Cyclist’s Palsy Treatment in London - Get Back on Your Bike, Pain-Free

Cycling should be about freedom, endurance, and flow, not discomfort or tingling fingers.If you’ve ever felt numbness or weakness in your hand after a long ride, you’re not alone. A condition called Cyclist’s Palsy can impact casual and serious riders. It develops when pressure on the ulnar nerve causes symptoms that range from mild tingling to muscle weakness and grip loss.

With the right advice and support, most cyclists can recover fully and prevent the issue from returning. From spotting symptoms early to exercises, there’s much you can do to help your hands.

Book your expert consultation today and get back to cycling without pain or numbness holding you back.

What Is Cyclist’s Palsy?

Cyclist’s palsy is a compression injury of the ulnar nerve - the same nerve responsible for the sensation in your ring and little fingers and some of your hand’s motor control. It usually occurs at the wrist or palm, where the nerve passes through a narrow tunnel called Guyon’s canal.

This compression leads to a combination of sensory and motor symptoms, and is most common in riders who spend long hours leaning on their handlebars - especially those riding on drop bars or in an aggressive forward position.

31% of cyclists experience some form of overuse hand pain - it is often worse when riding downhill.

Zones of Ulnar Nerve Compression

In the wrist, the ulnar nerve passes through three anatomical zones within Guyon’s canal:

1. Zone 1 - Proximal segment: Involves both motor and sensory branches - compression here causes mixed symptoms.

2. Zone 2 - Motor branch: Affects hand muscles but spares sensation - leading to weakness or hand clumsiness.

3. Zone 3 - Sensory branch: Affects the ring and little fingers without motor impact - causing tingling or numbness.

This classification helps determine the severity and focus of your symptoms, allowing our clinicians to tailor your treatment more effectively.

Cyclist’s Palsy vs. Other Conditions

It’s easy to mistake Cyclist’s Palsy for other hand or wrist conditions. Here’s how we help distinguish it:

• Carpal Tunnel Syndrome affects the median nerve and usually impacts the thumb, index, and middle fingers - not the ring and little fingers.

• Cervical radiculopathy (from the neck) often involves pain radiating down the arm and shoulder.

• Crutch palsy (radial nerve) affects the back of the hand and thumb extension, not the palm.

A clinical assessment helps confirm that your symptoms align with ulnar nerve entrapment specific to Cyclist’s Palsy.

Common Symptoms

Cyclist’s Palsy can present in a few different ways, depending on where the nerve is compressed:

• Numbness or tingling in the ring and little fingers

• Pain or aching in the palm, especially near the pinky side

• Loss of coordination in fine finger movements

• Weak grip strength or hand fatigue during everyday tasks

• In more advanced cases, wasting of the small hand muscles may be seen

Long rides or pressure on your wrist often make them worse.

How Long Does Cyclist’s Palsy Last?

• Mild cases often resolve within 1-2 weeks with proper rest and ergonomic changes.

• Moderate cases may require 4-6 weeks of rehab.

• Severe or long-standing symptoms could take several months to fully settle, particularly if muscle strength has been affected.

What Causes It?

The underlying cause is prolonged compression of the ulnar nerve at the wrist or palm. Specific contributing factors include:

• Leaning heavily on handlebars for extended periods

• Poor wrist positioning, often with flexion or extension

• Minimal handlebar padding or old, thin gloves

• Aggressive riding posture with forward weight distribution

• Prolonged vibration from the road, especially in endurance cycling

Handlebar width, glove quality, road conditions, and ride length all play a role in symptom onset.

Our Approach at Perfect Balance Clinic, London

At Perfect Balance Clinic, we don’t just treat the symptoms - we look at the full picture. Our approach combines detailed assessment, expert physiotherapy, and practical ergonomic solutions to get you cycling confidently again.

