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Dupuytrens Contracture and Cycling

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Dupuytrens Contracture and Cycling

Old 12-31-16, 10:27 AM
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Dupuytrens Contracture and Cycling

A couple months ago I noticed some small bumps in the palm of my right hand an inch or so below m ring finger. Those bumps have become lager over the past couple of months but have not increased in size over the last month. Saw my GP yesterday for my annual and showed her the bumps and she diagnosed Dupuytrens and referred me to a hand specialist, but getting an appointment is going to take a couple of months. She said that injections of Xaiflex are most likely treatment.

A quick search here indicates some folks have this condition and continue to cycle. I am wondering if I should start wearing padded gloves since I do have some pain during and after riding. I generally do not wear gloves because for me they have caused more problems than providing any benefit.

For those of you who cycle with this condition, any advice you can offer about riding and living with this condition?

Thanks.....
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Old 12-31-16, 08:35 PM
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I have it in my right hand. So far it has not caused me any problems during or after rides. I do, and have always worn gloves since taking cycling back up 15 years ago. I first noticed it a couple years back. When I went to a hand specialist after I noticed it, I was told if it doesn't bother me don't worry about it. It could get worse over time, or this could be as far as it goes.
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Old 12-31-16, 09:33 PM
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Outstanding!
I seem to have the identical symptom in the identical location in virtually the identical time frame. 3 days ago, I asked my wife (retired hot-shot nurse) - she had no clue. I didn't want to schedule a doctor - I am terminally lazy.
Now the issue is completely settled!!!

On a more serious note, I will check it out, but it sounds plausible.
Thanks.

PS - It doesn't seem to interfere with anything (at least so far) and it is not very large. But I am paying attention to it now.

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Old 12-31-16, 09:39 PM
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Got it. Both hands. Heavy lifting aggravates it. Nothing else I've noted. I use gloves riding and would recommend them Reasonably straight forward surgery or very expensive needle aponeurotomy (don't quote me on that) are the only 'permanent' solutions I know. Keep stretching!
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Old 12-31-16, 09:51 PM
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Most often, Dupuytren's Contracture is the result of being male, middle aged, and having Northern European ancestors.

But in rare cases, it can be the result of trauma, which is how I got it. A stupid pedestrian jumped off the sidewalk right into my path, on a narrow bridge, I jammed on the brakes, flew over the bars, and landed with my arms outstretched, resulting in Colles' fracture of my left wrist. Many months later, the DC began to form.

I had a needle aponeurotomy some years later, which hurt like holy hell! But it did loosen up the palm so I can hold the fingers out flat again. I do frequent exercises to flatten the hand against a flat surface, bend the wrist up to tighten the palm, then hold it for a few minutes. So far it is not getting worse.

BTW You know who else had DC?
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Old 01-01-17, 10:05 AM
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Thanks for the comments. As far as risk factors, I am well passed middle age, I have no "viking" (i.e. northern european) ancestry that I know of, but last time I looked I am still male. In late August I did have a crash where I flew over the handle bars and my right hand and other body parts did break the fall, so maybe that is a contributing factor.

My hand is compromised to some extent right now, but I have some arthritic fingers on that hand and the discomfort could be arthritis rather than Dupuytrens.

I ride more on the hoods than on the bar tops and use the drops when required, but most of the time I am on the hoods and any pressure I feel is at the base of the palm. I am just not clear about if using gloves will help to prevent things getting worse. if I can find a pair of padded gloves that work for me, I guess there is no harm in trying. And, probably need to use them for weight work as well.

Again, thanks for sharing your experiences as it helps to know that it is possible to continue cycling with this condition.
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Old 01-01-17, 04:10 PM
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I was operated on just 2 weeks ago for DP. It had worsened to the point that I could not put gloves on and could barely place my hand in my pocket or grab a jar off the shelf. At no point was the condition painful, just a bit debilitating. It never impacted my cycling. My condition was advanced as the ring and pinky finger almost touched my palm. This made for an operation of 2+ hours and lots of stitches across the palm and up each finger. I too was told to watch and wait 3 years back by an Orthopedist, wish I'd gone to see a hand specialist earlier. It went from manageable to needing to do something about it quicly for me . Fingers are straight now and PT is easy as you can sit in a chair and stretch the fingers as now I need to work on bending them (the irony). Its not real serious, but still no fun and it'll likely be 4-6 weeks total for the hand to be functioning well maybe a bit longer for 100%. Cycling is out for now.

So, keep an eye on it.
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Old 01-01-17, 04:21 PM
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Nothing you do or don't do (other than medically or surgically) will alter the progress of this. I've been watching the slow progress of a contracture in my left hand to where the pinky is bent 90°.

I almost had it treated almost a decade ago, but the surgeon explained the procedure in too much detail, and even invited me to watch. I ended up putting it off, and it's never bothered me enough since. Plus I have trouble finding a window where I'm willing to give up riding or diving long enough for recovery.

