BACKGROUND: Chronic ulnar nerve compression is believed to be the primary cause of sensory and motor impairments of the hand in cyclists, a condition termed Cyclist's Palsy. The purpose of this study was to quantitatively evaluate the effects that hand position and glove type can have on pressure over the ulnar nerve, specifically in the hypothenar region of the hand. METHODS: Thirty-six experienced cyclists participated. Subjects rode at a constant cadence and power output on a stationary bicycle with their hands in the tops, drops and hoods of a standard drop handlebar. A high resolution pressure mat was used to record hand pressure with no gloves, unpadded gloves, foam-padded gloves and gel-padded gloves. Wrist posture was simultaneously monitored with a motion capture system. Laser scans of the subject's hand were separately acquired to register pressure maps onto the hand anatomy. FINDINGS: Average peak hypothenar pressures of 134-165kPa were recorded when cyclists did not wear gloves. A drops hand position induced the greatest hypothenar pressure and most extended wrist posture. Padded gloves were able to reduce hypothenar pressure magnitudes by 10 to 28%, with slightly better pressure reduction achieved using thin foam padding. INTERPRETATION: The hand pressure magnitudes and loading patterns seen in steady-state cycling are of sufficient magnitude to induce ulnar nerve damage if maintained for long periods. Wearing padded gloves and changing hand position can reduce the magnitude and duration of loading patterns, which are both important to mitigate risk for Cyclist's Palsy during extended rides.
BACKGROUND: Chronic ulnar nerve compression is believed to be the primary cause of sensory and motor impairments of the hand in cyclists, a condition termed Cyclist's Palsy. The purpose of this study was to quantitatively evaluate the effects that hand position and glove type can have on pressure over the ulnar nerve, specifically in the hypothenar region of the hand. METHODS: Thirty-six experienced cyclists participated. Subjects rode at a constant cadence and power output on a stationary bicycle with their hands in the tops, drops and hoods of a standard drop handlebar. A high resolution pressure mat was used to record hand pressure with no gloves, unpadded gloves, foam-padded gloves and gel-padded gloves. Wrist posture was simultaneously monitored with a motion capture system. Laser scans of the subject's hand were separately acquired to register pressure maps onto the hand anatomy. FINDINGS: Average peak hypothenar pressures of 134-165kPa were recorded when cyclists did not wear gloves. A drops hand position induced the greatest hypothenar pressure and most extended wrist posture. Padded gloves were able to reduce hypothenar pressure magnitudes by 10 to 28%, with slightly better pressure reduction achieved using thin foam padding. INTERPRETATION: The hand pressure magnitudes and loading patterns seen in steady-state cycling are of sufficient magnitude to induce ulnar nerve damage if maintained for long periods. Wearing padded gloves and changing hand position can reduce the magnitude and duration of loading patterns, which are both important to mitigate risk for Cyclist's Palsy during extended rides.
Authors: Giuseppe Marcolin; Nicola Petrone; Carlo Reggiani; Fausto A Panizzolo; Antonio Paoli Journal: Medicine (Baltimore) Date: 2015-07 Impact factor: 1.817