Any ideas for cycling with thumb problems?

[DaveE128]

I have picked up an injury in both hands from a particularly rough mountain bike ride that means that I can't hold the handlebars on either my flat bar or drop bar bikes. There was very little pain on the ride, but from a day or so afterwards, I've had swelling and pain. This has been ongoing for 3 months now and not being able to cycle is a significant problem for me in all kinds of ways.

The problem seems to be the adductor pollicis muscles, so it's both the grasping the bars and the pressure between thumb and finger that are the problem. Often even things that aren't especially painful at the time seem to aggravate the problem a few hours later. It's very hard to rest them completely. but I have been doing my best to adapt and avoid using the relevant muscles.

I can just about ride a flat bar e-bike for short distances by resting my hands on top of the bars but it's far from ideal for control and there is still some pressure on the base of my thumbs which I think is not helping recovery. Shifting down gears is awkward as I can't really use my thumb, but gripshift would be impossible! (Perhaps I should try a thumb shifter on top of the bar?) I wonder whether rotating the brake levers up to a flatter position would help with control.

Although I'm waiting for a physio appointment, based on GP visits and progress to date (there is possibly some joint instability that could be be a factor), I'm concerned that this may be a long-term problem and I'm trying to work out if there are any ways that I can still cycle without aggravating it.

I want to be able to cycle commute 25-36 mile round trip, and recreational riding for fitness, preferably keeping up with road bikes.

I've put some S-bend clip-on aero bars on the road bike, which I've tried on the turbo. It seems I have a lot of adapting to do to the different position and of course access to brakes and gears means I will have to use the normal position some of the time.

I'm also hoping to try some stubby bar ends for flat bars to see whether I can support my weight on the other side of my hands using these.

Are there any different kinds of handlebar I should look at?

In the long term I wonder whether I'll have to try a recumbent cycle of some type, but not sure what the handlebar arrangements are for these - I know there are many types.

Does anyone have any experience of this kind of injury, or suggestions for things to try please? There must be others with thumb problems who have wanted to cycle in the past?!

[Navrig]

Trekking bars may give you more choices for hand positions and orientations.

[Jdsk]

Can you add a photo pointing with one finger to where the pain is worst.

What sort of changer on the dropped bars? And what's it like if you ride with the brake hood in the angle between the thumb and index finger? In that position I don't need to grip with my thumb at all.

Jonathan

[foxyrider]

What sort of changer on the dropped bars? And what's it like if you ride with the brake hood in the angle between the thumb and index finger? In that position I don't need to grip with my thumb at all.

Jonathan

+1 and bar top brake levers can be used with little/no thumb input so riding on the tops doesn't have to mean scrambling for the brakes all the time.

[531colin]

My thumbs are arthritic. I have many times been in the position where I can't wring out a dishcloth because it hurts too much; I am a bit better at living with the condition now, its a case of moderating what I do to-day, so that tomorrow I can carry on where I left off. I used to be able to build a few pairs of wheels in a day, now its a case of spending 5 or 10 minutes winding up the tension then leaving it for another day. Hey-ho......

I had to give up drops, theres no way I can hang on my thumbs to brake from the hoods. (I don't much like braking from the drops, I like to be able to get my weight back, particularly on tracks.) On flats, like the OP, I can ride with the heel of my hand on the grips, but if I try to ride holding the grips normally it feels like my thumbs are being torn off after a while.

I went over to bullbars at least 3 years ago. Bullbars allow me to ride, brake, and change gear all with any weight on the heel of my hand rather than putting any load on my thumbs, and reach can be made similar to the reach to conventional hoods. There is a long and variably off-topic thread; if you go here https://forum.cyclinguk.org/viewtopic.php?f=5&t=113772&hilit=bullbars&start=15 and scroll down to a yellow bike with green bar tape that shows the easiest way to do it using current equipment, ie combined brake/gear levers. I don't have my bars angled up as much as that, and if it were mine I would have put the levers as high up as practical; one of the snags with bullbars is that you generally have just the one hand position, you lose the ability to vary the reach, unlike drops where you have the ramps and hoods. Of course you lose the drops position as well.

