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Virtual Case Study: Arm & Hand Pain While Cycling

Arm and hand pain while cycling that worsens as you ride can be prevented by following these simple tips!

Patient Presentation: History, Background, and Complaints

Jimmy N. presents to my office head down, shoulders drooping, and upper back the shape of a question mark, barely able to muster an exhausted whisper when heard saying, “My head feels so heavy I can barely hold it up.”


He noted that the muscles in his upper back and neck feel as if they are in knots and that his arms become so tired that he has trouble holding himself up from the saddle.

cycling avatar with large head

In addition, he often experiences numbness in his hand and fingers later in rides, especially if not wearing his cycling gloves.

Physical Examination

Postural examination reveals that Jimmy’s head and neck are protruding forward, his shoulders are turned inward, and his upper back is excessively curved.  The muscles in his chest and the front of his shoulders are extremely tight and those in his upper back and arms are weak and easily fatigued.

Diagnosis: What is it Called?

Handlebar Palsy or (Ulnar Nerve Neuropathy)

A compression of the nerve running on the inside of the hand which causes tingling, numbness, and weakness of the ring and little finger.

Carpal Tunnel Syndrome or (Median nerve neuropathy)

Involves the nerve traveling through the wrist, which when impaired involves the thumb, index, middle, and ring fingers and may also cause generalized hand weakness.

Etiology: What Causes It?

The vast majority of upper body-related pain and discomfort while cycling is due to improper position and poor posture.  Follow the simple upper body pain prevention tips shown below to make the corrections necessary to avoid arm and hand pain.

virtual cycling avatar with big head riding towards camera

Treatment: What Can You Do About It?

arm and hand pain while cycling can be prevented
arm and hand pain while cycling can be treated with exercise

Referral: When is it Time to Ask For Help?

The Expected Outcome: Conclusion

A cyclist’s upper body is often overlooked and neglected causing the potential for injury, ride limiting fatigue, and pain which worsens over time.  


In order to avoid discomfort, and to protect your arms and hands from injury arising from weakness, improper positioning, and prolonged maintenance of persistent positions on the bike, it is important to ensure a proper bike fit.


In addition, by following a consistent upper body flexibility program, the long-term effects of poor posture can be corrected.

What about you?

Have you noticed that your posture off the bike is affected by your position while on it?  If yes, what have you done to address this issue?  Your fellow virtual cyclists would like to know.

For tips on how to manage lower back pain while riding check out this virtual case study recently posted on The Zom.

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