After 4500 miles on my V I've developed "tennis elbow"

[chicorider]

Hi all,

I have a year and 4500 miles on my V 2.0. My elbows began to hurt a little over a month ago, and I have recently been diagnosed with lateral epicondylitis, commonly called "tennis elbow." It is a condition that occurs through overuse combined with weakened forearm muscles and leads to tearing of the ligament that connects those muscles to the bone. In my case, two to three hours every other day of griping the handlebar and working against my legs as they churn the pedals has caught up with me, and now I barely have the grip strength to open a pretty loose peanut butter jar lid. Needless to say, I'm off the bike. It makes me sad. (27 years on a DF tied my back in knots, pushing me to go recumbent, the V being the first. My back is great...now it's elbows. Grrr...).

Ligament injuries are slow to heal--probably 2 to 3 months for me. After prolonged rest, then comes stretching and strengthening. You know, the physical therapy routine. Here's where I'm hoping to get some help from y'all's collective experience: when I do return to the bike, what can I do to reduce my chances of a relapse?

My current setup has my arms pretty well extended. Would bringing them in and having more of a bend at the elbows make things better or worse? Would having my hands higher or lower change the forces that my arms must endure? I climb a lot...is that an issue? On flats, I like to push hard...issue? These are some of the questions that run through my mind while I'm resting.

I know that I have some trial and error coming my way in terms of fit, ergonomics, and my pedaling style, but if anybody out there has experienced and worked through arm and elbow pain, or you have fit suggestions, I'm all ears. Thanks for the help.

 

[ratz]

Bull horns or drops? If I recall (not a doctor) doesn't that injury come from a "death" grip on a golf club or tennis rack like item?

 

[1happyreader]

doesn't that injury come from a "death" grip on a golf club or tennis rack like item?

Bob in tennis its a rotational injury , think turning a screwdiver , in laterals case loosening direction. Makes it tough to comb your hair.

griping the handlebar and working against my legs as they churn the pedals

Sounds like you are constantly pulling on the bars ?
Looks like an opportunity
put the palms to the grips,
open the fingers
work on the smooth pedal circle.

Pain is the bodies warning system.

later,,,, bye

 

[DavidCH]

Hey... really sorry to hear that. I try to mix my cycling every day. If I am having a recovery day I put the hands on the drops. I think its good for the bones to have a bit of a shake too so I mix the V with the mountain bike. I like cycling distance even with the mountain bike. With the mountain bike I have to move my hands all around the bars as I tend to get a bit of numbness in my hands. When riding with the V there is no numbness. The great thing with the mountain bike is bunny hopping over pot holes, I haven't quite been able to do that yet with the V.

There was a study done about bone strength; road bikes generally don't give the right conditions to strengthen bones. Not sure if the V falls into this category?

 

[MrSteve]

Your elbows are injured.
Stop injuring them.
How?
Learn to ride without your elbows.
Learn to ride with your legs, hips, head and even the frame of your bike doing the steering.
You may have to ride something else, something that keeps you off of your V 2.0, if you can't not use your elbows.

I'm riding injured as well!
When I got my new-to-me Vendetta, and roughly dialed it in when it was all bolted together, I hopped on it and went NUTS.
For weeks!
As a result, my quadriceps were turned into solid, aching bruises, my upper arms as well; same with the little
muscles in my feet.
Everything is healed now, except for some lingering, painful weakness in some forearm muscles and their connective tissue.
However, I really don't need my arm muscles to ride.
Experience, long experience has taught me how to ride these MBB/FWD bikes efficiently in many, many ways.

So, rest your elbows.
Either mount your bike on a trainer and still keep in shape that way.
Or, teach yourself to ride your bike without stressing your arms or aggravating your injured elbows.

 

[LarryOz]

Craig,
I am very sorry to here of your problems.
A few observations:
We all learn to ride in such different ways, and even if on the same bike, we develop habits (good or bad for our body) out of some bodily necessity to maintain the bike in the upright position.
It has been my experience that when at first learning to ride the V that my arms and upper body where just so sore. I could not believe it. It was like I had been lifting upper body weights the whole time I was riding (but worse!). I know I had a death grip on the bars for sure. I had to really focus while riding not to hold them so tightly, and that eventually went away for me. But I also started working out my upper body with free weights 3 times a week for about 30 minutes. That might have helped a little bit, but wouldn't say I think you problem is because you don't lift weights.
The V can be ridden with virtually no upper body input. (Jim P rides with no hands quite easily - Not me - I can do 1 handed for a long time if needed - but not no hands!)
I believe someone already mentioned trying to learn to lighten up your grip on the handlebars. I agree with that, but obviously you can't practice that now since you need to heal and recover.