Photo here of my current bullbars which give a bit more variety in hand position/reach.https://forum.cyclinguk.org/viewtopic.php?f=1&t=104410&hilit=Jones&start=105

[mjr]

I can just about ride a flat bar e-bike for short distances by resting my hands on top of the bars but it's far from ideal for control

It should be ideal for control. Flat bars should not be grasped with your thumb behind the bar, else an unplanned abrupt stop (a crash!) can break one's thumbs. Hands should be rested on top, with fingers curled around the "grips". If you are leaning on the bars more, maybe the saddle position is a bit off.

and there is still some pressure on the base of my thumbs which I think is not helping recovery. Shifting down gears is awkward as I can't really use my thumb, but gripshift would be impossible! (Perhaps I should try a thumb shifter on top of the bar?) I wonder whether rotating the brake levers up to a flatter position would help with control.

I would try an old style friction lever. I think I move mine without using the thumb unless I forget and "pinch" the lever end, which is often uncomfortable for some lever positions.

Normally brake levers on flat bars are best on the far side of the bar, almost hidden from view by the bar when riding normally. Might involve thumbs to operate. Another option may be a coaster brake (foot brake), but that has other drawbacks.

Good luck!

[Nigel]

I have picked up an injury in both hands from a particularly rough mountain bike ride that means that I can't hold the handlebars on either my flat bar or drop bar bikes. There was very little pain on the ride, but from a day or so afterwards, I've had swelling and pain. This has been ongoing for 3 months now and not being able to cycle is a significant problem for me in all kinds of ways.

The problem seems to be the adductor pollicis muscles, so it's both the grasping the bars and the pressure between thumb and finger that are the problem. Often even things that aren't especially painful at the time seem to aggravate the problem a few hours later. It's very hard to rest them completely. but I have been doing my best to adapt and avoid using the relevant muscles.

.............

I want to be able to cycle commute 25-36 mile round trip, and recreational riding for fitness, preferably keeping up with road bikes.

..........

Are there any different kinds of handlebar I should look at?

In the long term I wonder whether I'll have to try a recumbent cycle of some type, but not sure what the handlebar arrangements are for these - I know there are many types.

I'm not a medic, so this is just a cyclists opinion...

1 - body position. Its possible that a very upright position (old style gents bike of the 1950's), vertical back, and then negligible weight on bars may help. But, it comes at a cost of aerodynamics, and thus speed, so "keeping up with road bikes" may be no longer possible, at least without electric assist on the bike.

2 - bars, as well as bar shape, there is grip type. Don't know if the wider flat grips like the Ergon would help you ? tends to support weight more on the palm of hand.

3 - gear shifters, the ultimate expensive option is electronic shifting, which essentially requires a button to be activated to shift gear. But £_lots.

4 - recumbents. from my riding experience of several types, there is no weight load on the recumbent handlebars, and very little load on fingers/thumbs. Obviously gear shifters may be an issue, so grip-shifts may be out.

[DaveE128]

Thank you to everyone for the most helpful responses, I have lots of ideas to work with now!

I'm going to try bar ends and thumb shifter on the flat bar e-bike for now as it's low investment and complexity. If that works, I'll try bull horn bars on the road bike, which will probably be a lot more hassle in terms of brakes/gears, fit etc.

[531colin]

.......I'm going to try bar ends and thumb shifter on the flat bar e-bike for now.......

As you say, a quick fix, and it might work for you.
Inevitably to brake you will have to move your hands from the bar ends to the "main" grips (repeatedly if you ride in traffic) ; but also you won't know until you try it whether braking with the existing setup will work for you. (Assuming its a regular flat bar grip/flat bar brake lever setup.)
Its not much more work to fit long bar ends and fit the existing brake levers below the bar ends, that would take you to a setup very similar to mine here (I think bar ends are usually 22.2mm diameter, like flat bars?)
IMG_5139 by 531colin, on Flickr

Or here; aero base bars with levers under, (the MTB bar ends are to protect the brake lever ends from causing penetrating injury in a crash)
003 by 531colin, on Flickr

You will need a shorter stem to get the same reach you have now, and you might want the bar ends set in a bit from the end of the bars because your hands will be further apart than currently.

