How to Avoid Bicycle Injuries of the Hand & Wrist
Spring has finally sprung in Oakland County! Which means bikes are coming out of the garage and children and adults of all ages are once again enjoying bicycling and cycling.
But while biking is great fun, and good for your health, bicycling can also involve injuries – especially to the hands and wrists. And, in addition to injury from falls and crashes, research has found that approximately 31 percent of serious cyclists reported hand problems due to overuse.
So, whether you or your children are simply bicycling around the neighborhood, going on off-road adventures, or taking-up long-distance cycling, it is important to take precautions to protect your arms and hands from injury.
Causes of Bike Injury to the Hand or Wrist
There are three primary causes of wrist and hand injury from bicycling and cycling: improper positioning, sustained positioning or trauma from a fall or collision.
#1. Hand Injury from Improper Bicycle Positioning
Buying the correct sized bike, and having the seat properly aligned, is essential. A misfit between the cyclist and the bike can result in discomfort or injury to the spine, legs, and also the arms.
Symptoms that of poor positioning can include numbness and tingling in the any of the fingers or the thumb. Poor bicycle positioning can also result in problems with hand coordination and pain in the arms, wrist, hands and back.
To avoid hand injury from improper bicycle positioning, try to:
- Keep hands positioned no wider than shoulder-width apart
- Do not angle the wrists too far back, forward or inward.
- Change handlebars from straight to angled (or use “aero bars”).
- Wear padded gloves to absorb shock and vibration
#2. Hand Injury from Sustained Bicycle Positioning
Even with the best bike fit, sustained positioning while bicycling puts continued pressure and constant shock and vibration on the blood vessels, nerves, joints and muscles in the hand. As a result, bicycling for long periods of time can cause tissue breakdown and inflammation.
To avoid hand injury from bicycle sustained positioning, try to:
- Select a bike that is not excessively angled forward toward the bars
- Do core strengthening exercises if a bike with a steep forward angle is necessary
- Frequently move the body parts that are usually static during a ride
- Change hand holds every three to five minutes
- Stretch before, on breaks and after the ride.
#3. Hand Injury from Trauma (Bike Falls)
Bike falls and collisions are a common cause of injury in children. It goes without saying that a properly fitting helmet should be required safety equipment whenever and wherever a child or adult is bicycling. But two common injuries from bicycle falls cannot be prevented with a helmet: broken, sprained or separated collar bone (clavicle) and broken or sprained scaphoid (wrist bone near the thumb).
Avoiding hand injury from bicycle falls:
Wrist and hand injuries usually occur when the bike rider extends their arm to break the fall. But if the biker holds on to the handle bars while falling, the entire body can absorb the impact – rather than concentrating the force of the fall on these two bones in the outstretched arm. This can minimize the trauma to the wrist, fingers, shoulder and hand – and help avoid broken bones and sprained joints.
And remember, it is extremely important to see a hand doctor if you have wrist pain or swelling after a bike fall! Rapid treatment can help to avoid serious issues including avascular necrosis (failure of bone to heal) and long term loss of mobility or function.
How Hand Doctors Treat Bicycling Injuries
Bicycle-related hand and wrist injuries require specialized assessment and treatment from experienced hand specialists like Dr. Uzma Rehman in the Bloomfield Hills area. These injuries—ranging from scaphoid fractures and hook of hamate fractures to ulnar nerve compression and handlebar neuropathy—demand precise diagnosis through comprehensive examination and advanced imaging techniques. Early intervention proves particularly crucial for cycling injuries, as the distinctive mechanism of falling onto outstretched hands or experiencing prolonged compression from handlebar pressure creates injury patterns that benefit significantly from specialist evaluation within days of occurrence. This prompt care helps prevent long-term complications like malunion, chronic instability, or permanent nerve damage that can end a cyclist’s riding career.
Initial treatment of a bicycle injury often focuses on proper alignment of injured limbs, particularly for fractures and dislocations common in cycling falls. For displaced fractures, setting the bones in proper anatomical position may require closed reduction under local anesthesia or, for more complex injuries, open reduction with surgical fixation. Unlike general orthopedic care, hand-specific treatment addresses the biomechanical complexities of the wrist and hand essential for steering control and brake manipulation during cycling. Dr. Rehman’s specialized expertise enables her to develop treatment plans that consider both immediate healing and long-term functional requirements for returning to safe, comfortable cycling.
Immobilization through custom splinting or casting follows initial treatment, with the specific approach tailored to the injury pattern and healing stage. For cyclists, specialized orthoses often allow continued training on stationary equipment while protecting injured structures—an important consideration for maintaining fitness during recovery. These custom devices balance necessary protection with functional movement of unaffected joints, preventing the stiffness and muscle atrophy that compromise return to cycling. For injuries like cyclist’s palsy (handlebar neuropathy), specialized padding and positioning adjustments complement medical treatment to address both symptoms and underlying causes.
Surgical intervention becomes necessary for certain more severe cycling injuries, particularly unstable fractures, complete ligament tears, or nerve compression not responding to conservative measures. Dr. Rehman employs advanced techniques including minimally invasive fixation, arthroscopic repair, and microsurgical nerve decompression to address these complex injuries. The surgical approach prioritizes stability while preserving the range of motion and grip strength essential for bicycle control, braking, and shifting. Throughout surgical planning and execution, she considers the cyclist’s specific riding style, handlebar configuration, and competitive goals to create individualized solutions that facilitate return to optimal cycling performance.
Rehab After Bicycle Injury
Rehabilitation following cycling hand injuries requires specialized hand therapy protocols that Dr. Rehman coordinates with our in-house certified hand therapists. These physical therapy programs often begin with protected motion of joints, advancing through structured stages of increasing mobility, strengthening, and finally sport-specific conditioning.
The rehabilitation process incorporates elements that simulate cycling-specific hand positions and stresses, including graduated grip strengthening, vibration tolerance, and wrist positioning in various handlebar configurations. This comprehensive approach ensures cyclists can safely return to riding with proper technique that minimizes re-injury risk, often supplemented by equipment modifications like padded gloves, ergonomic grips, or adjusted handlebar positioning to protect vulnerable structures while maintaining performance.
Bike Hand Injury Doctor – Bloomfield Hills, MI Area
Have fun bicycling! But be aware of the most common arm, wrist and hand-related bike injuries, so you can take some of the necessary steps to prevent these injuries from occurring during your rides.
And if you experience “pins and needles” in your fingers during or after riding, aching or throbbing on the small finger side of the hand, or hand or wrist pain or swelling after a fall, schedule a consultation with experienced hand doctor Uzma Rehman, MD at her Bloomfield Hills area or Shelby Twp. Office.
