Ulnar and median nerve palsy in long-distance cyclists a prospective study

Background: Although case reports have identified the presence of distal ulnar nerve sensory and motor dysfunction in long-distance cyclists, the actual incidence of this condition, referred to as "cyclist's palsy," is unknown. Purpose: To determine the incidence of distal ulnar nerve compression in cyclists. Study Design: Prospective study. Methods: Twenty-five road or mountain bike riders responded to a questionnaire and were then physically examined and interviewed before and after a 600-km bicycle ride. Results: Twenty-three of the 25 cyclists experienced either motor or sensory symptoms, or both. Motor symptoms alone occurred in 36% of the hands (11 cyclists) tested; no significant difference in the incidence of motor symptoms was found among cyclists of various experience levels or based on handlebar types (mountain bike versus road bike). Sensory symptoms alone occurred in 10% of hands (four cyclists) tested, with the majority of these being in the ulnar distribution. A significantly higher proportion of mountain bike riders had sensory deficits compared with road bike riders; however, there was no significant difference in the occurrence of sensory deficits based on level of experience. A total of 24% of the hands (eight cyclists) tested experienced a combination of motor and sensory symptoms. These motor and sensory symptoms were equally distributed between road bike riders and mountain bike riders and riders of various experience levels. Conclusions: Cyclist's palsy occurs at high rates in both experienced and inexperienced cylists. Steps may be taken to decrease the incidence of cyclist's palsy; these include wearing cycling gloves, ensuring proper bicycle fit, and frequently changing hand position.