Tennis Elbow and Tendonitis when Cycle Touring

Update: So it's not carpal tunnel syndrome but Tennis elbow and tendonitis. I find it weird because my arms are never stretched but always a bit bend like in the picture. Got a Bandage now and will rest the arm two more weeks.

My boyfriend and I have been travelling 7000km in 5 months without any major problems or injuries (touch wood). BUT since we had to disassemble our bikes for the first flight I am not in the ideal sitting position anymore because I developed a strong pain in my left wrist which I never had before.

My saddle is adjusted the same but my handlebars are not it seems. At first, I thought it was but then this pain started and I am trying to readjust it to the original position but I don't seem to get it right (I had to take off the grips and outer and inner bar ends etc.

 Now I was wondering if I have pain in my wrist which is spreading all the way up to the flexor muscles (or the other way around). Do I stretch my arms too much or too little? Do I have to adjust my handles (Ergon gp2) more low or more up? I am thankful for any ideas :)

I would say put the handlebars higher so less of your body weight rests on your arms, if it doesn't work, try putting the saddle a bit further back. For me, wearing padded gloves (the ones where your fingers are free) helped a lot. Anyway, hope you'll find your position back, tailwind to you!
Sorry to hear about your pain. Often pain can come from a pre-existing problem that may not have been noticeable before you dismantled your bike and just a few small changes have brought it to the surface. I had similar problems with my wrists as they took a lot of the shock. You can try a couple of things. If you don't already try wearing cycling gloves as they have padding, also bring your seat forward 1cm this will make your position a little more upright and lower the amount of weight you put through your hands. Hope this helps
Lael Wilcox an ultra rider attached aero bars to her handlebars so she could rest her wrists on long rides. I just did the same. When my wrists start tingling I switch my arm position to the aero bars. Very effective. Also, I'm no doctor but could you be experiencing symptoms of carpal tunnel?
I thought that at first but the pain comes from a different position in the arm. It's a pain coming from the sides, below the pinky and below the thumb. The Carpal is the middle nerve. Also because my wrist and elbow are cracking when I move them (being or circle) I would think it's an inflammation in the tendon.
Sounds like you might benefit from a trip to the doctor. Get your "cracking noises" checked out. Ouch! Fyi...All the tendons in your hand pass through the carpal tunnel, so a restriction (by wrist position while riding or actual damage) could affect the thumb and pinky nerves.
Ah...okay. The waiting list for an orthopaedic doctor here in Berlin is 3 to 4 months. So I have to take care of this myself or see a doctor in Turkey or Georgia (we are here just for a short time - our trip is not over yet).
You can also go to a surgical ambulance if the pain is so severe and also tell them you want to cycle and cycle again shortly. They will understand or tell you. Beautiful!
Sorry, can't offer advice for an immediate solution, but next time you disassemble the bikes mark the seat post and handlebars so that you can get them back in the same place. A sharpie, a scratch in the paint or even a piece of tape.
I did but I cannot mark them for the handle itself.
The grips? I cant see why you couldn't just mark those too? Oh well, good luck.
Because there is no space to mark on the handlebars
Maybe taping both your wrists helps a bit?
I definitely wanted to get something for that because it's not getting better. Now I have been off the bike for 3 weeks and no improvement.
isn’t there any position in which your wrist is painless? There are some support systems available (hansaplast) that can fix hands in one position. And maybe Voltaren emulgel creme (in Nederland) helps
oh yeah... Most positions are painless. But when I wake up in the morning my arm is super sore.
and then when I twist it or try to lift something it's really bad. Voltaren did not help for me, Diclofenac pills do though.
A triathlon steer might help? So you can rest on your elbows
yeah I am considering this
with some practice, one can place elbows on the handlebar and join the hands on the front bag. If the road conditions allow it 🍀🤓🌈
Sorry to hear. Have you considered "tennis elbow"? Those things take longer to heal, but since Diclofenac helped, I would say maybe try Ibuprofen and rest. Also, some massages help too.
look at old photos from the trip and zoom in to see how the bike looked and try to replicate that position
I did that :)
Sorry to hear! It was very annoying that it used to be good, but it should be possible to find the right spot again. Several thoughts; -do you have a picture of before? That might show you the angle of your wrists in the right position. -putting the saddle backwards on its bridge (contrary to another answer) brings your point of gravity more towards your sitting bones which cause less pressure on the hands. -if it doesn’t stop, maybe go see a doctor and/or take proper rest until the pain gets less.