1. Detailed Assessment

We begin with a full biomechanical, neurological, and ergonomic review, which includes:

• Palpation and sensory testing of the hand and wrist

• Strength testing of hand muscles

• Screening for other conditions like carpal tunnel syndrome

• Posture and grip assessment on a bike or simulator

• Identifying which zone of compression is involved

We use this at Perfect Balance Clinic to create a plan for recovery and long-term prevention.

2. Expert Physiotherapy and Rehabilitation

Our treatment techniques are aimed at reducing nerve compression, restoring mobility, and promoting recovery:

• Manual therapy to relieve tension in forearm and wrist tissues

• Joint mobilisation to improve alignment and wrist mechanics

• Nerve gliding exercises (neurodynamics) to free the ulnar nerve

• Laser therapy (available at Moorgate & St. John’s Wood) to reduce inflammation and stimulate healing

• Activity modification guidance to reduce daily irritation

These techniques are delivered in a safe, progressive manner that matches your recovery stage.

3. Individualised Exercise Programme

Movement is key for nerve recovery. We’ll guide you through specific exercises including:

• Ulnar nerve glides

• Wrist extension and flexion drills

• Grip retraining using putty, rubber bands, or hand trainers

• Thumb opposition and pinch exercises

• Postural training to address poor cycling mechanics

All exercises are reviewed regularly and adjusted as you progress.

4. Cycling Ergonomics and Injury Prevention

Your bike setup plays a central role in both recovery and prevention. We’ll advise on:

• Handlebar height and angle adjustments to reduce wrist bend

• Brake hood and grip placement to support neutral alignment

• Upgraded bar tape or gel pads to reduce pressure

• Gloves with extra ulnar nerve padding

• Encouraging hand position changes every 10-15 minutes

We aim to make your cycling experience more comfortable - without changing your performance goals.

5. Ongoing Support and Cyclist Education

Our team continues to support your return to riding with:

• Education about safe cycling practices

• Tailored advice for triathletes, road racers, and commuters

• Return-to-ride protocols

• Periodic check-ins for setup re-evaluation

We help you get back on the road safely and stay there without setbacks.

Ready to Get Help?

If your hand feels numb, weak, or unresponsive after cycling - don’t ignore it. Acting fast makes healing at Perfect Balance Clinic easier.

Whether you’re training for an event or just commuting pain-free, we’re here to help.

Hear From Cyclists Like You

Many cyclists come to us frustrated by ongoing numbness, tingling, and discomfort - unsure of whether they’ll ever ride pain-free again. But after just a few sessions and some expert guidance, they’re back on the road stronger than before.

We regularly work with commuters, club cyclists, and competitive riders - and the results speak for themselves.

Prevention Tips for Cyclists

Even if you’re symptom-free now, preventing handlebar palsy is vital. Here’s what we recommend:

• Vary hand positions every 10-15 minutes

• Wear gloves with extra padding over the ulnar nerve

• Avoid over-tightening your grip - let the bar rest in your hands

• Keep wrists neutral - not overly flexed or extended

• Take short breaks during long rides to shake out your hands

• Check your setup at least twice a year, especially after a fall or new bike purchase

Ride Smarter - And Stay in Control

Cycling should be comfortable and enjoyable, not painful. If your hands are going numb, your grip is weakening, or you’re unsure why it keeps happening, now’s the time to take action.

At Perfect Balance Clinic, we bring together expert care, cyclist-focused rehab, and practical setup advice - helping you ride longer, train harder, and feel better on and off the bike.

Book your cyclist’s palsy consultation today and take your next ride with confidence, comfort, and control.

Book Your Appointment

Let’s help you recover properly and return to the activity you enjoy. Fill in the form below and one of our team members will reach out shortly to arrange your assessment.

Finding Us in London

Perfect Balance Clinic - Moorgate

Perfect Balance Clinic - St John’s Wood

Perfect Balance Clinic - Richmond

We offer early morning and evening appointments to accommodate your schedule.

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Perfect Balance Clinic, London