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Why hands hurt?

A bike fitting guide to resolving the most common issue in cycling

Hand pain and numbness is a recurring subject of discussion among cyclists and the number one complaint for cyclists seeking bike fitting services.

Hand pain is often accompanied by additional complaints of lower back pain and shoulders/neck fatigue. Even saddle discomfort and feet fatigue are often mentioned together with hand pain.

Why is the issue of comfort at the hands so common among cyclists? What's the source of this problem and what can be done to resolve it?

In this article we'll answer these important questions and attempt to demystify the myth that pain is an unavoidable companion to bicycling.

THE SIGNS

Typical tell-tale markers of hands pain and discomfort are shaking of the hands due to tingling, pins and needles, numbness and excessive pressure - requiring frequent changes in hand position on the handlebar. Stretching of the back while riding is also a typical sign.

This is not a normal part of the cycling experience and must be addressed to avoid further complications that may require medical intervention for nerve damage.

THE SOURCE OF HANDS PAIN

The source of hand pain is often connected to a number of details in your bike fit and your relationship to the bike. When linked together, these details can have a compounding effect and work against your comfort and even cause long-term issues.

Pain is a manifestation of a biomechanical misalignment in your current bike fit that if often the result of a cascading series of events that build upon each other.

Let's look at these events and break them down to the basics:

The position of the saddle

The position of the handlebar

The position of the hoods, shifter pods and brake levers

The conditioning of the core and upper body

THE SADDLE

The first culprit in your bike fit to be linked to hand pain is the saddle position.

Often misunderstood and overlooked by inexperienced bike fitters, the saddle position has a very direct relationship to hands pain. Frequently, the saddle position, type and profile are responsible for hands pain more than any other biomechanical alignment parameter in your bike fit.

The saddle is the central point of contact in your relationship with the bike. It helps stabilize your pelvis and deliver power to the pedals as the the main object of the bike fit position. This is the core of a cyclist relationship to the bike and the focal point of a cyclist's bike fit integration with the bicycle.

The saddle has many adjustments and a proper bike fit should address all of them.

THE SADDLE TILT

The tilt of the saddle - it's relationship to the horizon, whether pointing up or down - is a key detail in your bike fit.

Too much nose down and the weight of the upper body is pushed into the hands. The arms lock up in this position and all the terrain vibrations transfer to the hands, causing excessive pressure and pain that can climb all the way to the elbows and shoulders. Eventually, this can also lead to lower back pain.

Too much tilt up of the saddle also causes excessive hand pressure, but through a more complicated mechanism: the backward rotation of the hips. This counter rotation of your pelvis disengages your core and the support it provides to the upper body, thus putting more weight on the hands.

If you see a cyclist looking shaped like a "C", you can bet that's an issue with hip rotation and saddle tilt in the bike fit.

There is a sweet spot for saddle tilt. It's not universal and varies among manufacturers.

Saddles designed for aero bikes (road or triathlon) have a design point tilt: a specific nose down angle that keeps the pressure off the genitals when in a low body posture without putting too much pressure on the hands. The bike fit must set you up according to this design point.

Saddles made for mountain bikes tend to offer a wider sweet spot in a more level position. Your mountain bike fit should be aligned with a less saddle nose down tilt.

Finding hands pressure relief in your bike fit through tuning the saddle tilt works only if the saddle itself is right for you.

The saddle profile plays a major role in the bike fit and the potential for hands pressure and pain.

If the configuration of the saddle does not match closely the profile of your ischial bones, there will be pressure points in your butt, groins and genital area.

Hands pressure comes from the instinctive action of a cyclist attempting to reduce pain in the seat bones by supporting with his/her arms.

The wrong saddle profile also tends to bring discomfort not only at the hands but at the feet as well. This is very occult phenomenon understood only by a handful of bike fitting individuals. The wrong saddle profile creates neural path impingements that can transfer to the feet. It's a complex issue that exceeds the scope of this article. But it wouldn't be complete without at least mentioning the occurrence.

It becomes therefore paramount that, during a bike fit, the saddle model chosen by a cyclist is based on effective comfort - not weight savings or looks. And this is the reason why many manufacturers like Selle SMP have test programs with the best bike fitters where a saddle can be fitted and loaned to be experienced for a few rides.

THE SADDLE FORWARD AND AFT POSITION

The saddle forward and aft position plays an intimate dance with the next item in the list: the handlebar.

The saddle can be adjusted to move its position relative to the cranks. During the bike fit, this determines the power output. This position is highly dependent on the type of bike and the basic tenet of bike fitting.

The position of the handlebar takes on a supportive and complementary role to the forward and aft position of the saddle.

The relationship of the saddle to the handlebar is the very important for comfort. If the saddle is too close to the handlebar, the weight of your upper body is forced upon the shoulders. The shoulders in turn lock the arms and the hands receive all the terrain chatter.

