Cycling UK Forum

arnsider wrote: ↑12 Nov 2023, 7:25am My experience of the NHS is not particularly good here, since all I get are the words "Arthritis" and "Ageing" I'm told it's progressive and incurable and that only pain killers are the answer, but no suggestions of which, how many and a proper regime.
No investigation of the elbow problem and certainly no offer of Xray investigation or specific physio.
The knock on effects on lifestyle and mental health don't always occur to GPs, some of whom think that an active sporting life into seniority is just hedonism and we should roll over and slowly atrophy.

About a decade back (then in my late 40s) I was having rather bad knee problems on my right side so I went to the doctor. Got a pretty useless locum who suggested that a life of painkillers was the way forward, so I pointed out that that was The Wrong Answer and I subsequently got an X-ray and physio follow up. The X-ray showed a little arthritis but nothing that would really explain my particular issues, the physio had it diagnosed inside 20 minutes and with the exercises she gave me to do something about it the problem is pretty much gone (every now and then I feel a minor symptom, get back to the exercises and the problem goes back in its box).

Moral being that you sometimes need to get a bit bolshie with the first line: if/when you get to the right person in the chain the care is typically good.

Pete.

Is the elbow pain produced only by cycling or do other activities result in elbow pain?
The reason I ask is if it’s only cycling that triggers elbow pain we (as cyclists) might be able to suggest a remedy.
On the other hand, if elbow pain results from some other activity that your GP regards as “normal” then it’s possible that your GP might be interested in finding a resolution if elbow pain stops you washing up, ironing, or getting dressed for example.

Poit taken about being bolshei! I have been writing memos for my doc and folowing up with telecoms. At least, that way, I can have some control of the agenda. Maybe I should stick out for a face to face.
Regarding Elbow pain, I only get this after a cycle ride on my Flat barred E bike. It is unusual because the pain is far worse on my right side. I am right handed. Unfortunately I also have shoulder problems on my right side and really don't know it I have a frozen shoulder, Bursitis or Rotator cuff issues. Two consultations witht the practice physio produced nothing other than a few exercises and the aging/arthritis cop out.
Yesterday, I did twenty eight easy miles on my E bike around Levens and Arnside and today, walked about three miles in Ribblesdale.
The elbow is very sore and even Ibuprofen gel has not eased the swelling. I can hardly hold a tea cup.

arnsider wrote: ↑6 Dec 2023, 9:28pm ................
Regarding Elbow pain, I only get this after a cycle ride on my Flat barred E bike. It is unusual because the pain is far worse on my right side. I am right handed. Unfortunately I also have shoulder problems on my right side and really don't know it I have a frozen shoulder, Bursitis or Rotator cuff issues. .................
The elbow is very sore and even Ibuprofen gel has not eased the swelling. I can hardly hold a tea cup.

If you only get elbow problems after riding your bike, and not after things like mowing the grass or cutting the hedge, then it seems to me that its worthwhile thinking about your riding position.
First, a slightly left-field suggestion.....can you move your gripshift from the right side to the left? (assuming you don't already have a left gripshift.) This would help to explore whether the elbow issue is due to the gripshift or something else....my guess would be you don't use the gripshift often enough, and it doesn't require enough force cause a problem.

As far as I'm aware, there are 2 things which commonly create hand/wrist/elbow/shoulder/neck problems in cyclists; these are
having too much weight on your hands and...
holding the joints at an uncomfortable angle.

This is the current thread about handlebar shape, there are countless others....viewtopic.php?t=158665. Lots of people (including me) are much more comfortable holding handlebars which point (nearly) back to front, rather than (nearly) side to side.

i like to have little enough weight on my hands so that I can lift my hands off the bars without tipping forward.

Supplementary question, for anybody with knowledge or experience........
....if holding a cup of tea is a real difficulty after a relatively short ride, this doesn't sound like arthritis to me, it sounds more like for example tennis elbow or golfers elbow. I expect arthritis to be slow to flare up, and even slower to subside

arnsider wrote: ↑6 Dec 2023, 9:28pm ...
The elbow is very sore and even Ibuprofen gel has not eased the swelling. ...

Re: Ibuprofen: I find Ibuprofen (and most other NSAIDs) have no to negative effects on me. Gels or pills do nothing (or worse). I asked the physio (private) I have occasionally seen and she said it varies, for some Ibuprofen doesn't help and for others it does. She also commented that the gels have limited use (depending on body area - problem under layers of muscle and pretty useless). Just repeating what one physio said on this so may or may not be accurate.

For me Ibuprofen pills or gel have no effect. Naproxen has no beneficial effect but caused me horrendous water retention issues (to the point where I stopped after a few days).