Iris, I suggest getting it examined by a doctor if you have access to a medical facility. A simple XRay will tell you what is causing the pain. Bike fitting may not be the real cause.
thanks for the suggestion but I can't see a doctor ATM because I need an appointment for that and that takes many months
I can understand as this is not a critical situation you don't qualify for an emergency, so you have to wait. In India, we don't have this issue. We can get an appointment any time. Do u have access to online portals which give medical advice? Maybe you can try that route. Another option is online consultation with an ortho. Try with hospitals in India for online consultation They may help you. But they may ask you to do an x-ray. Do u need an appointment for an x-ray too? My advice is don't attempt anything without proper medical advice as you are having pain for a long time.
We need an appointment for everything's Germany. They make everything complicated.
Do you need any help with online consultation with doctors from India? There are few hospitals that are doing it.
that's actually a good idea. Do you have a contact?
I will get you some details for the online consultation
Let me know how it has worked out. If this did not work we can find others
Regularly change hand position on the bar. Avoids always stressing the same part of your wrist.
To me, it has nothing to do with the biking position I believe it’s more about the break you had got than your tendons veins muscles resist cooperating alongside your mind which is flying I guess Enjoy riding
ah, it started while I was still riding.
you need some time to adapt
Check that they are centred... check that your pannier weight is equal.... check that the pain is not coming from your neck... check that your steering column is perfectly squared and not having one handlebar pulled in a bit and the other pushing out a bit.
For long-distance you may want to use H bar where you can change positions and relax
I have multiple hand positions but thank you
Keep your wrist position straight as well as your neck
Not the kind of thing that is easy to diagnose from afar but you don’t say how you know your saddle is the same height. Or if your shorts or shoes have changed. I would lower the saddle an eighth of an inch. The problem however may be prolonged time in one position. I noticed your bars have limited positions available. I frequently change hand positions during long rides. You might want to move your phone to the other hand for a while.
I realize this won't help your current situation but I ride a recumbent trike. Which I absolutely love. Sure I am slower but never have to worry about butt, neck, hand or wrist pain. Obviously just food for thought for the long term. Safe travels.
If you feel a tingling sensation in your fingers it's possible that you suffer from Carpal tunnel syndrome, which is caused by swelling in the wrist and compression of a nerve. It's not uncommon in cyclists. What can help are tapes or rather a wrist brace, not riding, glucocorticoids (cortisone pills/injection) or in some cases surgery. If it gets worse I would definitely consult with a doctor.
no tingling so far.
Hi Iris, Professional bike fitter here. If you could describe the pain in the knee, I may be able to help.
not knee ....wrist. my knees are doing great despite the fact o have arthritis.
and my wrist hurts when I move my hand last or right... up and down is fine. The worst movement was sitting in the tent and taking the panniers from left to right (lifting and moving). And side-way movement like that. Like when my bike tends to fall to one side during pushing.on uneven ground and I have to stabilize it. I pushed my bike a lot in Oman.. through tons of desert sand and rocky roads. That's when it started.
is the pain on the outside of the knee, and is it a hot pain
This may not be possible, however, if you can find a decent bike shop you should ask them for a bike fit and then take notes on how high your saddle is and handlebar for future dissembling of the bicycle.
Eilidh Ogdèn, my daughter presently cycling across Africa. Any suggestions?
I work in a bike shop and bikepack - I see people come in all the time with bars and seats slightly out of angle - even a little bit can make a difference. Can you send a picture of the bicycle from the side that clearly seat/bar height/angle? You can also try minor adjustments just to see what works. Only change one thing at a time.
I will see if I have one :)
If you find you are stretched out too much, it may be causing you to put pressure on your ulnar nerve. It’s called ULNAR PALSY. Is it a shooting pain that radiates from your palm and up your forearms?
no, it's not quite like that. It's a numb, not sharp pain. And my palm does. not have any pain.
Oh, okay. Hopefully, it will pass and you will forget it ever happened.