Similarly, when the saddle is too far away from the handlebar, the back is too stretched out to reach the controls and the arms become locked out in the overextension. This also causes the hands to take all the abuse from the terrain feedback.

Let's look at the next item in the list: the handlebar.

THE HANDLEBAR

The position of the handlebar with respect to the saddle is very important in the bike fitting quest to resolve hands pressure.

An integrated handlebar/stem combo like this, saves on aero drag, but it cannot be adjusted during the bike fit and can affect the proper reach

The location of the handlebar on your bike fixes the hands point of contact and determines the overall reach - together with the saddle forward and aft position. It also can affect the handling characteristics of the bike.

A handlebar that's too far away from you causes hands distress and excessive pressure.

When the reach is too long, the arms become completely straight and the elbows lock out. A healthy elbow bend is a basic goal for bike fitting as this bend acts as a shock absorber. When the elbows are locked out, all the pressure transfers to the hands.

Also, when the handlebar reach is too short and the bars are too close to you, hands take a beating. This is due to the fact that all the weight of your upper body is on the shoulders and get transferred to the hands.

During a proper bike fitting session, the stem is routinely replaced to align your handlebar reach to your saddle position so the upper body can perform its supporting role.

The handlebar sweep set up for mountain biking is a critical part of a bike fit that will prevent hands pain

For mountain bikers the handlebar set up gets a little more complicated because of the sweep.

Sweep is the curvature built into mountain bike handlebars to reflect the fact that human shoulders operate in circular fashion when sweeping through the range of motion.

Human arms essentially move like the radius of a circle across the width of the shoulders range of motion. So handlebars are built to mimic this motion with a clever design so that the sweep can be increased or decreased with a simple twist of the bars on the stem.

There are 2 types of sweep built in most bars: back sweep (the horizontal turn radius of the shoulder) and up sweep (the vertical).

When set up incorrectly, the sweep of the bar plays havoc with the relationship of the wrists to the bar. Too much sweep forces the wrists into an unnatural rotation that puts tremendous pressure on the hand's ulna (the bone at the external edge of the palm and the wrist) and the underlying ulnar nerve.

Pressure on this nerve creates the same issues as we discussed above for road cyclists: numbness in the hands, tingling and even tennis elbow.

For mountain bikers this is a crucial part of the bike fit that often goes ignored by many bike fitters.

The handlebar position is also intimately connected with the position of the hoods, shifter pods and brakes: the flight controls, next on our list.

FLIGHT CONTROLS

The last piece of the bike fitting quest to reduce hands pressure is the relationship with the "flight controls": the shifter hoods for road bikes and the grips, shifter pods and brake levers for mountain bikes.

Often overlooked by inexperienced bike fitters, the position of flight controls is critical in achieving the "ergonomic design point" of components designed for a specific use.

Bicycle and ergonomics are not something we are used to hearing. But not only bicycle ergonomics exist; in the last ten years, the cycling industry as made a huge effort in this area, pouring into R&D and improving the comfort of riders with ever-sophisticated products.

Modern brake/shifter hoods are designed with your hand and grip in mind.

The sophistication of the ergonomics also means that they need to be aligned correctly during a bike fit or they will work against your comfort.

For road cyclists, modern shifter hoods are such a finely tunable piece of equipment that are a bliss to ride -when aligned correctly.

The transition between the handlebar and the hood is one key component in hands comfort.

Often, this transition is overlooked or downright set up wrong during the initial bike build and never improved.

If you experience your fingers tingling or going to sleep and all other items we discussed above are in check, then your shifter hoods ergonomics are out of alignment.

The transition between the bar tops and the shifter hood in this picture is incorrect

The "pins and needles" and hands pain in this case are caused by the lack of blood circulation and/or the depression of the a critical nerve in the palm of the hand, near the wrist on the pinkie finger side: the ulnar nerve.

The ulnar nerve -and blood vessels that run collocated to it- are responsible for a variety of functions in the hands. When consistently put under stress by applying excessive pressure, the nerve responds with the sensation of shooting pains that make fingers "go to sleep".

This sensation can climb to the elbow and give the same feeling as "tennis elbow".

From a safety perspective, this can be a hazard as this situation can severely reduce the ability to squeeze the brake levers adequately enough for a sudden stop.

A similar consideration goes for carpal nerves. Most people are familiar with these nerves because of the notoriety of stress caused by computer keyboards and the resulting carpal tunnel syndrome. Most cyclists use computers in their daily lives and the effect of poor flight controls ergonomics compound on those of of their daily professional instruments.

This is part of bike fitting that often completely forgotten by many bike fitters. Not a second thought is given to the ergonomics of the bike fit. When flight controls are overlooked, even a good bike fit alignment to the saddle and handlebar will fail the test of hands comfort.