Back in February, I crashed and tore my right front and rear rotator cuff pretty severely. I had to be REALLY careful, and once I had the injury and then surgery in March, I was totally off of my upper body weights program. What I had that I think really helped was an indoor trainer.
I have a KICKR trainer, and I love it. The V mounts to it very nice. But any trainer would probably work for you, except rollers.
This would let you keep riding the V with virtually no upper body input, so you can keep your fitness level up while you are recovering.
Anyway - I think, from what you have said, it looks like you have probably developed the habit of holding the handlebars too tightly
When you do get back on the V, it would probably serve you well if you tried to practice lightly holding the bars while riding, and let your legs learn to take most of the load.
They eventually will and you probably will not even noticed it until one day you see you barely need any handlebar input.
It might be pretty easy if you are going to be off of it for 3 months or so, and it will be almost like learning all over again.
Good Luck with the healing.

 

[Charles.Plager]

Since owning my Cruzbikes (but in neither case because of them), I've had moderately severe tennis elbow in both elbows (separated by a couple of years). In both cases, I found that it was more challenging to use my trigger shifters or even brakes, but it didn't affect my Cruzbike riding otherwise.

1. You shouldn't need to grip tightly the handlebars. Open palms should be all you need to counter pedal steer.
2. After getting used to the bike, you shouldn't need to fight pedal steer at all, just use it when you're really pushing.

In my two cases, I found that (1) the tennis elbow bands helped a lot and (2) exercising the "elbows" by squeezing squishy things seemed to help. But this does take lots of time (and in my case lots of ibuprofen).

Good luck!

Charles

p.s. I'm not that kind of doctor, so you probably ought not be taking medical advice from me...

 

[chicorider]

Thanks, everyone, for the good advice. Much of it echoes what I have been thinking, but it's good to compare notes with those who have more experience.

I ride drops, not bullhorns. I think I will pull the bars in a bit to encourage more of a push instead of a pull against the bar, with the real goal being a loose-fingered grip (my last real ride was on my Quest, which requires little grip at all, and I still came away with pain. That's when I knew I had to rest). I also developed a habit over the summer of sitting up at stop lights and starting off from that position, using my arms and a firm grip to hold my upper body up until I had enough momentum to lay back down (I am short, at 5'4", with shorter than average legs. Sitting up allows me to plant my left foot more firmly on the ground, instead of just my toes). I will most likely ditch that move and practice my starts from the reclined position; I can do it, just not as gracefully.

I do have a nice trainer, but the thought of spinning in my garage for two or three months straight sounds awful. I've already lost a bunch of fitness (that ride on the Quest was almost a month ago), so I'll probably take another month or so off, start spinning again late November, early December to get some fitness back while my elbows (hopefully) finish up their healing. And when I do get back out there, I'll start off easy and build up from there.

Oh, and DavidCH, when you figure out how to bunny hop your V, I think we'd all love to see it.

 

[Robert Holler]

Treat the handlebars as if you were gripping ripe bananas, and only go for the hardcore grip when you absolutely need that kind of power. I do a lot of practice on calm stretched not even grabbing the bars - I just barely rest my hands on them.

Heal well!

 

[Timothy Dale]

Ask your MD about steroid iontophoresis.

 

[DavidCH]

My left arm is playing up a bit. It starts hurting when I have to change chainwheels. I think I have a good case for upgrading to Di2

 

[RojoRacing]

one thing i notice a lot of cruzbike owner due is setup their bars so they look normal instead of in a way to work good with you body. it seems everyone has their bars rotated too far forward which makes you tip your wrist toward your pinky finger. it's nothing you'd feel on an everyday ride but i noticed it on my first 8hr long ride. after that ride i rotated my bars until the drops had my wrists perfectly strait and now i have no issues with my arms. even Maria pointed out how far my bars were tipped up when she first met me but i told her it was perfect.

my issue was mostly related to my wrist but as you may know the body is a fluid machine and it's common for one problem to cause others over time. i'd take a look at your setup more closely and look for small signs of body stress you probably don't notice everyday but are building little by little over the year. also if you extend the boom towards you so you elbows are a bit more bent then you'll have to again rotate your bars back to keep your wrist strait.

when i first started riding the v20 it was suggested i push the boom forward so my arms were a lot more strait. i found this caused me to constantly be pulling back on the bars and i couldn't relax, the torque steer while pedaling also because slightly worse. maybe you fell into the same trap and stuck with it too long. now with my wrists strait, elbows bent and relaxed there's less stress and i can ride more stable.

i'm waiting on a high res pic that shows my current setuo from the side as an example, post it if it arrives. if you have any pic of you on the bike from the side it could help point out anything obvious.

