elbow + forearm pain

[Climb01742]

the last month or two, i've had considerable pain in my left elbow and forearm, with lesser twinges in my right arm. i've been doing a bit of google research and have come across a few riders saying that riding on rough roads has given or worsened carpel tunnel syndrome. is such a thing possible?

two weeks ago, i got a bad cold and was off the bike for week. at the end of that week, my elbows/forearms felt noticeably better. coincidence?

for what it's worth, all my bars and stems are alu. and our new england roads sucks. and i did notice after riding my least forgiving bike recently that my arms felt not so good at all.

and this is just guesswork but i wonder if -- my left elbow/forearm feels worse because, since i shift gears so much more often with the RD (and hence my right arm), my left arm tends to be weighted more often?? just a guess but the left arm is definitely more sore.

any thoughts, suggestions, solutions? thank you in advance.

[93legendti]

I have it on occasion in my right arm. CVS sells a forearm wrap that places pressure on a spot 2" below your elbow and, for me, gives me significant pain relief. My pain comes from guitar playing and using a PC mouse. I use my left hand for the mouse quite a bit and it helps. When the arm is inflamed, it is surprising what can irritate it. I bought Camelbak Podium bottles, which are harder to squeeze than the bottles I am used to, and that action bothered my elbow.

If I am in bad shape, I will take a styrofoam cup, fill it 1/2 way with water and put it in the freezer. When frozen, I will peel off half of the cup so the ice is exposed and you can apply the ice to the affected area for 20 minutes, using subtle pressure as needed.

Specialized BG gloves also help.

[cmg]

sounds like a fit issue. is your saddle level? Can you release the bars and not fall forward while pedaling? if not level saddle and push back until you can then adjust reach to bars. this may result in a funky setup, saddle slammed all the way back with a 8 cm stem but you'll be pain free.

[malcolm]

Climb, with elbow pain I would think more ulnar nerve than median nerve which is the one implicated in carpal tunnel syndrome.

The ulnar nerve passes around the medial aspect of your elbow and can become irritated there and will give you symptoms into the forearm and hand. Usually your hand symptoms will be the lateral half of the 4th finger and the whole of the 5th or little finger. Carpal tunnel usually is focused around the wrist and will involve the other aspect of the hand, medial 4th finger over toward the thumb. Along with the discomfort will usually be some numb or tingly sensation in the same distribution.

I was having some ulnar nerve issues a few years back and moving around my hoods and a little narrower bar solved it. Have you changed bars or position recently? Mine also seemed worse on the trainer than actually on the road. This could well be just some tendonitis/inflammation as well. If you tolerate NSAIDs a 3-5 days of 600-800 of motrin 3 times a day may help. If it persists and you think it is nerve related you should see someone and have it checked out.

[victoryfactory]

I've noticed big differences in hand/forearm/elbow issues
by changing bar shape, tilt, brake location on the bar, hand position
and padding in the gloves or bar tape. Also saddle tilted back
1* or 2* can take a lot of pressure off the arms.

I think it's a mistake to think "I have ridden this same setup for X years
with no problem so it can't be the setup." YES IT CAN!

Are you riding in the drops or on the hoods? I find less arm/hand issues on
rides where I change hand positions often.

When riding on rough roads, you tend to grab the bars more tightly.
aka "death grip" which leads directly (according to me) to those
symptoms you mentioned.

good luck

VF

[zap]

Good advice posted so far regarding position (saddle back) and change hand positions regularly.

What also might help are dumbell workouts isolating wrist/forearm muscles.

[slowgoing]

tendon issues = rest till pain goes away + ramp up slowly.

Don't forget to also work out or work out more with your upper body so that the stress from riding won't overstress your upper body.

[1centaur]

Doing any weights? Any change in your physical routine? Moved furniture 2 months ago and injured something that keeps being slightly aggravated?