A proper bike fitter will spend onsiderable time working with hood-to-handlebar transition alignment, taping of the handlebars at the bar tops, brake lever reach (not only for mountain bikes, today components like SRAM offer this option on road bikes as well), shifter pods, suspension lock-out and dropper post alignment.

A well aligned cockpit prevents strains of the hands
For mountain bikers, there are even more adjustments and nuances that go into the ergonomics of the flight controls.
We mentioned the very critical handlebar sweep as it relates to wrist alignment and ulnar pressure.

But just as critical are the brake levers position, the lever reach, the shifter pods alignment and the grips..

The thickness and compliance of the grips is often an overlooked culprit of hand pain. Worn out grips have lost their ability to isolate the hands from the handlebar and can result in a variety of comfort issues spanning from fatigue to severe pain. The same goes for very thin grips.

The size of the grip is important. Not all grips have the same diameter. Some are larger and thicker, some are just larger (lock on) and some are thin by design - and everything in between. This is very important for women who need to carefully choose grip size to match their smaller hands.

Grips have specific applications. Cross country and trail grips tend to provide more cushion. Downhill and BMX grips tend to be thin and designed for the death grip required for short, intense periods of riding. Selecting the right grip may go a long way to improve comfort.

However, caution must be taken when attempting to mask a bad bike fit and neutralize hand pain with "ergonomic grips".
We have seen some severe cases where the pain subsided just enough with ergo grips to make is acceptable to the cyclist. However, the nerve damage grew over time to the point of requiring medical attention. Grips should be considered as part of a comprehensive approach to bike comfort and bike fitting - not in isolation.
The location and functionality of the brake levers has a similar effect as the bar sweep in the critical alignment of the wrist and the resulting pressure on the ulnar nerve. We often see brake levers positioned such that require extreme wrist rotation to activate.

Over time, brake levers that require straining to operate are going to cause repetitive use injuries, so great care must be taken in working with the lever reach alignment to prevent this issue.

AT THE CORE

We saved this for last because it's not something that a bike fit can fix during a session.

Most cyclists tend to neglect their core and upper body. And it's up to you to fix this.

A good bike fitter should know to test and point out if your core needs conditioning and if it's affecting your relationship to the bike.

The core is the opposite side of the token as the saddle. The saddle is the physical point of leverage between the upper and lower body; the core is the physiological fulcrum.

When the core is weak, there is instability between the lower body generating power and the upper body trying to direct it. This causes the lower back to destabilize.

To control it, a cyclist locks the arms. This in turn puts a tremendous pressure on the hands as they take the abuse from the thrashing generated by pedaling power and the terrain chatter.

After a few miles of this tug of war, the core exhausts its resources - and so the upper body. This causes the hands go to sleep and the lower back to ache as it starts curving up.

Without a proper foundation in the core, even the fittest of cyclists experience varying level of discomfort. The core supports the upper body and takes pressure off the hands.

The shoulders and arms play an important role also. A stronger upper body together with a strong core enables a cyclist to bend the elbows while riding. This flexion creates a suspension mechanism that takes pressure off the hands, shoulders and neck. The core provides some of the stability needed to support the torso and does so while generating power for the legs to do their business.

At parity of a good fit, cyclists with a strong core are going to outperform - and are significantly more comfortable.

Care must be taken when developing the core, however. Abs are not a significant part of the core. They are a veneer.

When developing core strength, the pelvic and dorsal muscle groups must be developed symmetrically, or issues with comfort may continue to dodge a cyclist.

Specific core exercises are outside the scope of this article. However, there's plenty of uTube videos that show core strengthening exercises for cyclists.

CONCLUSIONS

Hand pain is unfortunately a common issue facing many cyclists today. But it does not have to be a constant companion.

Hand pain comes from the complex interaction between a variety of factors in your bike fitting and ergonomics. No one factor plays such a larger significant role that a single course of action can be recommended. There is no magic wand that can be waved and caution must be paid to avoid buying into the hype of products that claim to cure hand pain - in particular ergonomic grips, handlebar gel wrap tape and gloves with generous amounts of padding.

Instead, hands pain must be addressed as a comprehensive approach to bike fitting and ergonomics, tending to each of the main culprits: handlebar position; saddle position; flight control ergonomics; core and upper body strength.

With proper bike fitting, knowledge of ergonomics and attention to details, hand pain can be removed from the riding experience.

Our bike fitting studio developed a set of specific bike fitting protocols designed to address comfort, pain and recovery from injuries.

We named these protocols "Bike Fitting for Injuries" and they are engineered to address a variety of comfort-specific issues while achieving all the typical goals of a bike fit - more power, better handling and faster speeds.

If you are experiencing hand pain, numbness and/or tingling don't delay getting a professional bike fit. We can help.

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