Preventing Cycling Arm and Hand Injuries

By Janet Apgar, OTR/L, CHT, ASTYM-cert for Athletico Physical Therapy

preventing cycling arm and hand injuries

As spring brings warmer weather and adds daylight hours, biking fever spreads!

Although biking is fun and can be good for your health, cyclists should still keep a few things about their bodies in mind before hitting those trails to prevent injury. Given its whole body involvement, cycling can involve a few injuries including ones to the upper body. In fact, one survey found that approximately 31 percent of cyclists reported overuse hand problems. So, whether your biking dreams entail off-road adventures or long-distance road cycling, it is important to take precautions to protect your arms and hands from injury, which can arise from one or more of these three causes: improper positioning, sustained positioning or trauma from a fall or collision.

Improper Positioning

Even after buying the correct sized bike and having the seat aligned, a misfit between the cyclist and the bike can occur affecting not only the spine and legs, but also the arms. Symptoms that may signal poor positioning can include numbness and tingling in the ring and small fingers, numbness and tingling in the thumb, index, and middle fingers, clumsiness with tasks involving hand coordination and pain in the arms, wrist, hands and back.

Some common positioning mistakes that can lead to numbness, tingling and wrist and thumb/hand pain include hands being positioned wider than shoulder-width apart and the wrists being angled too far back, forward or inward. These can be addressed by changing handle bars from straight to angled or using aero bars. Wearing padded gloves can also absorb the shock and vibration of the ride as well as allow for a looser grip.

Pain in the back and hands can stem from riding with rounded back and shoulders or with elbows locked in extension and can involve handle bars that are too low or too high in relation to the seat or tight hamstrings.

What is the right position then? The ideal riding position involves a neutral back, slight elbow bend, hands shoulder width apart and wrists in mid-position. Changes in handle bar height and angle (as mentioned above) as well as addition of ergonomic grips, added bar ends, adjustable height or adjustable angle handle bars can all assist to achieve the correct positioning.

If the above necessary positioning modifications are made and the affected body part is rested early enough, the symptoms should resolve within a couple of days. However, if symptoms involve coordination problems with the fingers or have been longstanding, it may take weeks to months to recover and may possibly require seeing a physician that is a hand specialist and/or an Occupational Therapist.

Sustained Positioning

Even with the best bike fit, sustained positioning while riding has the inherent risk of continuous pressure and requires constant shock absorption on the part of vital structures including: blood vessels, nerves, joints and muscles. This can lead to tissue breakdown and inflammation.

This can be especially prevalent with road bikes as their speed and aerodynamics require the trunk to be angled 60-75 degrees forward toward the bars (i.e., the cyclist is not as upright as the off road mountain biker or hybrid biker). This position requires strong overall core and upper body conditioning to go faster and/or longer distances. Addressing these areas as part of an overall fitness regimen can help prevent issues while riding.

Another way to counteract pain from sustained positioning is frequently moving the body parts that are typically static during a ride. This can be achieved by changing hand holds every three to five minutes and stretching on breaks or after the ride.

Here are a couple examples of stretches. Perform each stretch for five to ten seconds, repeating five to ten times during each break from riding. Notice that while both stretches involve the hands, they are stretched in opposite directions during each one.

  

Trauma

While the injuries that occur with bike falls and collisions are as varied as the impacts, two common bones broken are the clavicle (collar bone) and the scaphoid (wrist bone near the thumb). Extending the arm to break a fall focuses forces on these bones leading to injury during impact. Along with potential fractures, the clavicle is also prone to sprain or separation, which could require at a minimum sling usage or surgery depending on severity.

A scaphoid fracture can be easily missed as the telltale sign of this fracture, pain in the thumb side of the wrist, might not be felt as severely initially as other injuries. It is important to be vigilant of an injury in this area, however, as a design flaw in the blood supply to the scaphoid can lead to serious issues including avascular necrosis (failure of bone to heal) and long term functional impairment if not treated early. This is why it is important to not ignore wrist pain after a bike fall.

While prevention of falls and broken bones may not be entirely possible, if the biker holds on to the handle bars while falling, the entire body can absorb the blow of the impact rather than focusing the impact on these two bones in the outstretched arm. Wearing a helmet can also make the need to protect the head less of an issue during a fall.

Enjoying the Ride

By being aware of some of the most common arm and hand-related bike injuries, you can take the necessary steps to prevent these injuries from occurring during your rides. Should an injury occur, schedule an appointment at a nearby Athletico location so that our Occupational Therapists can help you heal in time for the next ride.

