Is adjusting the angle of a drop handlebar a viable way to reduce wrist pain?

Question

Those who spend a lot of time typing on a computer keyboard or playing on a music keyboard (piano, ..) learn that their wrists should remain as straight as possible. The idea is that the tendons that move the fingers go through a tunnel inside the wrist (the carpal tunnel) and if the fingers are moving incessantly for hours, then any angle will make the tendons rub against the wall of the tunnel. The tunnel will get inflamed (carpal tunnel syndrome) in the same way that moving a cable against the edge of a wood tabletop will make a groove in the table, and fray the cable.

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Cyclists with no history of wrist pain are just as prone to wrist pain on a bike. This suggests that the pain does not arise in the carpal tunnel at all.

I do try to move my hand location frequently, but I also like to maintain a reasonably high cadence since I then pedal with the least effort. The need to shift constantly means that my hands are almost always on the hoods, and that I seldom use the other four positions.

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Even folks who are regulars at the gym may have no way to eliminate having "weak wrists". The following is wild speculation: one workout or another may strengthen the muscles around the wrist, but nothing can make the wrist joint itself stronger.

I'm familiar with the few exercises that rehabilitate carpal tunnel syndrome and that prevent its reoccurrence, but on a road bike I can confirm that the pain does not even arise from the carpal tunnel. I'm shifting often, but nowhere near as often as the number of keys pressed during a typing session (yes, yes, such as this one). Also, the pain from the position on the handlebar is not nearly as bad as carpal tunnel pain. The latter is nasty because as soon as it is slightly inflamed, the pain quickly gets worse; maybe because there is less room for the tendons to move freely. The pain from the handlebar goes away after about 24 hours, whereas carpal pain can last weeks, or longer.

I've experimented with moving the seat tube up/down by 2-3mm at a time and this seems to be successful at identifying the most comfortable height.

After experimenting with multiple rides in each of two rotational settings, I'm now about to start iterating to turn the angle of the handlebar until I identify the one that makes my wrists as straight as possible, but before I experiment, I thought I'd ask the collective wisdom here.

Is adjusting the handlebar angle a viable way to reduce wrist pain? As you see in the picture below, I have so far adjusted the handlebar angle looking after the comfort of my lower back (another weak spot that I need to watch out for), turning it up. I'm assuming that they labeled the zero line to give us a hint that we may want to start by centering that zero line.

Edit: Aligning the zero line of the handlebar (horizontal axis of the circle) with the center of the stem (red line) made the hooks position too painful for my back. My solution has been to turn the handlebars up (by about 6 degrees, which turned out to be surprisingly a lot). This +6° solved back issues, but now my wrists on the hooks are abnormally turned up, and, sure enough, this leads to wrist pain–even after multiple rides to allow for the invevitable first-couple-of-times-pain. My question, briefly, is whether to iterate (binary search?) to find just the right angle. End Edit

If the frame is too large for me, then making my wrists and my back simultaneously comfortable may be a losing battle. I could seek that perfect angle all I want, but one or the other would be unhappy. The frame feels just about right (do even professional cyclists have access to custom frames that fit their bodies to the millimeter, in the same vein that professional skiers have access to custom-built boots? But I digress). Turning too far forward/down will make my wrists happy, but strain my back, and vice-versa. Seeking the sweet spot may be just a compromise to increase comfort, or at least to decrease the pain.

It would have been nice to have some graduation to read out the angle directly without having to add hand-written notes, but that gripe also applies to the seat tube, and so we can leave these issues to the constraints of fast factory production lines.

Just to clarify, the added context made for a long question, but your answer need not be long. If you can confirm "yes, finding the right angle is a compromise" along with a bit of experience, that would be a good start for me.

Answer 1

Putting your wrists at an uncomfortable angle on the bars can cause pain for any number of reasons. It can aggravate or maybe cause carpal tunnel, cause stiffness, cause road forces to not be properly absorbed by the joints, and the list goes on. So yes, there's no reason why the angle it came with should be right for you, and every cyclist needs to tune their bar angle to their liking. And yes, the nature of drop handlebars means that in doing so there will be compromises and trade-offs between how well each position works, which necessitates thinking about how much time one wants or expects to spend in each hand position.

