Help needed from the collective mind.

[Clayton]

I just got back from my Nerve doctor, a Physiatrist, pain specialist...I have had four total carpal tunnel surgeries. Three on my hands and one ulnar nerve relocation in my left elbow. The results from my latest nerve conduction study show that I have rather bad nerve damage in my left elbow that is permanent. Riding antagonizes the pain and numbness. I ride a Rivendell Atlantis and it has been pretty much my only bike for the past 20 years or so. I run a White Brothers suspension seatpost, B-17 saddle, 2.2 wide tires at 40 psi, 100mm dirtdrop stem at max extension and woodchipper bars. I wear gel gloves and use brooks handlebar tape. I see two options. Sell my Atlantis (oh God NO!) and buy a 29er with a front suspension fork or full suspension (I have a bad back and have had multiple back surgeries) or run my air pressure at 20psi with ridiculously fat handlebar padding.  I have very little weight on my hands as the bottoms of the drops are level or higher than my saddle. I have tried flat bars, bike fits, noodles, alt bars etc. The wood chippers are the most comfy so far. Does anyone have any experience with numb hands and cyclist palsy? I am counting on the collective mind...P.S. I have been a race team mechanic, a racers coach and managed bike shops, so I am somewhat knowledgable on bike fit and options. Also I can't ride stooped over due to my back problems, ie; road bike position. Rest isn't an option, because I refuse to own a car (PTSD issues) and the bike is my only transportation. Help? Thanks in advance. 

[dougP]

Clayton:

Sorry to hear about these problems.  Sounds like you've put a lot of thought & effort into managing them.  Have you tried Ergon grips?  If one tends to use the ends of the handlebars, they can be a big help.  Also the idea of ridiculously fat handlebar padding is worth a go.  Sounds as if you really can't put any pressure on your hands. 

dougP

[Steven Frederick]

Try Fizik bar gel under your tape.  It's the best of such products I've tried, and it really does make a difference.  If you can stand losing the brooks tape, Cinelli gel cork tape over the gel pads would be a double-cush whammy and also make for a fatter grip which may help in itself.  I've had similar problems tho not to that degree and I'm able to ride relatively pain and numbness free with some combination of the above. 

http://www.fizik.it/en/accessories/bartapes/Bar-gel/

Good luck!   Steve

On Thu, Aug 29, 2013 at 2:36 PM, Clayton <treef...@yahoo.com> wrote:

I just got back from my Nerve doctor, a Physiatrist, pain specialist...I have had four total carpal tunnel surgeries. Three on my hands and one ulnar nerve relocation in my left elbow. The results from my latest nerve conduction study show that I have rather bad nerve damage in my left elbow that is permanent. Riding antagonizes the pain and numbness. I ride a Rivendell Atlantis and it has been pretty much my only bike for the past 20 years or so. I run a White Brothers suspension seatpost, B-17 saddle, 2.2 wide tires at 40 psi, 100mm dirtdrop stem at max extension and woodchipper bars. I wear gel gloves and use brooks handlebar tape. I see two options. Sell my Atlantis (oh God NO!) and buy a 29er with a front suspension fork or full suspension (I have a bad back and have had multiple back surgeries) or run my air pressure at 20psi with ridiculously fat handlebar padding.  I have very little weight on my hands as the bottoms of the drops are level or higher than my saddle. I have tried flat bars, bike fits, noodles, alt bars etc. The wood chippers are the most comfy so far. Does anyone have any experience with numb hands and cyclist palsy? I am counting on the collective mind...P.S. I have been a race team mechanic, a racers coach and managed bike shops, so I am somewhat knowledgable on bike fit and options. Also I can't ride stooped over due to my back problems, ie; road bike position. Rest isn't an option, because I refuse to own a car (PTSD issues) and the bike is my only transportation. Help? Thanks in advance. 

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[William]

Boy that sounds pretty horrible.  A former co-worker at the bike shop had pretty major hand and elbow problems as well, and the four things in life he really liked doing were: drawing, guitar, cycling and mechanic work.  All four severely aggravated his conditions.  I know it was hard.  He did use a full-susp 29er for quite a while.  He also used a recumbent for a while.

