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Nerve injuries: Ulnar nerve neuropathy, carpal tunnel syndrome, and pudendal neuropathy

Q: My ring finger and pinky feel strange when I ride my bike. What's going on?

A: If you are experiencing problems with your ulnar nerve (the nerve that travels from the wrist to the shoulder), you may be having the following symptoms:

  • Your fourth and fifth fingers feel abnormal.
  • Numbness (less feeling in your hand or fingers)
  • Tingling or burning
  • Pain
  • Hand weakness

This condition results from activities like cycling, golf, or tennis. The first thing you can try is to change your hand positions on your bike if you feel pain while riding or after a bike ride.

If you have adjusted your hand position and tried resting but the pain hasn't gone away after six weeks, what are your options?

  • You may need to see your primary care doctor or a specialist certified in sports medicine. You may be referred to a neurologist (a doctor who specializes in nerve problems) or a physical therapist.
  • Pain medication or steroids may help the pain and reduce swelling.
  • A splint or elbow pad may ease symptoms.
  • Your doctor may determine that surgery is needed if your pain and symptoms get worse, if you are having trouble moving your hand, or if your nerve is degenerating (wasting away).

Q: I feel pain or numbness and tingling in my fingers or hands both off and on my bike. What should I do?

A: If you have a history of carpal tunnel syndrome or feel symptoms like these, you may have to adjust your hand position or ease up on cycling until your symptoms improve. Read more about carpal tunnel syndrome on our Dartmouth-Hitchcock Healthwise® Health Encyclopedia website.

This syndrome is characterized by:

  • Tingling (a painful prickling feeling) in the hands or wrists
  • Numbness of the fingers or thumb
  • Pain when the wrists are bent

Questions to ask yourself include:

  • Have I just begun cycling?
  • Have I increased the mileage or intensity (such as more hills) that I bike recently?
  • Does my seat height need to be changed?
  • Do I have a history of similar nerve problems?

Q: I have tried to change my exercise habits but the pain won't go away. What now?

A: If your symptoms don't go away or improve after several weeks of rest and modifying your activities, seek professional advice. You may need to see your primary care doctor, a specialist certified in sports medicine, or a physical therapist.

Q: I am experiencing numbness and pain in the groin while cycling. Is this common?

A: Male cyclists can experience groin pain or numbness, as well as erectile dysfunction – the inability to maintain an erection – caused by cycling. Damage to the pudendal nerve may result without a change in activities. Women can experience perineal injuries as well.

Things you can do to prevent or ease these symptoms include:

  • Change your position on the bicycle by lowering seat height to relieve pressure on the area of the perineum.
  • Change the angle of your seat by tilting the front of the seat downward slightly.
  • Consider buying a wider seat, designed to reduce pressure on the groin.
  • Recumbent bikes are also designed to relieve perineal pressure.
  • When riding, lift off the seat as much as possible.
  • Wear a good pair of biking shorts with padding.
  • Rest more frequently during or between rides.
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