During my first year of seriously cycling, I would experience numbness in my hands, particularly my last two fingers. My physical therapy mind engaged in figuring out what orthopedic issue was present. The clinical tests were negative for any major nerve involvement. So why did my hands become numb?

If you have ever hit your funny bone just right, you know how annoying it can be when your last two fingers become numb. On a side note, your funny bone is called the humerus. Get it, humor-us. I know, I know, a bad physical therapist joke. When you hit your funny bone, the feeling you get is the same feeling when cycling. This feeling can be quite problematic, especially when braking and shifting. The nerve at your funny bone near your elbow is called the ulnar nerve. The ulnar nerve starts as nerve roots extending from your neck. These nerve roots then combine at the thoracic outlet along your neck and become the peripheral nerve known as your ulnar nerve. The ulnar nerve continues to travel down the inside of your upper arm to the outside of your wrist and extends to the last two fingers of your hand. 

If the ulnar nerve is hit or compressed anywhere from its journey from the neck to the hand, then your last two fingers will become numb and tingly. The main point of compression when cycling is at the wrist. Typically, the wrist is tilted upward or radially deviated too far.

This increased tilting exposes the ulnar nerve at your wrist and creates direct compression when riding. Unfortunately, this compression type creates numbness and tingling at your last two fingers and is diagnosed as ulnar palsy. The good news is that the numbness and tingling are usually temporary, and there are quick and easy fixes.

Top Three Fixes of Ulnar Palsy

1. Handlebar tilt – If the handlebars are not tilted correctly, your wrist is forced upward too much. You continue to apply direct pressure to the ulnar nerve in this position. To avoid this position, slightly tilt your handlebars forward. 

Before making this adjustment, ensure that the rest of your fix is correct. Check out Do You Have Knee Pain When Cycling? and Do You Have Neck or Back Pain When Cycling? to ensure that your fit foundation is in the right ballpark. If the foundation of your fit is not correct, then you may prematurely tilt your handlebars.

Before tilting your handlebars forward, ensure that the starting position is correct. In addition, the hoods should be level. 

If they are not positioned correctly, first level your handlebars and test that new position for a few weeks of consistent riding. If you are still experiencing numbness and tingling, then slightly tilt your handlebars forward. Increase the forward tilt a few degrees. Be sure not to over-tilt the handlebars. Over-tilting the handlebars will turn the hoods of your shifters and brakes into a slip and slide for your hands. Hopefully, you can pinpoint a sweet spot for your hands after some trial and error.

2. Increase padding – Depending on the anatomy of your hands, you may need some extra padding to protect your hands, especially during long and bumpy rides. If you need more cushion, replace your handlebar tape with tape that has more cushion.

3. Vary your hand position – Even with the best positioning and treatment, you may still experience intermittent numbness and tingling. These symptoms are common during long rides or offroad rides. The long-term compression and vibration can create cumulative compression. To reduce the compression, try riding on the drops or near the center of the handlebars. 

After adjusting the tilt of your handlebars, adding some cushion, and varying the position of your hands, most people no longer have the dreaded ulnar palsy. What if you are not most people? You may need to consult a medical professional.

There are many causes of hand numbness and tingling. If you have done your due diligence by getting a professional bike fit, slightly adjusting the fit, and adding more cushion, consider seeing a physical therapist. As described above, the ulnar nerve and other nerves travel from the neck to the hand. Compression on a nerve anywhere from the top to the bottom of its distribution can cause symptoms. You need an expert to get down to the bottom of things. Your neck could be the problem, or your posture on the bike could be the problem. 

Typically, ulnar palsy is temporary if addressed correctly. However, don’t turn it into a long-term problem by wishing it away after months pass.