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What are Biking Injuries?

Bike accidents occur when a bike and its rider is hit by a moving motor vehicle or a part of it, or if the rider falls from the bike.

Many injuries are sustained from falling with an outstretched hand. According to the Centers for Disease Control and Prevention, there are an estimated 600,000 emergency department visits due to bicycle-related injuries, every year. The most common injuries are those to the extremities, especially the arms and wrists.

Types of Biking Injuries

Injuries related to riding a bicycle are related to either chronic overuse disorders or are a result of acute, traumatic injuries from falling off their bike or being struck. Many injuries occur as a result of riding and falling at high speeds, on and off road.

Injuries involving the hand, wrist, and elbow include:

  • Carpal instability: any malalignment of the carpus due to torn ligaments.
  • Cyclists’ palsy: ulnar neuropathy due to prolonged pressure to the heel of the hand.
  • Distal radial ulnar joint instability: unstable distal radioulnar joint with tearing of the triangular fibrocartilage.
  • Distal radius fracture: a break of the part of the radius bone at the wrist.
  • Elbow fracture: break to the elbow joint, including the humerus, ulna, and most commonly the radial head or neck.
  • Handlebar palsy: ulnar neuritis or ulnar neuropathy with numbness and weakness in the hand.
  • Perilunate dislocation: dislocation of the carpus relative to the lunate.
  • Pisiform fracture: fracture involving the carpal bone.
  • Posterior elbow dislocation: separation of the joint elbow surfaces between the upper arm and the forearm, the humerus and radius/ulna.
  • Scapholunate ligament injury: carpal instability due to ligament tear.
  • Phalangeal, metacarpal fractures, and sprains: finger and hand fractures and torn ligaments

Characteristics and Clinical Presentation of Biking Injuries

Symptoms from an injury in one area may radiate to another and may be difficult for the rider to sort out for themself. Patients who experience acute or recurring pain while biking should seek medical attention.

Symptoms may include:

  • Deformity or angulation that may or may not be painful
  • Wrist pain, weakness, giving away
  • Clicking sound when the wrist is moved ulnarly, radially, from flexion to extension with axial load, or rotation.
  • Pain, swelling, and stiffness at the elbow
  • Numbness, tingling or weakness in the hand
  • Pain, swelling, stiffness or deformity of fingers

Causes of Biking Injuries

Biking injuries typically present as chronic wrist pain, grip weakness, and/or restriction of wrist or finger and elbow movements from falls or heavy vibrations and bumps off-road. Fractures may also be associated with tenderness in the affected area.

Most pisiform fractures are a result of falling onto an outstretched hand (FOOSH injuries). However, these fractures may occur alone or associated with other injuries.

Getting a Diagnosis for Biking Injuries

Radiograph of the affected region are useful in diagnosing biking injuries. An X-ray image can usually confirm displaced and non-displaced fractures, which will determine whether or not manipulation or surgical intervention will be required. Magnetic resonance imaging (MRI) may be required to grade ligamentous injuries.

Sometimes a CT scan is helpful to evaluate complex multi-fragment fractures.

Treatment Options for Biking Injuries

Treatment for biking injuries generally involves temporary bracing, anti-inflammatory medication, and hand therapy. Patients with mild injuries may continue to cycle after receiving clearance while optimizing the ergonomics of their bicycle, ranging from seat height, handlebar thickness, aero bars and wearing padded gloves.

In some cases, a period of rest with refraining from cycling is required to injuries to heal. Severe cases that do not respond to conservative treatment may benefit from surgery.

Conservative Treatments

Treatment for biking injuries generally involves temporary bracing, anti-inflammatory medication, and hand therapy.

Patients with mild injuries may continue to cycle after receiving clearance while optimizing the ergonomics of their bicycle, ranging from seat height, handlebar thickness, aero bars and wearing padded gloves.

Surgical Treatments

In more severe biking injuries where surgical intervention is an option, careful evaluation for diagnosis and treatment options is always performed.

Simple fractures and sprains are often immobilized for an appropriate time period.

Fractures with misaligned or unstable fragments are good candidates for closed reduction or surgery to optimize function and comfort long and short term.

Preventing an Injury while Biking

Early signs of hand injury while biking are numbness or tingling in the fingers or palms, pain, swelling, and joint stiffness. In order to avoid acute or chronic injury while biking, there are a few guidelines to consider:

These preventative methods include:

  • Grip on handlebars should be firm yet relaxed.
  • Change hand positions frequently.
  • Remember to keep your wrist straight.
  • Try padded gloves or handlebar tape to reduce vibration.

Prognosis for Biking Injuries

Most injuries will resolve quickly with conservative treatment methods. Injuries requiring surgical intervention may require an immobilization period followed by rehab.

Depending on the type and severity of their injury, patients may need to participate in a physical therapy program to maximize mobility and strength.

If You Believe You Have Biking Injury Contact HandSport Surgery Institute

Please contact us to schedule an appointment with our talented team. People experiencing biking injuries should be evaluated to reduce the possibility of further injury and mobility issues.

If you have been injured, it’s important to be evaluated by a highly skilled professional. Call Drs. Mark and Jason Pruzansky at 212-249-8700 to schedule an appointment, obtain an accurate diagnosis, and start to restore comfort to your hand.

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