Cyclist Injuries: Avoiding Hand Injuries and Treatment Strategies


Chiaramonte, R., Pavone, P., Musumeci, G., Di Rosa, M., & Vecchio, M. (2022).  Preventive strategies, exercises, and rehabilitation of hand neuropathy in cyclists: A systematic review. Journal of Hand Therapy, 35, 164-173. 

cyclist injury

The Skinny:

The study was a systematic review done to get clarification on the diagnostic process for cyclist injury specifically for hand neuropathies and strategies for prevention and treatment.  

In the Weeds: Literature was searched in the following databases PubMed, EMBASE, the Cochran Library, and Web of Science.  

Exclusion criteria excluded duplicate studies, injuries that were related to sports not specific to cycling, and articles that were not related to peripheral nerve injuries.  

Inclusion criteria: Articles met the inclusion criteria if they included hand palsy due to peripheral nerve compressions of the ulnar and or median nerve specific to the cyclist injury

Initially, the search yielded 15,371 articles, after screening for inclusion-exclusion a total of 48 full-text articles were read, and finally 20 publications that met the full criteria. Two separate reviewers independently reviewed identified articles.  

Bringing it Home: 

cyclist injury

From the literature review, they concluded the following prevention and therapeutic strategies for treating common cyclist injuries

1.) Educate cyclists on frequent changes in the position of the upper limb, neck, and shoulder 

girdle (Anderson and Bovim, 1997)

2.) Adapt the handlebars or change position and change riding position (Haloua, et al, 


3.) Minimize nerve compressions by avoiding prolonged elbow extension and 

flexion, and wear neutral wrist orthosis and elbow orthosis at night.  Use padded gloves (Dy 

and Mackinnon, 2016)

4.) No treatment (Haloua et al, 1987, North et al, 1980 and Selcuk et al, 2015)

5.) Rest from the activity causing the compression (Malmaris and Zadeh, 1990)

6.) Cryotherapy, exercise,  and electrical stimulation (Bransdma, 1995)

7.) Anti-inflammatory drugs and steroid injections (Ummer and Albohm, 1990).

There are a few treatments available for peripheral nerve injuries caused by cycling, however, there is no specific protocol for these injuries according to this systematic review.  



There is very limited evidence on treatment options for compression neuropathies caused by cycling.    However, there have been a large number of studies looking at conservative treatment for peripheral neuropathies they are just not specific to one sport.  The best course of treatment for cyclists is not clearly defined and this may require therapists to rely on their current clinical skills and other research.  


Andersen, K. V., & Bovim, G. (1997). Impotence and nerve entrapment in long-distance amateur cyclists. Acta neurologica Scandinavica95(4), 233–240.

Brandsma, J. W. (1995). Manual muscle strength testing and dynamometry for bilateral ulnar neuropraxia in a surgeon. Journal of Hand Therapy8(3), 191-194.

Dy, C. J., & Mackinnon, S. E. (2016). Ulnar neuropathy: evaluation and management. Current rev musculoskeletal med, 9, 178-184. 

Haloua, J. P., Collin, J. P., & Coudeyre, L. (1987). Paralysis of the ulnar nerve in cyclists. Annales de Chirurgie de la Main: Organe Officiel des Societes de Chirurgie de la Main6(4), 282-287.

Kalainov, David & Hartigan, Brian. (2003). Bicycling-induced ulnar tunnel syndrome. American journal of orthopedics (Belle Mead, N.J.). 32. 210-1. 

Maimaris, C., & Zadeh, H. G. (1990). Ulnar nerve compression in the cyclist’s hand: two case reports and review of the literature. British journal of sports medicine24(4), 245.

Noth, J., Dietz, V., & Mauritz, K. H. (1980). Cyclist’s palsy: Neurological and EMG study in 4 cases with distal ulnar lesions. Journal of the neurological sciences47(1), 111-116.

Ummer, C., & Albohm, M. (1997). Cyclist palsy in the 90s. Human kinetics. 20-21. 

Selçuk, B., Kurtaran, A., Yildirim, Ö., Değirmenci, İ., & Akyüz, M. (2015). Cyclist’s Neuropathy: A Compression Syndrome of the Deep Motor Branch of the Ulnar Nerve: A Case Report. Neurosurgery Quarterly25(3), 337-340.

1 Comment

  1. Aaron Kubistek on July 11, 2022 at 5:17 am

    As a triathlete and a CHT this has burdened me for quite some time.
    I struggle to find a balance between a comfortable grip on my handlebars and preventing hand numbness.

Leave a Comment

More To Read

Stretching Alone Can Change P1 Bone Shape in Patients with Camptodactyly

May 20, 2019

Woo Hong, S. Kim, J., Sang Kwon, O., Ho Lee, M., Sik Gong, H., Hyun Baek, G., (2019). Radiographic Remodeling of the Proximal Phalangeal Head Using a Stretching Exercise in Patients With Camptodactyly. J Hand Surg Am, 1.e1-1.e10 The Skinny – Camptodactyly is a congenital, nontraumatic flexion contracture of the PIP in fingers other than…

Read More

Splinting and Stretch Protocol for Pediatric Trigger Thumb

May 10, 2020

Tan, A. C., Lam, K. S., & Lee, E. H. (2002). The Treatment Outcome of Trigger Thumb in Children. Journal of Pediatric Orthopaedics B, 11(3), 256-259. The Skinny:Pediatric trigger thumb is a “relatively uncommon” condition of unknown origins. Studies have indicated that spontaneous recovery of trigger thumb is around 25-40%, and chances increase with age.…

Read More

7 Tips for your Osteo Arthritis Patients!

April 18, 2021

7 Tips for your OA Patients!  Managing Osteoarthritis in the Hand Our hands are one of the most intricate structures in the human body. They are composed of a network of tendons, ligaments, and nerves that make it possible to perform daily tasks such as unlocking a door, peeling an egg, or sending an email…

Read More

Sign-up to Get Updates Straight to Your Inbox!

Sign up with us and we will send you regular blog posts on everything hand therapy, notices every time we upload new videos and tutorials, along with handout, protocols, and other useful information.