Median and ulnar nerve injuries in cyclists: A narrative review

Cycling is popular internationally as a mode of transport and sport. Cyclists often report sensory and motor changes in the hands during rides. In the past, assessment of these symptoms was based on clinical history, physical examination and neurophysiology. The aim of this narrative review was to evaluate existing publications and determine if there are areas for further improvement in the clinical setting. METHODS: Searches were undertaken in accordance with the PRISMA guidelines using four online databases: PUBMED, OVID, CINAHL and WEB OF SCIENCE. Articles were evaluated using adapted versions of guidelines for case and cohort studies. RESULTS: 2630 articles were found and 13 were included in the review. 2 considered median, 9 considered ulnar and 2 assessed both nerves. 11 were case and 2 were cohort studies. 7 discussed neurophysiology and 1 mentioned ultrasound as a modality of investigation. Interventions were described in 3 articles. CONCLUSION: The quality of evidence is generally low when considering this problem. Clinical assessment and neurophysiology are commonly regarded as the method for assessing nerve symptoms amongst cyclists. Advances in musculoskeletal ultrasound add to our early investigative repertoire and may help expedite management and limit future disability. In addition, further research is required into screening and preventative measures amongst cyclists.