Brachial Plexus irritation...anyone else?

For context, started training a couple of years ago with many years of athletic competitions under my belt, started mountain biking about a year and a half ago as another way to be a well-rounded cyclist. Enjoyed it immensely. Over time, I gradually got better and better about putting out power in a more aero, dropped position on my road bike. Training volume went up gradually. Generally doing just fine.

Then I started getting numbness in a classic carpal tunnel pattern during an XC race about 5 weeks ago on my right (dominant) side when putting down big efforts. I thought it was just numbness related to handlebar/grip positioning, but then I also noticed some strange sensations in my other fingers sometimes, also that it was immediately worsened/recreated in certain arm/neck positions. Took a few days off, felt better, then had it immediately return when I tried to do some endurance on the trainer. Numbness/pain immediately recreated by dropping my shoulder, outstretching arm, and extending neck (rolling head back), basically the position of riding in the drops on a road bike.

I don’t have any other carpal tunnel problems, no neck pain, no weakness, no sharp pain, just a general numbness. After talking with some a neurologist friend, the pattern would be most consistent with a brachial plexus (lower root) irritation/stretching created by riding with arms low and neck extended over time. These injuries are evidently common in high-energy crashes (motorcycles, ATVs, etc), and they can be devastating. Obviously mine is extremely mild comparatively, but still on that spectrum.

Anyone else ever experience this?

Also, this experience may serve as a warning…more aero doesn’t always work out.

Firstly, I’m not a doctor nor do I have anything above a basic understanding of this however, this is something similar to what I’m going through at the moment so I thought I’d share.

I’ve experienced some right-hand (dominant) numbness and loss of grip from time to time that seems to be triggered by a combination of desk work, cycling and strength workouts.

I’ve had bike fits and made adjustments so the issues aren’t as frequent or impact me as much but it’s still somewhat of an issue on the bike and in general work/life activities.

I’ve had shoulder/arm/hand/neck issues for a long time and it’s always been assumed by myself and various physios that it has been due to playing a lot of ‘throwing’ sports in my junior years.

I decided to get a proper look into this as it’s been going on a while and was referred to a specialist. We went through a number of tests and inspections including nerve conduction tests which all came back inconclusive - basically ruled out carpal tunnel and local nerve issues.
However, just the other week I had an MRI to inspect the brachial plexus that revealed I have an extra rib (cervical rib) which is likely causing neurogenic thoracic outlet syndrome. Have a bit of a google for this to find out more.

I’m still awaiting final reports from my surgeon before we work out a path forward. I’d like to avoid surgery as much as possible but if there are risks of it getting worse or causing further damage then a rib removal surgery might be on the cards.

So, I know this may not help you and it may just lead you down a path of an incorrect diagnosis but I guess what I’m trying to say is if it’s an issue for you, you should really get it checked out properly.
I should have done this a long time ago rather than just assuming it was x when it looks like it might be y.

I really appreciate you sharing that experience. Just like any other internet syndrome, I definitely came away saying I HAVE THAT :joy: I have an upcoming appointment with an MD to get it examined

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Hi. As per the preceding contribution, I’m not a doctor however am sharing my own experiences.

Was hit by a car when cycling in April last year. 3 broken ribs and knocked out (for a while) so 3 nights in hospital.

Back on the bike on late June and returned to training a month later with obvious expected reduced fitness.

Shoulder pain persisted which I attributed to ‘leftovers’ from the accident, plus some finger sensations similar to that which you describe.

Turns out it was nerve damage (brachial plexus). Had my flu jab in September in the same arm and within 24 hours my left hand was paralysed. Numerous MRI scans and conduction tests later, diagnosis and prognosis was:

Accident damaged my radial nerve via brachial plexus. Degeneration was occurring. Local inflammation from normal flu jab responses was straw that broke the camels back.

Paralysis persisted from end of September through to last week in April this year at which point it suddenly showed improvement. Now at about 75% to 80% of full strength and mobility.

On the basis of my experience I’d urge caution and where you feel necessary get your doctor to run some tests etc. Better safe than sorry.

Good luck :+1:t2:

Brachial plexus injuries are far less common without a mechanism of injury, such as trauma. What’s far more likely and common is traditional neck pain. Since you describe reaching further and extending your head it sounds like your neck is being stressed to a point where it isn’t tolerated. This is where bike fit shines to help remedy the situation and potentially reduce some of the aggressive end range positioning. As well, you may have noticed some loss of neck range of motion and/or pain. Situations like these are best addresses with physical therapy.

Great point, and I am very hopeful this is the case. I have had bike wrecks, but nothing recent and nothing major, and it has gotten markedly worse without any trauma. PT of one kind or the other is definitely in my future!