 

[chicorider]

Hi, it's Craig. I started this thread back in October. It's interesting to see it come back up.

I ended up having to take seven months off from pretty much everything. It hurt to lift a coffee cup or turn a doorknob. Arm braces, slings, physical therapy, and a lot of rest--the works. Part of my trouble was that I didn't address the pain soon enough. I kept riding with pain until tendinitis turned into tendonosis, which is when the injury develops scar tissue in the muscle. My rehabilitation needed so much time because I had to let the tendon heal and allow the scaring to clear. I mention this only to say that addressing the pain sooner is better than later. You probably won't "ride through it."

After months of going crazy from not riding, I got back on the V in May. The advice above was invaluable (thanks everybody), and here's my addition to it, based on my experience:

1. When I was learning how to ride the V, my natural tendency was to flex my arms to steady (or fight) foot induced pedal steer. For a while, my forearms were strong enough to do this for 30-50 miles. But if you flex a specific muscle for two hour or longer stretches, that muscle will eventually crump, putting the strain onto the tendons, which weren't meant to handle it for long. The tendon eventually fails, and voila, "tennis elbow." This early tendency to use my arms to fight my feet became my habit, even after I was over the learning curve. In other words, I figured that's just how you rode this bike because no one had ever told me otherwise. Some of the Cruzbike advertising even suggests that the beauty of the Cruzbike design, over other recumbents, is that you can use your arms to help leverage power. Using my arms sounded normal to my inexperienced self.

Up above in this thread, however, a few seasoned riders have said that I shouldn't have to grip the bars so tightly. They were right. When I got back on, I concentrated on a loose grip (Robert's image of imagining that the bars are ripe bananas is perfect). I also smoothed out my pedal stroke, especially when climbing. The big revelation for me was switching my thinking from fighting my feet to including them in steering the bike. Allowing my feet and hips to be part of the steering allows my arms to relax, and I can now ride most of the time, even at speed, with my fingers loose on the bar. No pain, even after a 70 mile ride with lots of climbing. I had to develop a new habit. My shifters are Dura Ace 9000 mechanical. No issues there.

2. My arms were too straight, contributing to the strain I was putting on them. My model is the V 2.0, with the older yellow and polished aluminum boom. I am a shorter rider, and I had my bars already adjusted as close to me as that boom would allow. Robert set me up with the much, much more adjustable V20 boom, which allowed me to bring the bars closer (thanks, Robert). Now I have about a 45 degree bend (maybe even a bit more) in my elbows. I also set the angle of my bars and hoods in the most neutral position I could find, rotating up and down until I found the spot that produced the least wrist and arm strain with a relaxed grip.

3. I now take precautionary measures to protect my forearm muscles. I wear a tennis elbow brace when working around the house, and compression sleeves when riding. I also stretch my forearm muscles two or three times a day to keep them loose.

I am pretty convinced that if I started out riding the V the way that I do now, I never would have injured myself. Put another way, my injury came as the result of a lack of knowledge. I figured it out, but did so the hard way. I don't know how prevalent such arm pain is with newer V riders; maybe I'm part of a small group. Then again, maybe not. I wonder if there is a way that Cruzbike could put a word out advising new riders about the importance of a relaxed grip, having some bend in the elbows, and including the feet in the steering rather than fighting them. I love the V and the Cruzbike design; my Quest is awesome for commutes; and I'm about to head to the garage to build up a new Silvio. I'm committed to the brand and design, but hope that other riders can avoid what I went through.

 

[ReklinedRider]

Hmm just now reading this thread, somehow missed it before.

Agree with all that's been said about avoiding the 'death grip', avoiding having your wrist tipped towards your pinky too much, etc.

Also to consider: tennis elbow/lateral epicondylitis is an overuse injury brought about by (surprise!) overuse, specifically of the muscles that extend the hand at the wrist. 'Extend' in this setting is moving the hand itself in the direction of the back of the hand, at the wrist.

If the reach to your brifter levers was a bit cramped for the size of your hands and finger length, you'd have to significantly and maybe forcefully extend your wrist to reach around and use your brakes or even the shift function. As many miles as you were putting on that V, that adds up to a lot of use of those extensor muscles.

That may or may not have anything to do with your injury by itself but could have been a factor when coupled with overly straight arms and using the dreaded death grip.

Also, 'fighting your feet' often involves using those same muscles in excess.

Try laying your entire forearm and hand on a table palm down. Don't lift your forearm at all but lift your hand off the table as fast and as far as you can a dozen or two times. If that in any degree seems to remind you of the pain you were having, maybe adjust the reach of your levers.
Just a thought.

