REF-890 · Akuthota et al., 2005 · The American Journal of Sports Medicine, Vol. · Paper · PubMed

The effect of long-distance bicycling on ulnar and median nerves: an electrophysiologic evaluation of cyclist palsy

Blimited evidenceMeasured on a mixed groupWritten before October 2026, being re-checked

Distal ulnar neuropathy ("cyclist palsy") has been attributed to prolonged grip pressure on handlebars, but earlier nerve-conduction evidence was case reports or small series. Fourteen adults (28 hands) had median and ulnar motor and sensory nerve conduction measured before and after a 6-day, 420-mile bike tour.

Afterwards, distal motor latency of the deep branch of the ulnar nerve was significantly prolonged; the other median and ulnar studies did not change significantly. Carpal tunnel syndrome worsened in 3 hands and began in 1 hand. The authors conclude that long-distance cycling may cause physiological changes in the deep ulnar branch and exacerbate carpal tunnel symptoms.

Participants

n=14 adults (28 hands) riding a 6-day, 420-mile bike tour. Sex, age and cycling level are not given in the abstract.

Protocol

Median and ulnar motor and sensory nerve conduction studies on both hands before and after the tour.
Post-ride questionnaire: cycling experience, equipment, hand position and symptoms during the ride.

Key Results

After the ride, distal motor latency was significantly longer in the ulnar nerve's deep branch, recorded at the first dorsal interosseous.
No significant change was seen in median motor or sensory conduction, nor in ulnar sensory and motor recordings at the abductor digiti minimi.
Carpal tunnel syndrome: electrophysiological and symptomatic worsening in 3 hands, onset in 1 hand after the ride.
The abstract gives no latency values and no link between questionnaire answers and nerve changes.

Practical Application

In 14 riders (28 hands) tested before and after a 6-day, 420-mile bike tour, the deep motor branch of the ulnar nerve conducted significantly more slowly afterwards, and carpal tunnel syndrome worsened in 3 hands and began in 1. To "is hand numbness on long rides just discomfort?": not always; several days of long riding produced a measurable nerve change in this group.
Inference, not tested here: because the change was in a motor branch to a hand muscle, a rider may notice clumsiness or weakness of the hand, not only numbness.
Numbness or weakness that persists after riding, or that keeps returning, is a reason to see a clinician rather than to ride through it.
Not from this paper; the base's own practice: change hand position often, use padding at the contact points and check how much weight the bike fit puts on the hands. The abstract does not say which of these factors mattered; the contact-point advice in SYNTH-63 is house practice.

Limitations

n=14 riders (28 hands), no control group.
No latency values, symptom rates or equipment/position associations reported in the abstract.
Short-term only: recovery of the nerve after the tour was not followed.
Written from the abstract and record metadata only (full text not read).
How this entry was checked and changed
Why this level

small cohort, n=14 (28 hands), no control group