On Thursday, August 29, 2013 11:36:24 AM UTC-7, Clayton wrote:

[Jim M.]

Have you tried albatross or bosco bars? They can allow you to sit upright and put no pressure on your hands. I 2nd the recommendation for Ergon grips too. Where are you? Maybe there is a list member nearby who can let you try those bars.

jim m
wc ca

[blakcloud]

I am with Jim M. on this one. A complete new position on the bike where less weight is going to the hands is in order. I have the Albatross bars and on my three other bikes I have Ergons, which are the best grips I have ever used. On the Albatross, I used padded bar tape for the grip. The reason is I hated the cable from the bar end when I used cork grips, this way it is wrapped under the tape. Nicer feel for my hands.

Lately I have been seeing in photos that people are starting to use Ergons with Alba bars which look great to me. Don't know if I could live with the bar end cable under the grip again but it might be worth a try.

[Zack]

first of all, condolences on dealing with what sounds like a terrible health issue. rough stuff.

i don't suffer from anything close to that, but was going to suggest trying a set of bosco bars.  they help me with neck and back pain.  the boscos get the handle/grips up higher than the stem, and i absolutely never feel like i am resting any of my weight on the bars.  i wonder if having the grips above the stem would be helpful, regardless of the height compared to the saddle?  (woodchippers look to me like they sort of slant downward from the stem, unlike the boscos).  

[Tim Whalen]

Hi Clayton,

I am very sorry to hear all of that.  I have a lot of spine damage and for a while was forced by back pain to a recumbent, both two wheelers and trikes.  I don't like them as much as an upright but they are super comfortable and it is riding and is enjoyable.  After some years I was able to get back onto my uprights and now ride a Roadeo, a Fargo on bike trails and a suspended 29'er on mellow single track. 

From your description it sounds like recumbents might be worth a try and might either let you get back to the Atlantis full time eventually or keep riding it some of the time by mixing it up. 

All the best for sure,
Tim

--

[Liesl]

Have you tried albatross or bosco bars? They can allow you to sit upright and put no pressure on your hands. I 2nd the recommendation for Ergon grips too.

Dang, Clayton!

I. too, suggest Boscos and Ergons, which I have for neck trouble.  My colleague Nils is an organist and suffers from carpel tunnel (plus his wife is an MD) and he had tried a bunch of stuff similar to what you are describing.  He switched out his drops to boscos, Miesha's, shimano MTB levers, barend shifters, and interupters on the flats by the stem.  It's a different world for him.  So Mieshas or Ergons and boscos.

best best best of luck, RCW

[Michael]

Let me add, bolt upright on Albas might be worth a try.

You may need a shorter stem, like an 8cm extension to get the bars back far enough. That's what my Alba setup is. Least amount of weight possible on hands - bolt upright.

I still get some hand stuff going on though. 

 

I knew a guitarist once who told me that using those hand grips exercisers eliminated his CT, if I remember correctly. Perhaps he caught it early. I remember him grabbing a guitar neck to pick one up and yelling out loud because it hurt.

[Eric Platt]

Another one to suggest Albatross or other bar.  Have had carpal issues in the past and sitting more upright has definitely helped.  From my experience, elbow flexing more than weight on hands seems to be a big factor.

 

Did have Woodchippers on my Fargo.  After a while, they seemed to contribute to the pain.  This would take some work, but maybe a set of Salsa Cowbell bars might be better.  Less reach.  You'd have to go to a threadless adaptor and different stem as the center is 31.8.

 

Been going to something similar on a non-Rivendell bike.  It may end up with Albatross bars as

Eric Platt

St. Paul, MN

--

[clayton bailey]

Hi,

Yes I have tried Albas...Similar, but not quite as swept back, with Ergons. However, they didn't work. Sigh...Thanks though...

Clayton

---

From: Jim M. <math...@gmail.com>
To: rbw-owne...@googlegroups.com
Sent: Thursday, August 29, 2013 12:12 PM
Subject: [RBW] Re: Help needed from the collective mind.