Glad you're finally getting better!

 

[ccf]

I'm having this same problem with my Silvio. The problem started after I made changes to the bike (rotated bars forward and moved them a little farther out) and after I started doing a lot more climbing. I was off the bike for two weeks recently for business travel, but soreness was there even after returning home. I have a tendency to sleep with my elbows bent, and that seems to aggravate the problem.

I've started trying to ride without grabbing the bars, instead just curling my fingers around them and leaving a little space. Sounds like rotating the bars and moving them closer to me would be a good idea, too. What about getting a curved slider? I feel like having the bars up increases by tendency to pull/hang on them.

This morning my Pilates instructor gave me some recommendations for stretching and releasing my bicep and forearm muscles. We'll see if that helps.

-Cliff

 

[DavidCH]

Well I have been ok up to now but with the new fitness regime I am doing between 100 to 140km rides.

Oddly enough surprise surprise. It's not the main muscle groups I have discomfort with, but my left arm because the brifter left lever tension is stronger and the over extension needed to change gear. See pictures. Is there anything I can do with these Shimano brifter levers? I would like to flair them out to the sides so that there wouldn't be so much extension in order to engage the gears. I have bull horns on and it appears the ultegra brifter can't be angled.

 

[LMT]

one thing i notice a lot of cruzbike owner due is setup their bars so they look normal instead of in a way to work good with you body. it seems everyone has their bars rotated too far forward which makes you tip your wrist toward your pinky finger. it's nothing you'd feel on an everyday ride but i noticed it on my first 8hr long ride. after that ride i rotated my bars until the drops had my wrists perfectly strait and now i have no issues with my arms. even Maria pointed out how far my bars were tipped up when she first met me but i told her it was perfect.

my issue was mostly related to my wrist but as you may know the body is a fluid machine and it's common for one problem to cause others over time. i'd take a look at your setup more closely and look for small signs of body stress you probably don't notice everyday but are building little by little over the year. also if you extend the boom towards you so you elbows are a bit more bent then you'll have to again rotate your bars back to keep your wrist strait.

when i first started riding the v20 it was suggested i push the boom forward so my arms were a lot more strait. i found this caused me to constantly be pulling back on the bars and i couldn't relax, the torque steer while pedaling also because slightly worse. maybe you fell into the same trap and stuck with it too long. now with my wrists strait, elbows bent and relaxed there's less stress and i can ride more stable.

i'm waiting on a high res pic that shows my current setuo from the side as an example, post it if it arrives. if you have any pic of you on the bike from the side it could help point out anything obvious.

Before and after photos showing the bar being raised, had the same issues with my wrists with them not being straight. I also extended the bar more to make my arms straighter with less of an angle at the elbow. Now all okay.

 

[ratz]

Good thread, it is hard to explain dialing this in and this one covers some good point, one of the advantages of at least a cheap trainer is you can carefully work on finding a straight wrist position. My build photos probably don't help as we are smaller people and with the work done to get the booms lower, which was part of the focus of getting the wrists straight and the elbows bent at the chest, it is just a fluke that we end up with relatively low brifters. For me that started as being cautious of arthritis problems,

Interesting in the tendinitis. We installed about 7 tons of concrete pavers in June, I gave myself tennis elbow unloading those cocky and one handed. It's a pretty bad case but it is healing slow and steady everyday unless I do somethings stupid like one arming a Gallon of milk.

Today in did a 150 mile ride, I didn't even think about the elbows, didn't hurt on the ride and felt better than it does at the end of the workday. That is the difference that 3 years of spinning the mbb will do. My arms don't do much unless I choose to have them do something.

Craig it sucks that you had go through that and thank you for sharing so others can learn, it is so important to not muscle the bars and to develop a light touch, loose grip, straight wrists, and a smooth round pedal stroke. Practice a low speeds will make that second nature

 

[RojoRacing]

this is my current setup from several months ago. currently i'm very pleased with the overall comfort on up to 13 hr rides. the only issue i still contend with is my knuckles getting stiff and aching from hanging off the bars in the same position all day. i don't feel i'm hanging on that tight but after 8 hrs i start to make an effort to take each hand off and repeatedly open and close my fingers every time i drink. this was one of my huge pains during last years 24hr but back then i could barely ride with one hand at all and only my left hand at that so it literally never left the bar if i was rolling. i can't say for sure if it's the same or gotten slightly better, but i know it's not worse.

 

[DavidCH]

Jason, your box under the seat would love a coat of paint. I tried to buy a Thor seat recently but Greg is in the process of moving so he isn't doing any more for six months. How do you find it? Does it give you a lot more power? And is it more comfortable at longer distances?