles and numbness in my left hand on one of my bikes, but nothing at all with the other. I can only put this down to the bar sweep and where the pressure is being applied on my hand as the distance from bar, height, ride position are as close as I can make them.

in4

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Re: Handlebar Palsy
« Reply #3 on: November 03, 2014, 02:19:40 pm »
There could be all sorts going on but, leaving aside any individual issues ( arthritis etc.)

Grips and grip position/rotation. Shape of grips too. Bars and all the variables associated with them.
As an illustration: I rotated my gp5s by a couple of degrees or so and the instant relief from numbness was a joy. Bikerta uses them too and she might have a view to share. Of course if you are using drops all this is completely irrelevant and you might have to wait for The Sage of Oregon for further advice/opinion.

lewis noble

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Re: Handlebar Palsy
« Reply #4 on: November 03, 2014, 02:25:51 pm »
Hello Steve

I had this problem, and it was very uncomfortable and discouraging.  At the time, I was riding a Raven Tour; fine bike, but I think too long in the frame for me - my posture has gradually become more upright over the years.  I recall discussing the matter with Robin Thorn, who suggested larger tyres, at a lower pressure, and advised against suspension forks on the grounds that whilst they would absorb large shocks / bumps, they do not successfully absorb the low level but constant vibration that causes much of the problem.  I played around with shorter stems etc to change my posture, but with little success.

I sold the RT in the end, for a variety of reasons - too 'expedition' focussed for the sort of riding I ended up doing.  I bought a Cube Acid mountain bike - yes, with sus forks, and found it much better.  But was it the sus forks that helped? or the fact that the posture suited my new style / requirements better??  I find I now get on better with the smaller frame / shorter reach posture

I liked the Cube, but not the forks.  I noticed I had them 'locked out' 90% of the time (though there was still a small amount of residual 'give'), to improve the handling. A year after I bought it, the Cube was stolen.  I ended up buying a Ripio (one of the last Thorn sold, I think) - choice of sus or rigid forks, (Mt Tura), but a posture and style that suits me.  Result? - no problem, hands much better, legs knackered from the extra riding I have been doing on it! I have never used the sus fork at all, now going onto my son's bike.   I have done at least as long rides on the Ripio as I did on the RT or Cube Acid.

So Robin was right, posture is the key.  Possibly also choice of tyres / pressures, grips etc. Would a shorter stem put less weight on your hands / wrists? At the expense of weight on your bum, of course.

I normally run on 1.6" Supremes, pressure around 55 - 60 psi.  I also have larger Duremes I can run at lower pressures if I know I will be on rough surfaces a lot.  I have never wanted to go back to sus forks.  

It is, of course, equally possible that whatever medical condition led to the pain has gone away, or the sensation has been 'superseded' by other aches and pains - I guess the mind behaves that way.  Also, if I am planning a long ride, I sometimes take painkillers before setting out; and keep 'topped up' during the ride.  If that helps, that's OK with me.

Good luck with it - we all hope you can resolve a discouraging condition.

Lewis
 

Swislon

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Re: Handlebar Palsy
« Reply #5 on: November 03, 2014, 03:21:31 pm »
Thanks for all the replies.
I feel sure posture (40 years at a desk and PC!!) has something to do with it but i have tried all sorts.
Now on well padded drop bars level or higher than the saddle. 32mm tyres not too much air.
Funnily enough my ride on Saturday was pretty good but the day after and today they just ache.
I have a Brompton with H bars and that isn't too bad but don't do much distance as its more an errand bike.

My friend is getting a Moulton this week. If he lets me borrow it we shall see how the suspension helps.

I have also emailed my Physiotherapist but spent last 2 years discussing with GP, Chiropractor and several Phsios. to no avail.
I shall persevere.

Steve

Slammin Sammy

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Re: Handlebar Palsy
« Reply #6 on: November 03, 2014, 03:40:55 pm »
Robin is right - posture is key, especially as it dictates hand position, orientation and grip strength.

We've covered this before, but I believe most RSI is caused by unnatural hand positioning coupled with loss of circulation and high stress.

Get bars that allow a natural lateral angle for your wrists from the posture in the saddle that's most comfortable, like the Thorn Comfort bars. (If they don't suit, then shop around. This side-to-side angle determines the alignment of your wrist and forearm bones, and will make a huge difference over long rides.) Your weight should be distributed between your arms and your bum, so if your hands are hurting, raise your stem/grips relative to your saddle. You can rotate the bars upward to help effect this.

All Ergon GP grips are designed to support your wrists, so rotate the grip until the support allows your hand to flow straight across the top of the bar, with minimal bend at the wrist. Finally, don't use a death grip - it restricts circulation and promotes vibration transmittal right up into your forearms, neck and back. The lighter the grip you use, the longer you'll be able to ride. I deliberately stretch my fingers out and rest only my palm on the bars most of the time.

Of course, all of the above assumes your on flat bars, not drops, but the same principles apply. Get your wrists straighter and at a natural angle, offload your hands, and use a light touch. With drops, you're helped by the availability of alternative hand positions.