[Vorpal]

I know folks on here don't like twist-grip shifters, but some people with thumb problems find them easier to do, especially if they can get them at a comfortable angle.

I have some arthritis at the base of my thumbs, and flat handle bars really aggravate it, if it is bothering me. Problems with shifters generally don't occur until I have been riding in a positions for a while that has aggravated the arthritis.

I can usually cope with riding on the hoods or drops of drop handlebars (so maybe what helps me won't be useful for you). Butterfly type handlebars as shown above are okay, too.

There are some good suggestions here, and I hope that you find a solution that works and isn't too expensive.

[PT1029]

Gear levers - flat handle bars.
Thumb shifters, I guess if you use them sort of with your hand palm over the lever, it might be ok. My memory of thumb shifters was straining my thumbs on the occasional clumsy/urgent shift, I ended up rather than pushing with my thumb, pushing with the base of my thumb/palm, helps to have the lever at the right position/angle on the bars to do this. Eventually I gave up and went to rapid fire levers.
Rapid fire levers.
Top lever is easy, pull it towards you with your finger, a light action (you are just releasing a spring ratchet).
Lower lever, with your hand with palm upper most under the handlebars, you can push the lever with the palm/base of your thumb, if needed use your fingers to grip the lever body to get a better grip/push on the lower lever. Worked for my partner with RSI on her wrist at one point a few years ago.
Drop bar gear levers.
Bar end levers might work for you? I can use mine without using my thumb if needed (assuming the handle bars do for you that is).

Ages ago there was a thread on here about someone with RSI on her wrists and was unable to grip her handle bars. Her partner ended up with a solution, basically quite (very?) high flat bars with upwards sloping tribars and elbow pads, as the tri bars in the middle were quite long, only a light grip was needed, most of the weight was taken just by leaning/resting on the handlebars. I forget the lever arrangment, possibly bar end gear levers at the front/end of the tribars, and brake levers on the tribars a bit like 531 Colin's bull bars.
Steering this way is quite easy. I have flat bars with long inward curving bar ends (a crude description, they are Scott AT3 handlebars). Resting my forearm across the flat section grips and the end of the bar endy bit I can steer the bike quite well without actually gripping anything, just resting on it (not recommended for rough surfaces!). I have used this to ride 1 handed (or 1 armed) and then with my 2 spare hands fully unfold/rearrange a paper map (including while going around a roundabout - best done without other traffic about just to be on the safe side!.

Making sure your gear cables are clean/oiled in the outer housing and under the BB cable guide will make quite a difference.
Grip shifts type levers with a bigger diameter will help with grip/leveage, so a DIY larger grip might help, especially if you make the grip lumpy, 3 or 4 sided for an easier grip, as per the Rohloff lever in the butterfly bars photo up thread.

[531colin]

...........
Rapid fire levers.
Top lever is easy, pull it towards you with your finger, a light action (you are just releasing a spring ratchet).
Lower lever, with your hand with palm upper most under the handlebars, you can push the lever with the palm/base of your thumb, if needed use your fingers to grip the lever body to get a better grip/push on the lower lever. .........

Seems a bit awkward?
I'm trying to visualise this.....
What happens if you rotate the lever 180 degrees round the bar, so it points towards you not away from you, and its now upside-down?
Whats normally the lower lever (thumb lever changes down with a "high normal" rear mech, ie the usual sort) needs more force because you are pulling the cable against the gear spring....upside down you pull it towards you with index/middle finger.
Whats normally the upper lever (changes up, needs less force because you are just releasing a pawl) ....upside down you push it away from you with thumb(?)
Have I got that right? does it make any kind of sense? (this kind of thing makes my head spin)

[arnsider]

Twist grip changers every time, coupled with anatomic handlebars.
I have a flat bar e bike with thumb shifters and it's the one draw back. My right hand is particularly arthritic.
Years ago, I had a Claud Butler Oddysey with anatomics and grip shift. Excellent
Forget the prejudice around grip shift., they are first class. Most of the detractors have never used them.