A MEDICAL PERSPECTIVE

A Case of Mountain Biking Induced Wrist Injury and
its Improvement by New Biking Technology

Arthur Audie Smith MD
University of Tennessee Medical Center, Knoxville Tennessee

I have been an avid road and mountain cyclist for about 25 years.  For the last decade, I have  been competing in the XTERRA off-road triathlon series as well.  Unfortunately, about 7 years ago, I begain developing a severe pain in the lateral side of my wrist that at its worst would keep me from riding my bike.  I soon had to give up any and all raquet sports such as golf, tennis or softball as well.   On some days I was unable to play my piano and began to become  very concerned that this would affect my work since  I am an anesthesiologist at the University of Tennessee Medical Center in Knoxville.

audie

Eventually, I was evaluated by several  hand specialists whom at first found nothing to explain the pain.  They then recommended an  MRI.   Dr. Anthony Allen, a hand radiologist at the University, found what is termed  pisotriquetral osteoarthritis which is indeed a condition that can be attributed mountain biking.   This should not be confused with Carpal Tunnel Syndrome.

Dr. Allen, adds his comments:  Audie’s  MRI demonstrated fairly severe pisotriquetral non-acute arthropathy.  The remainder of the wrist was largely normal.  This presumed overuse injury (as well as a number of other wrist injuries) has been reported in bicyclists, but especially off-road enthusiasts,  in the literature (1) .  Further,  its occurance appears to be more widespread than previously known.

Even thought I am a physician, I have great reluctance for trying  medications or surgery unless less intrusive methods have been tried.  I , therefore, attempted to get relief through physical therapy, chiropractic and massage.  However, all were without improvement.

I  also  attempted to modify my bike grips by using softer grips as well as adding extra layers of cork ( even to my mountain bike grips), different padded gloves, longer travel forks, etc.  again without improvement.

One day while getting my bikes worked on at a local bike shop, I saw the Ergon grips.  My first impression was that the shape made sense but if the material wasn’t flexible, it wouldn’t help.  No one in the shop had used them so they couldn’t give me first hand information about their effectiveness.  I bought them anyway and was surprised that in my very first outing, I had remarkably less pain in my wrist after a 2 hour ride.  Now that I have been using them for about 3 years, I do not find my bike time limited by wrist pain. I regularly do 12 hour mountain bike races( the Hill of Truth race) and continue with the XTERRA races. (over 50 total….so far)

Although,  I  am still aware of my injury,  I have yet to experience the debilitating pain that was present prior to my use of this product.  In addition to outfitting my own bikes with the Ergon grips, I also have given them as gifts to various friends.

1. Pathologic Conditions of the Hypothenar Eminence: Evaluation with Multidetector CT and MR Imaging http://radiographics.rsnajnls.org/cgi/content/full/26/4/1021

Pathologic Conditions of the Hypothenar Emi- nence: Evaluation…
fracture of the pisiform bone or the hook of the hamate bone, osteoar- …… pisiform bone or evidence of pisotriquetral osteo-. arthritis (Fig 17). Clinical and radiographic find- …. Cartilage lesions of the pisiform and the triquetrum are found mostly on the … among mountain bikers and off-road cyclists be- …
radiographics.rsnajnls.org/cgi/reprint/26/4/1021.pdf

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One Response to “A MEDICAL PERSPECTIVE”

  1. Its strange you mention cycling because I used to do along of road biking and I had to give up because of wrist pain. The last time I tried cycling was about 5 years ago, after a couple of years break due to pain. It was really heart breaking to have to give up cycling as it kept me really fit, sharp and out/about. Unfortunately, my doctors haven’t been so supportive and pretty much I’ve had to be on my own dealing with recovery.

    Its nice to see that you managed to get back on your bike and I’ll be looking at those grips very closely. I kept thinking about trading my old road racing bike in for something more sedate like a city/mountain bike 😉

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