When riding my Trek 520 (with VO rando drop bars), I spend a lot of time on the tops, followed by the hoods. I almost never go down to the drops. I've often wondered why no one has come up with a "GP-shaped" grip to use on the tops, so as to support the wrist in a straighter posture (unless they do exist, and I've missed them  ???). My bars are padded with gel wrapped by Brooks lather tape, and are comfortable to hold, except for the wrist bend. I would envision a design that comes in two halves, and bolts together over the tops to clamp the bar at the correct angle. (Any budding designers in the house? We could buy a 3D printer and make a fortune! :) ;))

Rockymountain

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Re: Handlebar Palsy
« Reply #7 on: November 03, 2014, 03:44:16 pm »
About a year ago I suffered from this in both hands and went to see a neurologist who diagnosed carpal tunnel syndrome. I was referred for an op on my left hand which was particularly bad (numbness in the middle and index fingers and half of the thumb). The doctor reckoned it had been caused by (i) riding (ii) gardening and (iii) wearing my watch too tight on my left wrist. I was booked in for surgery when my wife broke both her arms in a bike accident. I, therefore decided to cancel the op - having one good hand between two people didn't sound sensible. I took a break of six months from the bike (more as solidarity with my wife) and changed my watch strap, making sure it was loose. It all seems to have worked because the numbness has gone away in both arms. I just make sure I protect the wrist and don't bash the palm of my hand when I'm gardening or cycling. All seems fine now.

Fraser

Andre Jute

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Re: Handlebar Palsy
« Reply #8 on: November 03, 2014, 06:29:44 pm »
This is about microvibrations and how to stop them getting into your hands. I went from harsh 37mmMarathon Plus with front suspension and ergonomic grips, and a lot of hand pain, to a solid fork and rock-hard Brooks edge-on leather ring grips further stiffened by short bicycle spokes, and no hand pain. The trick was that when I changed bikes, I went to low pressure 60mm Big Apple balloon tyres. Everything else, including my posture, which is well developed and the bikes fitted to it to within a millimeter, is very much the same. Today I noticed again how my pedalpal's bike shivered along the chip'n'seal, a nasty generator of broad-frequency vibrations, while mine, even with a much stiffer frame, glided serenely over it. i think Schwalbe should get a lot of credit from, among others, physiotherapists for reinventing the balloon tyre.

Danneaux

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Re: Handlebar Palsy
« Reply #9 on: November 03, 2014, 08:27:48 pm »
Quote
Of course if you are using drops all this is completely irrelevant and you might have to wait for The Sage of Oregon for further advice/opinion.
Thanks for the kind reference, Ian. Unfortunately, I am in the same boat, having apparently sacrificed my hands to the Cycling Cause starting well over 250,000 miles ago.

Things started to go south for me at Uni taking extensive classroom notes and riding 12,000mi/year and quickly picked up speed with all the note-taking in graduate school. During this time, I had my own automobile repair shop to help pay the bills and I horribly abused my hands by overuse and using well beyond their limits. Then, further randonneur and extreme touring on very rough roads really finished things off. I also may have suffered a small stroke after surviving a murder attempt in '94, as my left hand was left noticeably weaker and less agile than before the head injury which included a triple skull fracture, shattered left eye orbit, another broken nose and a free fracture of the maxilla (upper jaw) while wearing a helmet.

Really, I think the present problem is a combination of things, all cumulative, but compounded by consistent pounding by very, very rough roads and non-roads over many years. It doesn't help that manufacturers decided to universally change the placement of padding in cycling gloves to leave the very place I need it devoid and innocent of any sort of cushioning whatsoever. I'm not sure what their goal was, but I'm finding my pounded-out gloves from decades ago are still better than current offerings.

I have found several things help with hand pain and drop handlebars, if that's what you're using:

• Gloves with full, thick, dense padding in the palms. If you know where to get some now, please tell me. I have had limited good luck stuffing sheets of wetsuit material (bonded knit-backed blown neoprene) into the palms of my gloves.

• Try to get a posture that will evenly distribute your weight between hands and bottom. For me, this works out to a 45° angle for back and 45° for arms when riding atop the brake hoods. You can see photos of me on my bikes in the Danneaux's Sherpa and Danneaux's Nomad galleries that show this.

Avoid a too-long-reach stem so you're not putting as much weight on the heels of your hands. As time has passed, brake hoods have lengthened (thanks to STI setting the sizing standard, even if you don't use brifters) and now most drop-bar riders are actually perching wholly on the brake hoods, some of which are harder than others. Try switching to slightly softer Cane Creek hoods if you're presently using Tektros. Because brake levers are longer, they can stretch you out too far unless used with compact-reach handlebars with shorter top ramps to compensate for the ~1cm longer reach of the lever-hoods.

• Actual placement of the brake levers can make a big difference to comfort on drop handlebars, as can the handlebar bend. I like randonneur handlebars very much for this reason, and prefer my levers be placed relatively high, with the ends of the lever blades even with the bottom of the drops or a centimeter or so above it. Some prefer their brake levers much higher. Whatever works to aid comfort is fine so long as you can still squeeze the brakes at full force in all needed positions.

