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How Can I Make ‘Trigger’ Thumb Less Painful When Riding?

Question: I have pain in the base of my thumb and “trigger” thumb that has required steroid injections over the past two years. I have been told that cycling and holding the bars can aggravate this and that it’s a recognized cycling injury. I ride about 4,000 miles a year. I also cross country ski, and gripping the poles can be aggravating as well. I have carbon fiber handlebars and use Fizi’k gel under Fizi’k’s thickest bar tape. Is there anything else I could do to help prevent this from recurring? Thank you. — Jim F.

Coach Fred Matheny Replies: I have a similar injury to yours — a “gamekeeper thumb” with badly stretched ligaments from college football many years ago, and aggravated by a fall while backcountry skiing in my area of western Colorado. So I can identify with your problem.

I have tried various remedies to alleviate the chronic pain while riding and also using poles for snowshoeing. None of them has worked perfectly, but they may give you some ideas.

  • Wearing well-padded gloves helps a little. I don’t notice much difference with more flexible handlebars.
  • A PT made me a brace for the thumb that works okay on road levers but is very painful while riding mountain bike bars.
  • I have tried physiotape, using the same taping pattern that I used on the bad thumb in college; it was shown to me by the athletic trainer. This helps a little also but can become restrictive and cut off blood circulation.

In short, nothing seems to help in the long term. I notice the pain more when braking a lot on twisting mountain descents or hiking on snowshoes uphill for long periods when I’m using the poles for additional leverage.

I have been advised that I should have surgery done but that it might not work well since the initial injury occurred many years ago. So I use ice after rides that make it flare up and just live with it the rest of the time.

I hope this helps, at least somewhat, and I’m sorry that I don’t have a quick fix for what sounds like the same gimpy thumb that I have.


Coach Fred Matheny is an RBR co-founder who has four decades of road cycling and coaching experience. He has written 14 eBooks and eArticles on cycling training, available in RBR’s eBookstore at Coach Fred Matheny, including the classic Complete Book of Road Bike Training, which includes 4 eBooks comprising 250 pages of timeless, detailed advice and training plans. The Complete Book is one of the many perks of an RBR Premium Membership. Click to read Fred’s full bio.

 

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