Oh, I can relate. With a string cycling induced maladies behind me over these decades of tours, the one that's so needlessly remembered is when I hadn't put a marking on the seat post to tell me the exact location in the seat tube. Nursing a bum knee in a support vehicle on the Pacific Coast Highway was the pits. But that was early on. A subsequent broken hip, ulnar neuropathy and ablated arrhythmia are seen here as only setbacks along the road.
I assume now that your wrist is injured the hurt will continue until it heals. I would record bike measurements for the next time.
I cut little marks into the painting so that I will never have to worry about it, even when rubbing over it. It tells me where all the components have their right position. ;)
It’s impossible to diagnose your wrist problem from a distance, so by far, the best advice is to find a way to get an x-ray and/or an MRI of your wrist and go from there. But if that isn’t possible, and given your approximate age, you may simply have inflammation of the wrist due to overuse—it’s fairly common. Icing the wrist can be helpful, taking a few weeks off from cycling can be helpful, and there are also strong anti-inflammatories like those one-week daily steroid packs which can dramatically reduce inflammation and are often available in the developing world at pharmacies without a prescription.
steroids we cannot get without a prescription here but maybe in Turkey, I can get them. Do you have a name for one so I can check there. How did you assume my age btw? :))
Medrol Dose Pack is one of the common ones. It’s taken over one week in decreasing doses every succeeding day. It is prescription in the developed world, less so in the developing world. Regarding your age, I’m just assuming based on the mileage you’re doing that you aren’t in the latter third of your life. If you were, it would suggest other possible probabilities for what may be creating your condition.
nope... I am 44 ... So seems you guessed right :)
You need to take professional medical advice. Take care.
Do not worry. Is as of the plane's seats as the cause. You have a little pain okay, sooner or later it disappears as it came. Knowing what I am talking about I can recommend what I recommended. Take it easy,🌌 , do not overestimate that. Stretching should help yes, little by little. You'll see in 1-2 weeks pain completely vanished.
Adjust the handlebar higher so there is less pressure (weight) on the hands.
What you need is "Erlösergriff". That is a German word for the exact anti-pain technique. Just translate and google or do google and translate after. It takes some experience to manage Erlösergriff alone. However, with the help of your boyfriend, you two can manage together. In case of stretching does not help little by little. Erlösergriff does. Within a few seconds.
i will Google that
you should. If pain stems from the wrist right, it is both explanation and solution. Moreover Just again. Or at least keep me/US Here posted If that is my Suggestion helped. Tyvm and enjoy your Trip. Safe Trip. Mike Micho
Well, Note, please, you guys should think about the Transport of Bikes .... Luckily I quit Service in Domingo. Explanation: #USAF COL Gentes taught me Erlösergriff.
I think I see that you have a straight wide handlebar. Good for mountain bikers, but not for others like professional road racers. These handlebars are one of the modern fads. Not ergonomic, hence leading to problems. 70% of mountain bikers have pain in the wrist, but not many racers. So try some solution. I think your friend has a tilted handlebar. I send a photo of a small solution, the Flowgrip. Watch the angles in the wrist, marked in green and red. Red = pain.
but the Tx400 comes as a travel bike with one. Slightly curved handlebars. But yeah... I've noticed, that I mean. Hand. turning on the outside slightly. So give it a shot I'm changing the handle
Might not be enough. Look at the angle between your forearm and palm. Should be zero in the left-right direction.
I'm going to set it this way... I can still turn the steering wheel depending on which direction it goes. pretty much crooked.
Have you considered fitting tri bars, you can put a lot of weight on your elbow/forearm area and give you a chance to heal. Tri bars can give you another position for comfort at any time.
I've had many issues with my wrists and also ride with Ergon grips on my flat bar bikes. When adjusting the grip, I found what works best is rotating the grip up (picture 1, with arrow) so the supporting part of the grip is touching the bottom of my palm. What you want is to support the wrist so that is straight (picture 2, green circle) and not flexing back (picture 3, red x). Hope this helps and you can alleviate your pain.
