Even when your health is a top priority, it does not mean that you are immune to having issues with your body and health. It really depends on what stressors you face and if your body is prepared for them. If you surpass your body’s stress threshold, it will kindly let you know. I recently found this out.
Canada Day long weekend: spectacular Toronto summer weather just asking for outdoor time and two birthday bike rides culminating in 264km of cycling in a 24 hour period. I spent more time on the bike than off of it…. and my body paid for it.
Even with an excellent bike fitting and good ergonomics in the saddle, I woke up with numbness in the pinky finger and half of the ring finger. No neck pain or anything else of note, just numbness. I have heard dozens and dozens of patients describe the sensation of this predicament and while experiencing this myself, the first thing I thought was, “Wow, how cool is this!”
After the initial amusement and novelty wore off, I realized how annoying it was to be unable to feel one’s fingers. I can also understand the concern someone would have if they did not understand the physiology of what was going on.
Most often this issue results from many hours in one posture – check – but more often it stems from continuous sitting or sleeping with your arm or neck in an odd position.
I know that this pattern of numbness corresponds to the sensation loss of the ulnar nerve. I also know that it was not likely related to a spinal nerve injury and disc herniation – thank goodness. If it had been just the pinky finger, or the pinky and index finger together, I would have been more suspicious of an aforementioned nerve root problem.
This type of numbness pattern is quite common in cyclists because of the strain on the neck incurred by long hours hunched forward on the bike. The ulnar nerve represents the lowest part of the brachial plexus nerve bundle leaving the neck into the arm and it can be easily compressed. The compression of the ulnar between the wrist and the handles bars also promotes this pattern of numbness. However, the chief cause can almost always be traced back to the neck and spine.
Without treatment, this irritation of the ulnar nerve can become a more serious ulnar neuropathy, in which swelling and / or inflammation around the ulnar nerve causes prolonged symptoms of weakness, sensory changes, and eventual muscle wasting.
The moral of the story is that I got adjusted two times that week, did some acupuncture on myself, and I am back to normal – i.e., I cycled 100km plus this weekend with no issue.
I know that most of the issue was the result of irritation in the neck affecting the nervous system that was being worsened by muscle tightness in the hand.
I also know that the symptoms would have likely gone away without treatment, but that I would have been more susceptible to it recurring throughout this summer from the stress of cycling or blogging. Just because the symptoms go away because the injury is sub-threshold, does not mean the problem is fixed.
I know to take care of a self-induced problem before it gets worse, and becomes a more permanent and chronic pattern; chronic problems rarely have acute fixes.
Whether it is too many hours at the desk or too many kilometres on the bike, strain above your body’s tolerance, will result in a problem. There are few office workers that have not noticed that working uninterrupted without a break can cause numbness and tingling down the sciatic nerve into the legs or from the neck into the fingers.
With time and proper training, your body can adapt: to increase its threshold to the strain of the bike or desk and to strengthen the muscles that need to withstand the most load. Ensuring that the nerves and joints function as they should (e.g. through adjustments of the spine) allows you to tolerate more stressful positions for longer.
Until you quit your desk job or I stop cycling, shouldn’t we all improve our tolerance?
- Dr Alex