It doesn't affect my riding in any material way, except that I know that a crash on my left side could very well break two fingers.
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Old 01-02-17, 11:06 AM
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I was diagnosed with it ~20 years ago. Seemed to get worse for a couple years, then the size of the "nodules" reduced slightly, and it's remained fairly benign since then. A hand doctor i visited recently (for an unrelated issue) insisted that it was probably a misdiagnosis if the symptoms didn't get worse or improved. Anyway, it's never interfered with my cycling ...but there are plenty of other reasons I can think of for wearing padded gloves when riding.

btw, a friend of mine was also diagnosed with DC and didn't get off nearly as easily as I did: She just recently had extensive surgery and will be off the bike for a couple months.
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Old 01-04-17, 02:35 PM
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Here's what the Mayo Clinic says about using gloves Dupuytren's contracture Lifestyle and home remedies - Mayo Clinic
Basically, may help, worth a try.
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Old 01-04-17, 07:13 PM
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Thanks ... the Mayo Clinic site says:

"Avoiding a tight grip on tools by building up the handles with pipe insulation or cushion tape
Using gloves with heavy padding during heavy grasping tasks"

I guess I will try padded glove and see what happens. The GripGrab Super Gel looks like it offers lots of padding so I plan to try those first:

SUPERGEL
1005
The SuperGel is the most shock absorbing glove in the range, featuring high end materials and 6 mm DoctorGel padding. This pair of gloves offers maximum protection against fatigue and numbness of the hands related to cycling activity. It is the perfect choice for riders who desire maximum comfort on the bike.

DoctorGel? | Gel Padding for Cycling Gloves | GripGrab
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Old 01-04-17, 07:35 PM
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Originally Posted by metalheart44 View Post
Thanks ... the Mayo Clinic site says:

"Avoiding a tight grip on tools by building up the handles with pipe insulation or cushion tape
Using gloves with heavy padding during heavy grasping tasks"...
While padding may help if you have pain relate to the contracture, it doesn't do anything for the problem itself. For years it was thought that these were caused by something we did, or environmental factors, the current theory is that it has an underlying genetic cause and will run whatever course is "programmed" regardless of anything we do or don't do.

As I said, I've been living and watching the progress of a contracture in my left hand for 15 years or so. At the time, there were early signs of one in my right hand. The surgeon who would have treated me, said there ws no guaranty that it wouldn't come back, especially since there's family history. He said to consider the surgery successful if the left hand stayed OK for a while as the none in my right developed. So far, however, the right hasn't progressed at all beyond the incipient stage.

Who knows, maybe if I treat the left hand, the right will take that as a cue, or maybe not.
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Old 01-05-17, 10:37 AM
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Originally Posted by FBinNY View Post
While padding may help if you have pain relate to the contracture, it doesn't do anything for the problem itself. For years it was thought that these were caused by something we did, or environmental factors, the current theory is that it has an underlying genetic cause and will run whatever course is "programmed" regardless of anything we do or don't do.

As I said, I've been living and watching the progress of a contracture in my left hand for 15 years or so. At the time, there were early signs of one in my right hand. The surgeon who would have treated me, said there ws no guaranty that it wouldn't come back, especially since there's family history.
"Current theory"....based on what studies? I will bet there have been none since there is no money in it for a big pharma company.. Most 'genetic' predispositions are triggered by or exacerbated by environmental and behavioural factors. I've watch the progress of the condition in my father and myself. My observation is that heavy lifting is a factor in its progress. Thanks for the pessimism but I'll keep doing my stretching, wearing gloves and taking whatever other common sense steps I can to slow the progress of the condition (especially when recommended by an organization such as the Mayo Clinic).
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Old 01-05-17, 11:54 AM
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Originally Posted by Mountain Mitch View Post
"Current theory"....based on what studies? I will bet there have been none since there is no money in it for a big pharma company.. Most 'genetic' predispositions are triggered by or exacerbated by environmental and behavioural factors. I've watch the progress of the condition in my father and myself. My observation is that heavy lifting is a factor in its progress. Thanks for the pessimism but I'll keep doing my stretching, wearing gloves and taking whatever other common sense steps I can to slow the progress of the condition (especially when recommended by an organization such as the Mayo Clinic).
I wish you luck, and didn't intend to dissuade you from trying whatever you thought would help, or at least help you feel better.
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Old 01-05-17, 02:04 PM
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Originally Posted by Mountain Mitch View Post
"Current theory"....based on what studies? I will bet there have been none since there is no money in it for a big pharma company..
You'd lose that bet. 418 publications in the last 5 years, although not all are studies, there are also reviews and discussions.

About 75% of clinical trials are funded by commercial interests (Big Pharma, device makers, etc.) Much of basic research is funded by Governments and private foundations, including one for Dupuytren's fund
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Old 01-05-17, 08:19 PM
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Its been 3 weeks since my operation for severe DP, thought I'd make some observations.