That said an exception for me might be Diclofenac - I believe Diclofenac gel (I use Voltarol) does help me.

But when talking about personal experience it's impossible to be accurate as there is no control. Take medication and get better and maybe you'd have got better without the medication. Don't take medication and don't get better then maybe you wouldn't have got better with medication.

Ian

Psamathe wrote: ↑7 Dec 2023, 1:47pm ...
But when talking about personal experience it's impossible to be accurate as there is no control. Take medication and get better and maybe you'd have got better without the medication. Don't take medication and don't get better then maybe you wouldn't have got better with medication.
...

Yes, it's almost as if we need to run controlled trials to know the effects...

; - )

Jonathan

Thank you for mentioning weight on handle bars. I might try raising the bars and/or tilting my saddle backwards.
Hbar adjustments are nowhere near facilitated like they were before Ahead sets overtook the quill stem.
Perhaps a short cranked adaptor might be the solution and I could fit one without too much extra strain on the cables.
Reading further, it seems that I have tendonitis.hence the inflammation in the forearm.
Oddly though, I bumped into a pal returning from my ride yesterday, whilst he was a late starter and hoping to make the cafe before shutting time.He showed me a couple of exercises; one where you crank your hand backward against the wrist joint and rotate the hand clockwise, back and forth. The other where you bend the elbow tight and dig your left index finger into the crook.
It seems to work as this early, I can hold my cup to my lips which I couldn't do before.
Agreed about Ibuprofen gel! About as useful as a chocolate Fire Guard.

Moving the saddle back will take weight off the handlebars

Well, I have replaced the stem with a 20-60 degree adjustable that not only lifts the bars but brings them closer to me which results in a more upright position. Recently, I fitted a Cane Creek Elastomer seat post which combined with my trusty B 67 gives me good damping over rough tarmac. It seems counter intuitive to move my saddle back. I would have thought that doing this would result in stretching the upper body further and putting more weight on the bars. I will however give this a try. I've also found a good site on You Tube operated by a physio in my area
https://www.youtube.com/watch?v=_DH1JwKT5lk
He advocates wearing a wrist brace for arthritis problems and an elbow brace for tendonitis. These are not expensive purchases and I'm quite willing to give them a go.

arnsider wrote: ↑24 Dec 2023, 8:40am It seems counter intuitive to move my saddle back. I would have thought that doing this would result in stretching the upper body further and putting more weight on the bars. I will however give this a try.

The principle is to move more of the body behind the pedals as explained in @531colin's bike fitting guide. However, you may need to adjust / shorten the stem to avoid stretching forward if this is less comfortable.

Centre of mass in the body is near your hips/belly; it follows that moving the saddle has more effect on weight distribution than moving the handlebars.
Generations of cyclists have known this!
“Modern mountain bike geometry “ uses steep seat tube angles to bring weight forward to keep the front wheel grounded with very short reach .

arnsider wrote: ↑24 Dec 2023, 8:40am Well, I have replaced the stem with a 20-60 degree adjustable that not only lifts the bars but brings them closer to me which results in a more upright position. .....He advocates wearing a wrist brace for arthritis problems and an elbow brace for tendonitis.

Haven't had an elbow brace yet, but found as recently as the fortnight prior to Christmas, that both a robust wrist and knee brace have been beneficial. I don't remotely believe they undertake the role of some fully plaster to a previously broken bone, but the knee brace simply seemed to keep the knee area much warmer - which certainly helped, as 4 Hr's with the knee exposed to cold air, definitely resulted in a 48 Hr ache. And simply resting the painful wrist on the handlebars, rather than holding the bars, has helped

Many many thanks, especially to 531colin for the link to Bike Fitting DIY.
I might start from scratch with a new fitting.

arnsider wrote: ↑24 Dec 2023, 8:40am It seems counter intuitive to move my saddle back. I would have thought that doing this would result in stretching the upper body further and putting more weight on the bars.

Yes but ...

You have to shorten the reach (as you have done). I have a VK adaptor to get the saddle right back (bliss ) but I am then confronted with how to shorten the reach. I have a 40 mm stem with 70 deg rise - job sorted. I spent pages of my life on this very forum (with help from many (especially Colin) to get this right. I'm 70, I'm still cycling (out yesterday on the bike), no aches or pains.

arnsider wrote: ↑24 Dec 2023, 8:40am It seems counter intuitive to move my saddle back. I would have thought that doing this would result in stretching the upper body further and putting more weight on the bars.

It does seem counter-intuitive... but try the following:

Stand a couple of feet back from a table and lean on to it, putting the weight on your hands. Now take the weight off your hands without moving your feet. You do that by moving your bum back.

There is a catch, which is your core and neck muscles have to do more work, but as catches go it's probably smaller than having painful elbows!

Pete.