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Common Hand Injuries: Text Thumb; Little League Pitchers: Do’s & Don’ts; Importance of Sleep for Optimal Recovery

Episode 17.35 Rerun

Segment One (01:10): Dr. Nik Verma sitting in this week for Dr. Cole joins Steve andImage result for thumb overuse Nicole Kauppila from Athletico Physical Therapy to discuss Tech Thumb injury.

Each year as we approach the holidays, smartphones are listed as a top gift.  With use of smart phones – tech-related injuries called “tech-thumb” resulting from unnatural movements like constant texting are on the rise.

New smartphones often means even more time straining thumbs, in fact young adults spend a staggering one-third of their waking hours on smart phones. Nicole describes causes, symptoms, prevention and treatment for overuse injuries of the hand.


 Segment Two (11:46): Dr. Nik Verma, Head Team Physician for the Chicago White Sox talks with Steve about how to avoid overuse throwing injuries in young athletes; avoid training in one sport all year long, high pitch velocity and pitch counts that can cause damage from repetitive load on the growth plates of young athletes.

Image result for little league pitcher


Segment Three (20:14): Todd Sayer, PT from ATI Physical Therapy talks about the importance of sleep for optimal recovery; the correct supportive neutral sleep position; avoiding compressed shoulder joint in side sleepers.

How you sleep dictates how you perform, so whether you are falling short on logging enough sleep each night or poor sleep posture is inhibiting a solid day’s performance, making a few simple changes can help to enable a good night’s rest and support your body’s ability to adapt and adjust.

Todd Sayer  is a Senior Regional Director with ATI. He has 18 years of clinical experience specializing in treatment outpatient orthopedic and sports medicine injuries as well as chronic pain and post-operative care.

Overcoming Sleep Challenges and Discomfort

Tips for Preventing Common Skiing Injuries

By Tara Hackney, PT, DPT, OCS, KTTP for Athletico Physical Therapy

tips for preventing common ski injuries

Skiing is a popular outdoor winter activity that we tend to hear a lot about during the Winter Olympic Games. With the Winter Olympics occurring in PyeongChang this year, it is expected that the skiing will be making headlines in the coming weeks – from discussing amazing performances to unpredictable injuries.

Although skiing is a sport where lower body injuries are more common, upper body injuries can occur as well. Read below to learn about five common injuries that downhill skiers should be aware of, as well as tips to prevent these injuries from occurring.

ACL Tears

Most anterior cruciate ligament (ACL) tears occur from a non-contact knee injury, meaning the tear occurs when the knee is in poor positioning, not by the knee being hit or fallen on. In skiing, ACL tears can occur due to landing a jump in poor form with the weight too far back or when a skier tries to prevent a fall. Skiers who are falling should try to let the fall happen as safely as possible rather than trying to fight it to stand up. Trying to prevent a fall could result in twisting the torso in relation to the lower half, which may lead to knee twisting. This is when the ACL can tear.

MCL Injury

The medial collateral ligament (MCL) is on the inside of the knee. It is often injured or torn when the skier falls after trying to slow or stop by using the ski tips pointed toward one another in the snowplow position. MCL injuries are more common in beginner and intermediate skiers. Tips to decrease risk of MCL injury include making sure weight is balanced when in the snowplow position and staying on runs that are a comfortable challenge but not too advanced for the skier’s skillset.

AC Sprain

An acromioclavicular (AC) joint sprain is an injury to the ligament that holds the AC joint together at the top of the shoulder. Injury to this area is usually caused by a fall onto an outstretched arm. Skiers can decrease the risk of this type of injury by pulling arms toward the body should a fall occur, rather than trying to catch themselves on an outstretched arm.

Clavicle Fracture

Another injury that can occur when falling on the shoulder or outstretched hand is a fractured clavicle. The clavicle is the bone that is commonly called the “collar bone.” The best way to decrease the risk of a clavicle fracture is to decrease the risk of falling by sticking to runs that align with the skier’s skillset.

Thumb Sprain – a.k.a. “Skier’s Thumb”

Skier’s thumb occurs when a skier falls with a pole in hand. This can cause the thumb to overextend and sprains the ligament on the inside portion of the thumb. There are thumb stabilizers available to skiers that need them, otherwise the best way to prevent this injury is to avoid putting hands through the ski pole loops unless absolutely necessary.

Safety First

These are just a few of the injuries that can occur in downhill skiers. Although data shows that women are at a slightly higher risk of knee injuries and men are at a higher risk for shoulder injuries, it is important for all skiers to put safety first – especially inexperienced or novice skiers.

It is also important to note that there may be a higher incidence of head injuries associated with ski jumping or snowboarding where aerial tricks are being performed. To decrease the risk of head injury, helmets should be worn by all skiers and snowboarders. Should muscle soreness or pain occur after hitting the slopes, make sure to visit the nearest Athletico location for a complimentary injury screen.

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