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ulnar nerve help

gwdykes@hotmail.comgwdykes@hotmail.com
in General Training Discussions
Spent morning at minor emergency clinic, woke up at 3 with significant wrist pain, diagnosed as pinched ulnar nerve doc says likely from aero bars, originates from elbow, will add padding and stay off it but would appreciate any advice from the haus

Comments

  • cgres123cgres123
    Padding can make it worse too I say time for a refit.
  • Jess WithrowJess Withrow

    Hey Greg - saw your post on the dash yesterday (sorry it took me >24 hrs to get around to a reply!  Looks like my response time is as slow as my S/B/R these days!)...  I have a few thoughts:

    • John K makes a great point, and I completely agree that your pain/nerve compression could be originating from someplace other than the ulnar nerve/cubital tunnel (it's like the carpal tunnel, but in the elbow...  a small, tight space where the nerve runs through and can become irritated/compressed).  Compression at the cubital tunnel is the obvious answer given prolonged elbow flexion when riding aero, BUT, there's the possibility that it's less about HOW you're compressing the nerve and more about WHY you're compressing it.  I think it would be beneficial for you to look proximally and determine whether you have rotator cuff/lower trap/rhomboid/lat weakness - anything that would allow your upper traps and/or delts to take over the job of stabilizing your shoulder, placing it in a more forward "hunched" and elevated position.  If this is the case, you're putting a LOT more pressure down into your elbow and onto that cubital tunnel.  
    • Any neck pain/tightness?  It could be a C5-6 or a thoracic outlet issue - the ulnar nerve passes under the clavicle and tight scalenes (at the front of the neck, above the clavicle) can also irritate the ulnar nerve.  I HIGHLY recommend having those scalenes looked at!!!
    • Dave is also right - more padding really doesn't equal more better.  I specialized in wheelchair seating/positioning for a number of years, and when a patient had pressure issues, the answer was very rarely, "add more padding."  Consider your saddle - very little padding compared to, say, a recreational mountain bike that my father-in-law would ride (yes, he rides with a big cushy saddle no matter what JW tells him!).  If you had saddle issues, you would look for a different saddle or tweak your fit...  go here first with the aero set-up, too.  
    • ART - yes, yes, yes.  Definitely find a good provider with certification in nerve entrapment!  
    • Nerve gliding exercises can also be helpful, but probably a good idea to speak with a therapist before starting them - they can cause more irritation if not done properly...  Here's a quick video:  http://youtu.be/_Pwi8piDXMQ

    Good luck - keep us posted!  

    Jess

  • gwdykes@hotmail.comgwdykes@hotmail.com
    Jess, Thank you very much for the insight,  makes a lot of sense, particularly the connection to neck and shoulder tightness and pain as I have been experiencing some of that.   I did get a professional fit and adjustment in February including a new Adamo saddle and have never been more comfortable from that perspective.  Thank you again for the help. 
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