But, it's very common for wrist, arm, and upper body pain and discomfort to be caused by bars that are too low or far away, causing weight distribution and posture problems that can't be solved by bar angle. Too much weight is going through the wrists, and more fundamental changes need to be made to do much to address it. The major parameters that are turned to here, beyond frame size and given a correct saddle height, are stem length/rise/height and saddle fore/aft. Bar extension and drop play important roles too, but are changed less easily.

It's unfortunately common to see cyclists do radical things to their bar angle on road bikes, i.e. turning it way up, to try to achieve a more comfortable position, when it's plain as day there are fit problems happening that can never be solved that way. In doing so they almost always make the drop position near-unusable.

A major reason for this dynamic is that road bikes come designed for the needs and priorities of the stereotypical athletic road cyclist and those who aspire to emulate them, hence long and low positions. There are many questions here about this.

If you want to get things actually right re: bar angle, you must never forget you can change your brake lever clamp position too. Again, there's no reason to expect the position it came with to be right. Doing so can be used to, for example, keep your posture and wrist angles reasonable in the drops while making things more comfortable on the hoods. The flip side is that usually when people feel the need to move them to extreme positions, it's again an indication of other, larger fit problems, the common example being moving them way up on the bars to get a more relaxed upper body position on the hoods, when just moving the bars up and back would do the same thing more effectively and without wrecking brake lever access in the drops.

Another way of looking at is this: If you're going to be riding drop bars, you want the drop position to be comfortable, usable, and offer good access to the brake levers. Otherwise there's little reason to use drop bars. The bar clamp angle makes a pretty dramatic difference in the angle your wrists wind up in while on the drops. (Ergo drop shapes greatly exacerbate this because they want your hands to be in one place only, while round drops offer more freedom). Trying to use bar angle to dial your hood position first and your drop position second therefore doesn't work unless you happen to get lucky. The best results are had by selecting a handlebar model, a rise/extension for it (based on the frame and stem dimensions), and a brake lever clamp position that allows everything to work all at once. The aforementioned stereotypical athletic road cyclist certainly may be able to tilt the bars up or down slightly on a new bike and go, but it's often the case that the further one is away from that archetype, the more they'll need to rework the stock position to get a fit that's acceptable.

Answer 2

I'm attempting to elaborate on Nathan's excellent answer.

The original question alludes to the fact that you generally want to keep your wrists straight in multiple settings. This extends to your position on the bike. The graphic below is from a Bikefit.com article on handlebar position. Indeed, in the graphic, they did rotate the handlebars to address wrist angle (the left graphic has these handlebars rotated too far down.)

How should you rotate your handlebars anyway? Bikefit observes that:

Historically the most frequently used method of determining the handlebar’s rotation was putting the bottom of the drop parallel to the ground...

This is true, and it might inform the graphic on the left panel above. However historically, handlebars were shaped a bit differently from today. If your handlebars are advertised as classic bend, they are more like historical handlebars. The photo below from a Cyclingtips article on setting up handlebars is what appears to be a classic bend handlebar, albeit with the bottom of the bar not quite parallel to the ground.

In any case, with this type of handlebar, your neutral position will have the bottoms approximately level. (Side note: today, classic bend bars seem to be favored mainly by professional road cyclists. They genuinely require the lower position allowed by the drops, and they actually have the physical flexibility needed to maintain that position. Most of us lack the flexibility.)

If you rotate your handlebars, you need to take care of the interplay between the angle of the handlebars and the position of the levers on the handlebars. In the Cyclingtips image below, the rider tilted the bars up, presumably to address their wrist angle.

However, the quote is instructive:

It’s common for riders to clock their handlebar upward in order to get the hood angle where they want it to be. However, that then places the bar at an awkward angle, and also creates a longer “effective reach” when you’re on the hoods. In reality, these bars should probably be rotated back downward, and the levers slid further up on the bar.

