Best 5 Exercises for Cyclist’s Palsy

Ulnar nerve compression or cyclist palsy (rarely called Guyon canal syndrome) is a wrist and hand presentation that can affect anyone, but is more common in cyclists. It is caused when there is sustained pressure on the ulnar nerve which results in neurological symptoms in the hand. Some other sports include tennis, wheelchair sports and in some cases office work. Due to the position of the ulna nerve, it is predisposed to compression from external forces e.g., bicycle handlebars. Basically, gripping strongly with a combination of vibrational force is a key problem for cyclists. Cycling on bumpy ground or for endurance events is a big issue.

Most people complain of loss of strength and sensory loss in their fingers and hand. In rare cases it can lead to further complications to sensation, strength and loss of muscle in the fingers and hand. These will often escalate to surgery. Mostly these types of injuries get better within a few days with no lasting effect.

If you are an athlete participating in cycling, wheelchair sports or tennis it is beneficial to be aware of how to reduce your risks of getting cyclist palsy.

Tips for Cyclist’s Palsy:

  • Get properly fitted to your equipment whether it be a tennis racquet or a road bike.
  • Ensure you are not gripping your equipment too hard – this can increase the compression if you are gripping strongly.
  • Choose your terrain carefully, if you are feeling symptoms of cyclist palsy it is important not to reaggravate it. Choose a smooth terrain if cycling. On-road is likely to be far better than off-road.
  • Take regular breaks, no matter what sport you engage in it is important to realise your limits. Rest often heals.
  • Try physiotherapy at Surrey Physio, often this is the quickest way to be seen and treated by a physiotherapist or osteopath and get results.

What Surrey Physio can offer

We can help treat Cyclist’s palsy by taking a detailed history of your injury, physically examine you and provide a tailored rehab plan to suit your needs. At Surrey Physio we have experienced staff trained in electrotherapy, acupuncture, massage therapy and exercise therapy. Treatment can include hands on therapy to release tension and reduce inflammation in the affected area. We can also offer basic advice on bike fit and posture to minimise future occurrences of cyclist palsy, although more specific advice may be required from a bike coach or technical bike shop. We also use frictions and mobilisations to the wrist, as well as electrotherapy such as ultrasound and shockwave. In addition, we can also use a steroid injection if other options have been exhausted.

In the meantime, we have developed 5 exercises we think could help you improve your symptoms.

Improve Grip Strength

Prevention is better than cure. One good way to prevent cyclist’s palsy is to strengthen your fingers, hand and wrist. There are lots of ways to do this, but using a grip strength trainer is a great method. You can buy one from . Squeeze ten times, for three sets. Repeat every two days. Gradually increase the resistance to build up your wrist strength.

Ice your Wrist

Usually inflammation is a key problem with cyclist’s palsy. The inflammation causes a compression on the nerve. Using ice (wrapped in a tea towel) should help reduce inflammation and pain in your wrist. Hold the ice on the inside of your wrist for 10 minutes, and repeat twice per day.

Ulnar Nerve Stretch 2 Sitting

Sit with good posture, and place your non-affected hand over your collar bone and shoulder on your affected side. Use this hand to hold down your shoulder blade to stop it rising up during the next part of the exercise. Join your thumb and finger on your affected side, making a ring. Lift your shoulder to 90 degrees as you hold the shoulder blade down with your opposite hand. Bend your elbow so the ring you made is positioned just above your shoulder. You should feel some sensation into the little finger. To make the exercise stronger, side bend your neck to the opposite side and extend your wrist towards your shoulder blade. Hold the stretch for 30 seconds and repeat three times.

How to Improve your Wrist Bend

Use your hand to bend your own wrist. Make sure you keep your wrist relaxed. This is a passive exercise used to improve the mobility of the wrist and stretch the forearm muscles. Hold the stretch for up to 30 seconds, and repeat three times.

Using a Table to Stretch your Wrist into Extension

Place your palm flat on a table with your fingers pointing towards you. Straighten your arm while you keep your palm flat on the table to create a stretch to the forearm flexor muscle group. Hold this stretch, and relax.

Cyclist palsy syndrome is a condition that can significantly impact the comfort and performance the public. However, with the right treatment and prevention measures, it is possible to recover and continue cycling without experiencing the symptoms associated with this condition. Physiotherapy plays a crucial role in the treatment of cyclist palsy. At Surrey Physio we offer a range of treatment options and services to help you recover and prevent future occurrences. If you are experiencing symptoms please do visit us in clinic and speak to our amazing team.

(Therapists, osteopaths, sports therapists, chiropractors reading this page… if you love the exercises here, then please check out the amazing exercise prescription tool You can sign up for a free 14-day trial, and it’s affordable to buy, with pricing starting from £11.23 per month.

If you are a patient, in pain, or elite performance, please call us to discuss your case further. Surrey Physio have an amazing team of therapists to help you recover from pain, but also to achieve top performance. Call us on 0208 685 6930 or click the link at the top to book online.)