I find carpal tunnel hard to fathom - bike motions are not as exactly repeated nor a truly repetitious as the motions I associate with that syndrome.

Rest, ice, PT feel like the right path.

[2LeftCleats]

Sounds like a version of tennis elbow (tendinitis). Probably from the grip. As noted, possibly some fit change is necessary. I think this is less likely than nerve type injury (carpal tunnel). Avoidance of activities that provoke this is essential to recovery and that's probably why you felt better off the bike a while. If you were gripping too tightly because of the rough roads, possibly this is a causative factor. Sometimes the forearm wrap and changing hand position can help. These can be frustrating and slow to recover. Occasionally steroid injections work, if conservative treatment has not.

[spiderman]

Sounds like a version of tennis elbow (tendinitis). Probably from the grip. As noted, possibly some fit change is necessary. I think this is less likely than nerve type injury (carpal tunnel). Avoidance of activities that provoke this is essential to recovery and that's probably why you felt better off the bike a while. If you were gripping too tightly because of the rough roads, possibly this is a causative factor. Sometimes the forearm wrap and changing hand position can help. These can be frustrating and slow to recover. Occasionally steroid injections work, if conservative treatment has not.

sounds like lateral epicondylitis to me, too.
...rest, ice, the tensor ban and anti-inflammatories are all reasonable...
but the best advice is not holding on too tight on the rough roads...
--soft hands on the hoods -- even on cobbles--
other pt modalities can also help if needed
but reserve injections as a last resort.

[sevencyclist]

I had a fit done with Rick Yu at Eden Bicycles in East Bay a few weeks ago. We raised my bar a little, and put me on the Easton EC90 SLX3 carbon bar that has 1cm less reach, and now my right hand carpal tunnel syndrome has improved. While not totally gone, it bothers me a lot less during the ride.

I was anti carbon until this experience. Some of the improvement definitely came from the position, but I know the dampening effect of carbon helps a lot as well to reduce the shock to the front system. I can definitely feel the difference.

Hope this helps.

[quattro]

James, I had a bout of tendinitis about two years ago, I'm no Dr. and didn't stay in a Holiday Inn last night, but what you describe sounds similar. I visited an occupational therapist here in Needham, after about 2-3 weeks of therapy it subsided and went away. I did change a few of my activities that I determined may have caused the problem in the first place, cycling was not one of them. For me working with light barbells was the problem. Hope this helps PM me if you would like any additional info.

Regards,
quattro

[WadePatton]

some ideas:

fatter front tire and/or less pressure.

less pressure up front by modifying position-with bar height or distance. (assuming proper setback).

non-radially spoked front wheel.

should be a good start.

[Keith A]

James -- Your pain sounds just like mine. I saw an ortho doc last week and I have what doc spidey stated...lateral epicondylitis, commonly called tennis elbow. My doc said it takes four months to fully heal and to wear the armband (this is the one that I have...Aircast (http://www.aircast.com/index.asp/fuseaction/products.detail/cat/4/id/32)) ALL the time except when I sleep and shower. He also said to back off on the cycling, but I'm having a hard time doing so :rolleyes:

[Climb01742]

thanks VERY much to everyone for their replies. based on some of them, i've done further research. my pain seems to follow the path of the ulnar nerve, in particular at the palm of the hand and inside of the elbow. it also dawned on me, again based on some of your insightful comments, that some of my gym workouts may have been causal as well. the last few months i've been doing two core exercises where, in a push-up position, i have dumbbells in my hands. doh. both place a lot of body weight on the palms of my hands where the dumbbell handle is. between riding and gym workouts, the palms of my hands, and hence the ulnar nerve, have been stressed every day the last few months. dumbbell, indeed, eh? going forward, i'll: axe the two core exercises for others, get some PT, ice+anti-inflammatory, and be even more careful about varying my hand position. then the forearm wrap will be my next option. again, thanks to you all so much. without your thoughts, i'm not sure i'd have connected the dots. :beer: