<You can also find this article in the September 2009 issue of The Racing Post>
Photo by Augustin Ruiz
Numbness or tingling in the hands is a relatively common occurrence in cyclists. I’d venture to say that most serious cyclists have experienced this phenomenon at least briefly while in the saddle.
However, the way in which it afflicts one person or the other can vary widely. To understand this we have to look at a “wiring diagram” of the body. That is, we have to understand some basic neuroanatomy.
There are many potential causes of tingling or numbness in the hands. These include autoimmune diseases that attack your own nervous system, nutritional deficiencies that impair the ability of your nerves to operate, or structural issues that physically put pressure on the nerve.
An actual impingement – that is, a pinched nerve, even if only while in riding position – is probably the most common reason cyclists experience this phenomenon. Tingling or numbness that only occurs while in the saddle definitely pushes structural issues to the top of our list of possible diagnoses. Since this is what most cyclists tend to experience, we’ll spend most of our time here exploring that possibility.
The nerves that supply feeling to your hands (as well as your sense of temperature, pain, pressure, and muscular control, etc.) start in your neck. There is a different spinal nerve, or nerve root, that supplies each of the areas consisting of your thumb and index finger, your middle finger and palm, and your ring finger and pinkie, respectively.
This means that if you have numbness that you feel only in your thumb and index finger, it means something different diagnostically than if you experience it in just your pinkie, or even in your whole hand.
This is where the “wiring diagram” comes in. There are typically only two or three places where each nerve root can get pinched. Where the roots start, in the neck, is a very common location for impingement.
If your numbness goes away after keeping your neck extended (i.e. looking up) for a minute or two, that’s a good clue that this might be where your problem is coming from.
The neck is not likely the source of your troubles if you experience numbness that covers the whole hand. For this to happen, all three of the primary nerve roots that supply the hand would have to be pinched at the same time. The only places this can really happen easily is in the area under your collarbone, or clavicle, and as the nerve bundles pass through an area deep in your armpit. After these points the nerves tend to spread out as they supply varying areas all around your shoulder, upper arm, forearm, and hand.
Around the elbow is another area where nerve bundles can experience impingement. This is why we refer to smacking your elbow in just the right way as hitting your “funny bone”.
What makes it funny (other than the name of the bone, the humerus) is the nerve that passes relatively close to the surface of the skin and supplies parts of your forearm and hand. Giving it a good whack is enough to send strange signals to your nervous system, which you experience as a tingling or buzzing sensation. You can then imagine what pinching a nerve off, even mildly, for longer periods of time can do.
A common misconception about any tingling or numbness in the hands is that it must be a condition known as carpal tunnel syndrome (CTS), where impingement of a nerve happens at the wrist. The carpal tunnel is a channel formed by the bones of your wrist and muscular and ligamentous attachments binding them together.
There is only one nerve that passes through the tunnel, and it supplies sensation and muscular control to the thumb side of your hand. This means that if you experience any tingling or numbness at all in your middle, ring, or little finger it is unlikely that you have CTS. The impingement is likely coming from one of the spots mentioned above.
Now that we’ve gone through some ways to distinguish one problem from another, what can you do about it? First, posture is king. Riding with your ears up close to your shoulders is a good way to increase the odds that you’ll pinch a nerve under your clavicle.
Similarly, riding with the head down (chin close to your chest) can set you up for problems in the neck. With neck problems especially, daily postural habits make a lot of difference.
Repeatedly reading in bed or watching TV on the couch with your head propped up, or working on a computer with the center of the screen lower than eye level can increase the likelihood of impingement in the neck. Frequent overhead activity (think painting a ceiling) can predispose you to compressing the nerves around your shoulders.
Long-standing cases of tingling or numbness typically need treatment. Specific, precise chiropractic adjustments of the neck, shoulders, and upper back can provide a lot of relief. Therapy should also be directed at correcting muscular issues that can impair shoulder and neck function and support.
If you have numbness in all fingers of your hands on both sides, especially if it continues while not riding, non-structural causes should be ruled out. Any good chiropractor, MD, or physical therapist should be able to help you narrow down what is happening in your particular case.
In short, if you’re having this problem, start being a detective. You might just solve your own problem or, at worst, you’ll have more precise information to provide your doctor that will help immensely in diagnosing, and ultimately fixing, the problem.
Great post! Thank you!