Have you tried albatross or bosco bars? They can allow you to sit upright and put no pressure on your hands. I 2nd the recommendation for Ergon grips too. Where are you? Maybe there is a list member nearby who can let you try those bars.

jim m
wc ca

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[Clayton]

Thanks to everyone for your advice. I sincerely appreciate the collective. I should have expounded on my explanation. The conduction in my hands isn't too bad according to the tests. My current position on my bike is very upright. The lower drops are at the height of the saddle. I have very little weight on the bars as  ride mostly on the hoods. My doctor told me the two places to avoid pressure on my hands are on the flat part on the outside interior palm and just back from the center of my palm. With the drops, I hang my hands from the fat of my thumb from the hoods, if that makes sense, which does not touch either area. Ergons put weight on the flat part of my outside palm. So do regular grips. Albas and such, also don't work. My primary problem....is in my elbow, according to my tests. I have owned a tour easy, which was hell on the back because I couldn't unweight over my rough roads and bumps. The only thing that makes any sense to me is vibration? I think the best thing to try from your advice is stupid thick bar tape. I'll try the Fizik tape with two layers of foam tape and let you know how things go.....Thanks again to all of you!

On Thursday, August 29, 2013 11:36:24 AM UTC-7, Clayton wrote:

[BenG]

Hi Clayton.  So Sorry!  You're farther down that road than me, so I'd appreciate your advice in return.  As far as riding goes, I'll offer something.

My tingling, burning and yet numb finger symptoms went from tolerable to not so, just one month ago.  Although there was some aggravation/trauma in July, in the form of an

encounter with a caulking gun, the diagnosis by Orthopedist is carpal tunnel syndrome.  Work involves a good bit of typing, and I've been type-1 diabetic for 40 years, so I assign to riding a minor significance in terms of its contribution to this condition.  I rode above-saddle Alba bar for last 3 years; a big, new Hillborne since May with really high Bosco bar; yet carpal seized the day.  Doc sold me a Hely & Weber wrist brace to maintain neutral position at sleep, so I wear it to ride, also.  My pain frequency and intensity are both improving, and riding has gotten much more comfortable.  I've washed the brace without damaging it.  Surgery may still be in my future, but I'm going to let the brace run its course first.

I meet the bar by letting my forearm bring the neutrally-braced wrist and passive hand to the Bosco grip, and then I just allow my hand to guide that grip without "flexing" my wrist.  So far, so good.  Incidentally my grip is just purple cloth tape over "cork" tape, wrapped tightly by Rivendell's builder, and not very cushy.

Wishing best for you, Clayton,

Ben

[LF]

It may be heresy ... and I'm just sayin ... not speaking from experience ... but ... whadja think of a (recum) bent?

L

[bobish]

Clayton, I've been there. I went to a recumbent and it cured it until I could figure out other things (clean up diet, strengthen back, sleep with wrist brace, take more breaks from intensive activities which caused flare ups). Now I have a recumbent and a couple of DF bikes and after years of being totally "'bent," I'm riding the DFs almost exclusively. I no longer sleep with the wrist brace but I wake with numbness and pain some mornings (nothing like before though). Pain is not gone but it's no longer debilitating.

Since you can't abide rough roads on the tour easy, you might consider trying a recumbent with suspension (bike or trike). Of course, this after you've exhausted the tweaking options on your current bike. As for the tour easy, you can unweight over rough roads if the pedals are close enough to the seat back (push yourself up off the seat bottom). Also pneumatic suspension. With a disc brake in back, you'd be able to get a pretty fat tire on there and run it low pressure. I have a 37 and it looks like there's room for much more.

Anyway, you're on your own personal journey and if my experience is any indication, it's going to be along process. Good luck!

• Perry

[James Philip]

Hi Clayton,

Sorry to hear about the condition. I hope this helps - while out on the road a few weeks back, I met gentleman who "apologized" for his triathlon aero-bars by explaining that he had carpal tunnel, and that resting on his forearms was the only way he could ride any distance, as he had difficulty holding onto the hoods of his bike. When I read your post, I wondered if this might be an option ?

