Guyon's Canal Syndrome

Finding a name & the cause is a whole lot easier than finding a fix. The ulnar nerve branches and passes through the wrist through two tunnels. The medial passage is called Guyon's Canal or Tunnel. Once it passes through the canal, which is roofed by the medial ligament, it the branches into two once more, one nerve going to the pinkie & the other to the ring finger. Compression of this canal is what causes the tingly sensation I have in those fingers. The middle finger is also served by the ulnar nerve, but it branches before Guyon's Canal and appear to the be ulnar nerve that many gloves are made to protect.  I need protection of both. Technically, I have mild Type 3 Guyon's Canal Syndrome; no motor impairment, just tingle fingers.

The treatment can be surgery for extreme cases, and mild cases can become extreme cases. But in mild cases the best course is to find the movement or activity that is causing the compression and eliminate it. So...

Even though I know at some point I will be going to an aerobar, there are two main reasons why I am not changing up my entire system. First, replacing the stem & handlebar so that I can use the aerobar is a helluva lot of work on the Talon. With internal cable routing for the rear brake, it's just something I don't want to mess with until I HAVE to. That might be when I'm up to 3 or 400k, I suppose. Secondly, right now I think that pedaling in the aerobars would be uncomfortable because I'd be kneeing myself in the belly with each pedal stroke. So I probably wouldn't use the aerobars at this point anyway. Other reasons...well, the carbon bar probably has 'some' dampening effect over an AL bar, and the ergo shape of the bar is more aero and again, has to be at least a little more comfy than a round AL bar.

What steps am I taking? Well, first I've lowered the angle of the handlebar itself, giving me easier access to and more room on the drops. Prior to this riding in the drops meant either holding onto the bar with the lateral half of my hand or bending my wrist and putting pressure on the medial side so that part of my wrist was on the flat & part was on the bend. This should help even out the pressure so that my entire hand is on the flat part of the drop, or my entire hand is on the bend: my choice, but either way there should be marginally less pressure. I will most likely move the shifters up a bit to compensate for rotating the bar downward, otherwise I might have more pressure or a weird wrist angle in the hoods. I'll have to play with that to see---I might even take it in to Miles Ahead for a quick fit without bar tape just to see what they say about moving the shifters up (or anything else).

Once I get the fit done & my shifters adjusted to the right height, then the real fun begins. I'm going to put at least 1 layer of bar phat across the entire bar, even the top, with an extra layer in the depression made for resting the medial palm (compression point). I may even add an entire layer over that, giving me 2 layers + that extra layer for the palm depression. And whereas it is ubiquitous to wrap the tape under the hoods, I am going to add some bar phat on top of the hoods where I rest my hands, connecting that bar phat with the rest that's on the bar, and then wrap over that to blend it all in to the rest of the bar. I've done a test run with old tape: I think this is going to be crazy thick but quite possibly incredibly comfortable. The hoods will especially be very wide, but I think that will make them much more comfy to rest my hands in, not to mention that it will dampen a lot of road noise. Of course, I'll be wrapping everything with LizSkins DSP tape, 1.5mm, to add just a bit more cushion as well as all-weather grip. I may look like a total Fred with this setup, but then I'm trying to ride for hundreds of miles, not short little races where problems like this never crop up. You've got to be creative and use your brain!

Most obviously, I'll top it off with gloves. I've used the Pearl Izumi gloves that supposedly protect the ulnar nerve. Maybe the did, but the cause my hands to hurt where the padding was. But due to that fact in addition to the amount of science that Specialized claims to put into...everything...I'm going to go with a Specialized gloves. In their advertisement pic, they at least show the branching of the ulnar nerve so they, at least at some level, are aware of the fact that the ulnar nerve is actually 2 nerves that pass through the wrist in two different places. We'll see how these work out.

And finally (I think), I'll run my front tire pressure down 10#s to 100psi, and I'll also remove the Aquarack and replace it with the Xlab Carbon Wing. I should not feel anything behind me. I always feel my thighs contacting the Aquarack and this has to move me forward at least occasionally. And in the game of riding >100 miles, the smallest things can make a difference.

Now, I must not ignore once final thing, but it is not a quick fix. This nerve compression I'm experiencing is COMPRESSION, meaning that pressure is being placed on the canal(s) for an extended period of time. While I am doing everything I can to reduce the effect of that compression, the real, root fix of the compression is to reduce pressure from the source--which is me. This is to say that as I lose weight from my top half, there will be less pressure (& compression) delivered to the handlebars. So while it's good that I'm addressing all these other issues, I must never lose sight of the most significant root cause. I need to lose weight. I've been more or less stagnant for months at ~230. It's time to get rid of that.

Anne pointed something out, however, I've ridden 100 & 111 without this problem, and those rides occurred at either a greater weight or only slightly less than what I am now. While this is true, it just throws another wrench into the mix, so rather than racking my brain trying to figure out what was different then, at this point I'm going to stick with the plan I have. If it doesn't work, then I'll continue my research/guessing game.

Of some note, today is Wednesday and the tingly sensation in my pinkie's & ring finger's has shown some subtle improvement. Let's keep it moving that direction!!! If only I knew a way to intervene & speed along my improvement.