• Watch handlebar clamp diameter. I am appalled to see large stem-clamp diameters come into play on some drop-bar tourers, as they can make 'bars *too* stiff. A nice drop 'bar in 25.4-26.0mm diameter will generally be much more comfortable. Already, threadless stems are much stiffer than quills and can add to the problem.

• Buy a tire gauge and set whatever front tire you are using to an appropriate pressure, likely lower than what is in it now. A 15% drop in rim height when loaded with your body and cargo weight is about right. Frank Berto pioneered work in this area, and our own JimK extended it to a wider range of tires. A search of the Forum archives will find both. There's also an Android app for setting differential tire pressures under load, which works pretty well. See: https://play.google.com/store/apps/details?id=com.edisongauss.bertotirepressure Vittoria also offer one, but I have not found it as useful: https://play.google.com/store/apps/details?id=com.vittoria.itirepressure

• Go to a wider, lower-pressure front tire as Andre suggests, and air it up (down) appropriately.

• Pad the handlebars to increase surface area an absorb vibration. My favorite is Grab-On closed-cell grips compression-wrapped with padded handlebar tape.

• Move your drops upward until the tops are level with the top of the saddle, no more than 2cm below it...or try putting them above, as John Saxby has done. You'll be more likely to actually use the drops if you can reach them easily...another endorsement for shallow-drop 'bars with compact reach.

• Oddly, counter-intuitively, I've found a lot of apparent front-end vibration actually has its source at the rear. Fitting a suspension seatpost (I prefer the Thudbuster LT and ST models, though there are other good ones including StuntPilot's SR-SunTour, which he has reviewed nicely. A parallelogram design will be more responsive and will preserve saddle-to-bb distance more than a telescopic design) will help hand comfort. When the rear tire reacts to a bumps, it pitches the rider forward abruptly, increasing pressure on the hands through the handlebars. My testing showed converting and modulating abrupt rear bumps/shock input to a lower amplitude and frequency or spreading them over a greater time duration between peak loads really helps my hands. In other words, fitting a suspension seatpost also helped my hands as well as my back and neck, so I stay more comfortable overall and my hands do notice the difference. I was as surprised as anyone to find this, but it has helped.

• Fitting a suspension seatpost does address some road shock, but it is half the battle. A suspension fork *might* help, but unfortunately the current telescopic designs aren't best for the sort of low-amplitude, high-frequency road shock that tears up hands on drop 'bars. A telelever design would be be much better (and for the same reasons as the parallelogram sus-seatpost design), but are largely absent after a brief flare of MTB popularity in the 1990s. A parallelogram sus-stem would be nice, but the last go-'round with those, the market found the pivots wore fairly quickly and nobody liked the maintenance or sloppy feel that imparted. For these reasons, the best approach at the front with drop handlebars currently is to fit a tire with wider cross-section/higher profile and fill it with appropriately low pressure and so absorb much of this vibration through an air spring as Andre endorses. I have also grown to hate chip-seal paving with a white-hot, passionate intensity. >:( Wider, lower-pressure tires help on it as well, perhaps better than anything.

I'm doing all the above and find it helps, but its effectiveness depends on road surface and time on the bike. The roads in Eastern Europe were brutal at times this summer, and my hands are just toast after 300-400km, 17+ hour days in the saddle, especially if some of that is on gravel. I really can't write legibly anymore and depend almost entirely on hard keyboards and (sometimes) styli and "swipe- and gesture-based "soft" keyboards. I seem to be teetering on the edge of carpal-tunnel syndrome (really, I am in denial) and have been diagnosed with Reynaud's syndrome/VWF/HAVS (see: http://en.wikipedia.org/wiki/Vibration_white_finger ) and still suffer the effects of frostbite from riding in temps lower than -17°C and having my fingers freeze to the handlebars. My hands hurt sometimes all the way to my armpits, and now my fingers also cramp and draw across my palms to the point where I have to sometimes pry them open using the handlebar as a lever.

If I could go back in time and tell my Immortally Youthful Self one thing, it would be that a young body can get away with things for awhile, but the chickens will eventually come home to roost; damage is cumulative over 35+ years of riding like mad. As with sun damage (paying a major price for that as well), prevention is the best cure and you'll always be happier tomorrow if you address some of these things today.

I sound like Grandpa. Ick, but there's hard-won truth there as well.

Best,

Dan.
« Last Edit: November 03, 2014, 09:52:36 pm by Danneaux »

Swislon

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Re: Handlebar Palsy
« Reply #10 on: November 04, 2014, 04:25:58 pm »
Thanks for all the replies guys. Dan you are a legend and an inspiration.
I am going to print out your reply and hang it on the wall.

Physio doesn't think she can help....
I'll try some  exercises I've found on the web and try and strengthen my hands and forearms which she thinks may help some.

I'll also keep fettling the bike with all your ideas... something may just make the difference.

Steve