From the rest of your original post, however, I understand that your lower back may not allow you to use aero-bars in their more traditional position, but how about something which looks like this: http://sheldonbrown.com/org//thorn/index.html and placing the aerobars where Sheldon had the top flat bar ? 

If you decide to try aero-bars, I also found a thread on a Triathlon forum which suggests J-shaped bars to be better suited than S-shaped or straight bars (http://forum.slowtwitch.com/gforum.cgi?post=1067607) as they place the hands in a more comfortable position.

I hope that helps !

Regards

Jim

On Thursday, August 29, 2013 11:36:24 AM UTC-7, Clayton wrote:

[Deacon Patrick]

That approach matches mine, Perry. Crutches (anything padded/supportive) sould be used as a last resort, and then only temporarily if possible. While I've not dealt with these issues, I have found that getting the foundational things right (diet, core strength, active proprioception, etc.) allows the body to function and recover as much as possible, which often eliminates the problems faced, or at least allows the body to work around them. I call it accessing God's engineering.

With abandon,

Patrick

[clayton bailey]

Thanks Jim!

I am kinda broke all over. Since my neuropathy is mostly in my elbow, I am a little leary about leaning down on tri bars, besides the 'ol back... I tried the super padded bar tape today, but it just made things worse. I think it is sort of like having a too squishy saddle. It worms it way into the places it shouldn't touch. I am running the Fizik gel padding under brooks tape currently...Seems to be the best I can do. I don't know whether it is position, elbow bend, vibration, hand placement or?.....stumped. I have tried everything I can think of. I might try an elbow brace next. Thank you for your suggestions. I will ponder over getting some aerobars. If I can get them high enough, I'll give them a try.

Clay

---

From: James Philip <ja...@jimflip.com>
To: rbw-owne...@googlegroups.com
Sent: Friday, August 30, 2013 7:38 AM

Subject: [RBW] Re: Help needed from the collective mind.

[Clayton]

I have been thinking of going to a full boinger 29er, but...... Rivendell doesn't make them.....sniffff.

[Clayton]

Thanks for the tip. I have been using Fizik bar gel under the Brooks tape. I forgot it was under there! I discovered it yesterday when I tried two layers of Cinelli gel tape over it.... Three layers of goosh turned out  to be  too soft, pushes into the parts of my hand that the doctor told me not to put pressure on. Back to Brooks over gel pads....

[Clayton]

 Hi Ben, This is where the Doctor told me not to put any pressure on my hands. The line shows where I had my surgery. As you can tell, the outside X is the one that is hardest to not put pressure on. I hang my hands by the "thumb muscle" off the side of my brake hoods. Egons put pressure on the outside X, and resting my hands on the bars holding the hoods puts pressure on the middle X. Cyclist palsy is normally the ulnar nerve, the outside X. My hands, post surgical, show almost normal conduction. It's my left elbow that is causing the problem. I hope this photo shows you where not to put your weight. I try to keep the pressure on the web between my thumb and forefinger. Best of luck to you.

[Jimmy Hutch]

Ape hangers would look badass on an Atlantis and they might allow you to hang on with your finger tips. I don't know how they would affect the elbow but they are cheap and may be worth a try. However, if you are 5'8"ish, you should give up, grow a long beard, get a recumbent, and donate the Atlantis to this jerk.

Good luck.

-Jimmy

[clayton bailey]

HaHa! Thanks for the laugh! I really needed it.... 

---

From: Jimmy Hutch <ji...@jimmyhutchinson.com>
To: rbw-owne...@googlegroups.com
Sent: Friday, August 30, 2013 4:08 PM

Subject: [RBW] Re: Help needed from the collective mind.

Ape hangers would look badass on an Atlantis and they might allow you to hang on with your finger tips.  I don't know how they would affect the elbow but they are cheap and may be worth a try.  However, if you are 5'8"ish, you should give up, grow a long beard, get a recumbent, and donate the Atlantis to this jerk.