True, those adjustments can Help. Those "Grips" became unpopular, because they are comfortable, but look "old school" to say it like this.
okay, I will definitely try!
 just lay down on the ground. Like an embryo. Move your left leg across the right leg and pull up your left knee with your right hand to the chin. Take a deep breath before. Don't hold your breath. And then, when relaxed, pull your knee up! Rather rapidly. Be careful. Not too far! Maybe 5-10cm upwards to the chin. Make sure your right leg is long. You'll hear a clicking sound on your left wrist. And feel relieved. It is not bones, but that hard muscle that causes the sound, because it was stiff before caused by forced seating position. You cannot injure yourself but it takes some courage. We in the army help each other. One goes position like described. And other one does pull the knee up in the direction of the chin. Try yourself out. Even that position alone should confirm you are on the right way. As you feel relieved. And then... Just pull hard the way described and pain is past. You are not injured. It is just uncomfortable. True. Anyway, don't worry. Pain will leave, either by time or by Erlösergriff.🙌
I agree that the top of your hand must be in a straight line with your lower arm. Not flexed and not extended👌
Hi Iris, besides that I got carpal tunnel(which I had operated on last week), I also got tennis elbow, which is far more painful and goes up from the wrist, flexors to the elbow. If I try to get something out of my back pocket, my arm is far too stiff and sore. I should relax my arms more on the bike and not have it locked all the time😅. Hope you find relief soon.
get well soon and I hope you can get back on the bike soon. You are right... I lock my arms a lot especially uphill. I will try to ride with more awareness
btw... it's a tennis elbow. Thank got no carpal tunnel!
Get a stem extender. It puts you in a more upright position so you put less weight on your hands/palms. Also, if you have the cash, get a vibration dampening stem. Red Shift is the best I’ve tried. Also, try replacing your gloves with new ones with gel pads on the palm. Get well soon.
I have an extender but was taking it easy on the gloves. I will go back wearing them.
I dropped my saddle just a small amount and the problems with numbness and wrist ache stopped altogether.
You were lucky. You are one of the many who do not understand that the angle between forearm and wrist can deviate too much from the optimum in two local coordinates/directions, yielding that problem. You mentioned only one, probably the less relevant.
lucky or not. I'm still happy to be free of the numbness in my fingers and the ache in my wrist which is very relevant to me.
It may be that lowering the saddle makes my wrist naturally strait on the bars. As in I'm not leaning down on them so much. I don't know
The reason why riders try this: it is the only easy method to change something. I don't see much benefit from this. Changing the horizontal angle is nearly impossible without replacing the handlebar.
Well, it's very strange that my problems seemed to stop after the adjustment. Maybe it was coincidental.
This may be another problem. It is just a simple fact that the hands and the bum are burdened unnaturally by cycling.
trust your intuition instead!!
Did you wear a watch or tie any new things around your wrist after the flight. I had the same problem with my bike after I change my watch. The problem gets better after I remove it
no, I did not
. Anyway if you find the solution it would be good to know. Plan to cycle from Malaysia all the way to Thailand soon. Something I would like to avoid
So I got diagnosed with tennis elbow... thank god, not carpal tunnel synonym. It's weird because I don't stretch my arms at all.
Maybe you are a bit stretched and also bars a bit low. Try twisting then upwards and backwards! Also, your stem, have you got it the same way up as before? One way will usually give you 10°of rise the other zero, go 10° hope you get sorted
my stem is exactly the same as it's not adjustable. I never stretch my arms so I thought I am sitting pretty okay. But I will definitely try to adjust it a bit anyway. I got a Bandage now for my wrist and elbow (which turned out to be a tennis elbow). Sight ...
re your stem, if you removed it from the bike and handlebars when packing you may have refitted it upside down, they are designed to fit either way. Usually, one way is flat and the other way has a bit of rising. So not adjustable, just part of the design. Equally, even if you didn't remove it, note that you can and refit upside-down to alter the ride position, assuming it is an A head stem, that fits onto the top of the forks, not a quill, that fits into the forks! Hope that makes sense! I had awful pain in my forearms when I set off, I changed the bars to give me a higher shorter reach and it cured it straight away. Good luck
no, I actually don't understand :) I have a 45% rise (change the stem as well got an extension) so I don't even know if it's possible to change the position.
I have a tennis elbow, too. From sitting at the desk all day. I wish I had gotten it from riding a bike all day! :-D
oh no :( I am sorry to hear.