Highlights
- •Cyclists experience direct and indirect osteoarticular traumas and compression neuropathies from extreme repetitive and sustained compressive force on the volar wrist.
- •Despite the range of treatment available for peripheral neuropathies, a unique and common protocol is lacking on this specific topic
- •The first strategies to avoid peripheral neuropathies or reduce the initial symptoms are preventive strategies, period of rest since the beginning of the symptomatology, rehabilitation training with muscle strengthening, orthoses especially at night.
- •Symptoms refractory to conservative treatment (preventive strategies and rehabilitation) should be treated with pharmacological or surgical approach.
Abstract
Background
Recreation, transportation and sport are the most common uses of bicycles. Unfortunately,
repetitive bicycle use can also cause injuries, such as osteoarticular direct and
undirect traumatisms and sometimes compression nerve entrapment caused by an extrinsic
compressive force.
Purpose
The aim of the study is to define diagnostic process, preventive strategies, and treatment
of ulnar and median neuropathies in cyclists.
Study Design
Systematic review.
Methods
A search was conducted on PubMed, EMBASE, the Cochrane Library, and Web of Science.
Two reviewers independently reviewed articles and came to a consensus about which
ones to include. The authors excluded all duplicates, articles involving individuals
with other sport-related injuries than cycling, and articles unrelated to peripheral
neuropathies. Articles were included if hand palsy was due to peripheral compression
of ulnar or median nerve in cyclists.
Results
The search identified 15,371 articles with the keywords “Peripheral Nervous System
Diseases” OR “neuropathy” OR “ulnar palsy” OR “median palsy” AND “bicycling” OR “bike”
OR “bicycle” OR “cyclist”. The reviewers analyzed 48 full texts. There were 20 publications
that met the criteria and were included in the systematic review. These articles were
used to describe the main methods used for diagnosis, prevention and treatment of
hand neuropathy of cyclists.
Conclusion
Despite the range of treatment available for peripheral neuropathies, a unique and
common protocol is lacking on this specific topic. For this reason, we delineate a
definitive recovery protocol to show the best therapeutic methodologies present in
the current literature. Preventive strategies, period of rest since the beginning
of the symptomatology, rehabilitation training with muscle strengthening, orthoses
at night are the first strategies, but if the symptoms persist, pharmacologic treatment
and eventual surgical decompression are sometimes the unique solution.
Keywords
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JHT Read for Credit
Quiz: # 847
Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
- # 1.The study design is
- a.RCTs
- b.systematic review
- c.qualitative
- d.prospective cohort
- a.
- # 2.All selected articles dealt with
- a.carpal tunnel syndrome
- b.cubital tunnel syndrome
- c.radial tunnel syndrome
- d.compressive peripheral neuropathies involving the hand
- a.
- # 3.The literature showed
- a.a consensus as to best practices in treating this class of cases
- b.only one commonality across all studies
- c.no common management protocol
- d.that hand therapy is of little to no therapeutic benefit
- a.
- # 4.One important preventive strategy is
- a.carbohydrate loading before cycling
- b.ergonomic positional considerations when cycling
- c.ride fixed gear cycle when training
- d.low dose steroids during training
- a.
- # 5.The first line of management at the onset of symptoms is rest from function
- a.true
- b.false
- a.
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Article info
Publication history
Published online: December 28, 2021
Accepted:
November 13,
2021
Received in revised form:
November 5,
2021
Received:
February 10,
2021
Footnotes
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
No potential conflict of interest was reported by the authors.
The manuscript has been read and approved by all the authors.
The manuscript represents honest work.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