In addition to the quote, this influences the reach from your hands to the levers when you're in the drops. I will second a comment from Vladimir F: the drops are for all people, not just racers, and if you have average flexibility but you can't comfortably use the drops, the bars may be set up wrong.

The general advice from Cyclingtips seems to be that you should get the handlebars into a neutral position, then position the hoods on the bars so that the hoods are at a slight rise. The image below depicts a good neutral starting point for many modern handlebars.

This YouTube video by John Weirath, a bike fitter, is also very instructive. (note: he started with his handlebars rotated very far down for illustrative purposes.)

In sum, altering the angle of your handlebars may put your wrists in a more neutral position, but it will also affect how you use the rest of the bar, including the tops and the drops. Bear in mind that if you adjust your lever position and handlebar angle, you may change the reach to the hoods. If you shorten the reach to the hoods, then chances are this isn't an issue, but lengthening it might be less desirable depending on your flexibility. Last, also remember that professional bike fits are beneficial no matter what level you ride at; I am aware that they are pricey, but they can be very helpful in sorting out position changes like with your wrists.

A final side note: I see you are using 10-speed Campagnolo shifters. I am unable to conclusively verify this, but I recall hearing that these shifters may work better with certain handlebar types than others. I recall that on a more modern ergonomic handlebar, I had the hoods positioned well, but the reach to the brake levers was slightly long when I was in the drops. In this forum thread, several posters seem to be saying that they felt Campagnolo shifters work better on handlebars with classic bends (i.e. more traditional drop bar style, not more modern ergonomic bends). They did not specify which generation of Campagnolo shifters this applied to, and I cannot verify this from my own experience. This may ultimately be a non-issue, but perhaps it is something to be aware of.

Answer 3

(The following is unproven. After a few experiments, I will either remove this line or delete this answer.)

My question was off in one important detail. Turning the handlebars up simultaneously makes my back and my wrists happy. The issue then is not whether to turn it up, but by how much.

A bike fitter is no doubt helpful, but a personal cycling instructor, one who inspects a cyclist and points out what they're doing wrong, may also be helpful, and in a complementary way. In a sense the former fixes the bike; the latter fixes the cyclist. The discussions here acted as the latter. We're really talking here about bike riding ergonomics. Continuing the analogy with typing, a physician or a physiotherapist may recommend lowering the keyboard shelf, to enable more straight wrists, but their help is pointless unless the user understands the need to type with their elbows beside their waists.

The solution (and this is personal, i.e. YMMV) was to learn how to use the hooks position properly. I cycle on asphalt trails, shared with adults, unpredictable children, and wild ducks and geese that think, correctly, that they own the place. I was hence putting fingers 2, 3, and 4 (counting with the thumb as finger #1) on the levers, all the time that I'm on the hooks, which is most of the time. I'm not sure why I did that. I don't drive with one foot perpetually on the brake pedal, but on a bike I figured I might as well be perpetually in the "ready to shift or brake" position. Having recently moved from an MTB may have been a factor. On an MTB it's not really feasible to keep the thumb and index constantly on the rapid-fire shifters, and a new road cyclist may be tempted to think "here is finally a shifter that I can hold all the time."

It may be more sensible to hold the handlebar, and to move fingers 2, 3, and 4 to the levers anticipating the need to shift or brake, then return to wrapping the fingers around the handlebars.

Moral of the story: if your car has a manual gearbox and you sometimes keep your right (left in the UK etc) hand perpetually on the gear stick (gearshift/shifter) since 1- you're shifting frequently in traffic, 2- you have no other as useful position for that hand, or 3- laziness, since it avoids having to constantly drag that hand between the 2 o'clock (10 o'clock..) position on the steering wheel and the shifter, you may have decided when starting to road cycle that putting the fingers perpetually on the levers is a good idea. It isn't. Holding the levers turns the wrists up by an angle that makes the carpal tunnel no longer straight. That is ok while shifting, but it's not a good position to keep for long.

If the above holds, it's unclear what useful customization is provided by an adjustable stem. Possibly, an adjustable stem fine-tunes the size of the bike frame, making an off-the-shelf bike size better match the rider, who would otherwise be somewhere between two sizes.