Good luck.

-Jimmy

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[William]

[Jeremy Till]

Hi Clayton-

No expert or anything here, just throwing out other ideas.  If I remember correctly from pictures of your Atlantis you've posted here, the WB suspension seatpost you have is a zero offset seatpost, which when combined with the B17, even given the relatively slack STA of the Atlantis (72 deg, I would guess) might still give you a relatively forward riding position.  I find, especially with brooks, that even with a STA in the 72 deg region I need a high-offset seatpost to feel well balanced and not like I'm loading up my hands and arms all the time.  I use the Nitto S-84 "Wayback" post on my Quickbeam (with a Flyer) and my Long Haul Trucker (with a B17).  Of course, this will also increase your reach to the handlebars, so it might be something to try in combination with trying a more upright bar like the Bosco or Albatross, again.   Also no suspension, so maybe time to invest in a sprung saddle?

Just an idea....

-jeremy

On Thursday, August 29, 2013 11:36:24 AM UTC-7, Clayton wrote:

[cyclotourist]

Have you gone the counter-intuitve approach and tried bars with
minimal/no padding? Maybe just some cloth tape? The fatter the wrap,
the less comfortable I am, but that's w/out the nerve damage you're
dealing with.

>> have very little weight on my hands as the *bottoms of the drops are
>> level or higher than my saddle*. I have tried flat bars, bike fits,

>> noodles, alt bars etc. The wood chippers are the most comfy so far. Does
>> anyone have any experience with numb hands and cyclist palsy? I am
>> counting
>> on the collective mind...P.S. I have been a race team mechanic, a racers
>> coach and managed bike shops, so I am somewhat knowledgable on bike fit
>> and
>> options. Also I can't ride stooped over due to my back problems, ie; road
>>
>> bike position. Rest isn't an option, because I refuse to own a car (PTSD
>> issues) and the bike is my only transportation. Help? Thanks in advance.
>>
>>
>

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Cheers,
David

"it isn't a contest. Just enjoy the ride." - Seth Vidal

[Cyclofiend Jim]

Yeah... I was just going to post a similar experience to cyclotourist's.

When I put Oury grips on my mtb, I had pretty immediate wrist and hand issues. Dropping back to a slim profile grip eliminated it.

You might play with thin diameter bar/tape combined with a specific gel pad right at the point of pain - that would reduce direct impact and vibration, but let you keep your hand in a more close position.

Best of luck and sorry to hear you are having such troubles.

- Jim

cyclofiend.com

[George Schick]

I have access to a dual boinger Trek Fuel 90 MTB with wide flat bars.  Along with that frame, which puts much pretty much in an upright position, I have more hand numbness issues than I do with my other three bikes, two of which have drop bars.  In other words, I'm not sure that the suspension is going to do much for your issues.

Like some of the other posters, I'd be strongly inclined consider either a recumbent or a trike - at least for a while (which could become permanent if things improve enough).

[Deacon Patrick]

Or a large diameter grip that is not padded. I love my cork grips covered with cotton tape. Amazing conductivity of the road/trail and my big hands are happy.

With abandon,

Patrick

[Clayton]

Again, I want to thank all of you for taking the time to post your advice. It is deeply and sincerely appreciated. I wish I could buy everyone coffee and maple bars..... Or a beer. I love this group. Nice people and a great resource. Thanks again.

[Clayton]

Update on my possible fix..... Aerobars. I found two sets of aerobars for sale at the local used sporting goods store. Both were broken at different spots. On one, the bar extensions were jammed, but had good pads and the other had bad pads. I paid $30.00 for both and frankensteined them. I now have very high pads on a very high drop bar. They are so high, that my back does not give me too much grief, and my hands are barely touching the loop. I rode quite a bit yesterday and my hand didn't get seriously numb. YAY! I just wish they were not so damn ugly. Maybe I can hack off the loop and just use the pads....nah...Thank you James Philip!

[Clayton]

Thanks James! I think the aerobars are going to work.