The effect of long-distance bicycling on ulnar and median nerves: an electrophysiologic evaluation of cyclist palsy.
BACKGROUND
Distal ulnar neuropathies have been identified in cyclists because of prolonged grip pressures on handlebars. The so-called cyclist palsy has been postulated to be an entrapment neuropathy of the ulnar nerve in the Guyon canal of the wrist. Previous studies utilizing nerve conduction studies have typically been either case reports or small case series.


OBJECTIVE
Electrophysiologic changes will be present in the ulnar and median nerves after a long-distance multiday cycling event.


METHODS
Cohort study; Level of evidence, 2.


METHODS
A total of 28 adult hands from 14 subjects underwent median and ulnar motor and sensory nerve conductions, which were performed on both hands before and after a 6-day, 420-mile bike tour. A ride questionnaire was also administered after the ride, evaluating the experience level of the cyclist, equipment issues, hand position, and symptoms during the ride.


RESULTS
Distal motor latencies of the deep branch of the ulnar nerve to the first dorsal interosseous were significantly prolonged after the long-distance cycling event. The median motor and sensory studies as well as the ulnar sensory and motor studies of the abductor digiti minimi did not change significantly. Electrophysiologic and symptomatic worsening of carpal tunnel syndrome was observed in 3 hands, with the onset of carpal tunnel syndrome in 1 hand after the ride.


CONCLUSIONS
Long-distance cycling may promote physiologic changes in the deep branch of the ulnar nerve and exacerbate symptoms of carpal tunnel syndrome.
Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Anschutz Outpatient Pavilion, Box 6510, Mail Stop F712, Aurora, CO 80045-0510, USA. venu.akuthota@uchsc.edu
Venu
V
Akuthota
Christopher
C
Plastaras
Kirstin
K
Lindberg
John
J
Tobey
Joel
J
Press
Cynthia
C
Garvan
D000328:Adult; D001642:Bicycling / Q000293:injuries / Q000502:physiology*; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000502:physiology* / Q000503:physiopathology; D008875:Middle Aged; D009431:Neural Conduction; D011446:Prospective Studies; D014459:Ulnar Nerve / Q000502:physiology* / Q000503:physiopathology; D017769:Ulnar Nerve Compression Syndromes / Q000209:etiology / Q000503:physiopathology