I worked for 40 plus years woodworking, building or teaching woodworking. I'm righthanded so almost always, tools were held in that hand. My DP is in my left hand. Reading through this thread I also began to wonder if riding on the hoods, which is normal for me, may have added pressure of some sort to exacerbate the condition. Then I remembered that DP typically starts in the ring finger and only drags the pinky finger along later on, at least that's my experience. Once the pinky joined in things worsened quickly, less than a year before I could not put on a pair of gloves etc. So, in my experience at least,there's not a lot to be done about it except possibly try to stretch the fingers early on. I did read somewhere that DP is more common among those afflicted with Gout, which I have but manage.
So, stretch and do what you can.
The operation is no fun. My condition was advanced and I should have sought treatment earlier. My best guess now is that it will be about 2 months for recovery. Again, its just a hand and did not involve cardiology or oncologists or any life threatening issues and for that I'm thankful, and I'll be better soon enough. Best advice is to keep a good watch on it and to make appts with hand specialists sooner rather then later.
BTW, my father was a Greek immigrant and my mother was the daughter of 2 Scottish immigrants so theres some northern european genes but not enough to make a good case. 5 older brothers, none of whom even knows what DP is.
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Old 01-05-17, 09:32 PM
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Originally Posted by SloButWide View Post
You'd lose that bet. 418 publications in the last 5 years, although not all are studies, there are also reviews and discussions.

About 75% of clinical trials are funded by commercial interests (Big Pharma, device makers, etc.) Much of basic research is funded by Governments and private foundations, including one for Dupuytren's fund
So I looked at the "one for Dupuytren's". It appears to indicate that one of the triggers (start point) is stress/strain. It also includes environmental factors such as injury, tobacco, alcohol and drugs. In other words, both genetic and environmental/behavioural component.

I specifically doubted that there were any studies of the results of those who tried to control environmental factors and used excercises like stretching compared to those who did not. I knew there would be various trials...those are NOT double blind studies!
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Old 01-12-17, 05:18 PM
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Great thread! I had never heard of this, but I do have a noticeable swelling (both hands, slightly larger on the dominant left) of the palm just below the 4th-5th finger web. I have no pain or disability of any kind, but I noticed even back in high school that my ring fingers would relax into a more bent, more palmar orientation than the others. I know what to watch for in the future, should it progress. My ancestry is primarily Scots and English, with some Dutch and German, so I guess I qualify for the "northern European" part.
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Old 01-12-17, 05:40 PM
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I have had surgery for it 3 times. It needs to be surgically removed or your hand will eventually turn into a claw. Once it gets bad padded cycling gloves are mandatory. The bad news is it takes several weeks after surgery before you can ride again. I used the trainer after two weeks.
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Old 01-16-17, 08:40 AM
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Wow surgery 3x--that's punishing! I have this too and like the rest, let it go too long--just real busy and don't want down time. I'm over 60, Dutch-English, and have run 12-14 ranks thru our wood stove for 22 years. I cut, split and haul all the wood myself so a perfect candidate for this "disease". Really enjoy it though and good cross-training.

I converted to Di2 several years ago since mechanical shifting was becoming a challenge and very happy with it. Do I think cycling exacerbates it? Yes-being on the hoods 90% of the time in a half-fisted position over 4000 miles last summer and the occasional death grip on tough climbs seemed to make mine worse. Though I tried to be aware of relaxed hands. Those who have a mild case, I suggest lots of hyper-extension stretching and wearing a bike glove at night with a tongue blade inserted thru the affected finger outlet extending to the palm. I'm gonna try this while riding.

I had Xiaflex injected 2 months ago--6 "TB shots" over each of two tendons on same hand. Then went back 2 days later for the hyper extension. It has really worked well but requires constant work hyper extending/stretching. I soak it in hot water then really work it hard and sleep with the tongue blade setup. The tendon injection tracks were tender 10-14 days but I was using it the next day and could put on tight rubber gloves after 5 days when the significant swelling went down. Overall not bad to go thru--just watch Youtube videos on the surgical procedure is convincing. Hope this helps some of my fellow victims!
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Old 01-16-17, 11:44 AM
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I have it in both hands, and both feet for most of my adult life. My dad had it also, and never had it treated, with bad results. When it becomes a problem, I have it removed surgically with excellent results. I've never been disappointed in the surgery, and even watched a couple times. I've got lots of scars on hands, fingers, and feet, but nary a problem in functionality.

I say go for it!
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Old 01-21-17, 11:29 AM
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I have it in both hands. I was told it's an hereditary condition and (in the UK) is often a sign of Scandinavian blood. It started in my right hand and has now started in the left. For the first couple of years the nodules hurt, but then become less prominent (and less painful).

Mine seem to be progressing quite slowly. My brother-in-law (a blue-eyed blond - i.e. looks a lot more Viking than I do!) is almost ten years younger than me and has a much more severe condition. He's had at least two operations on each hand. Both included skin grafts and both hands are quite a mess.

I was also told that not only is there no cure (just periodic corrective treatment), there is nothing that can be done to arrest the progress. It's just luck of the draw what speed it progresses.

On the plus side, it's not affected my cycling at all, apart from the occasional knock which is painful.
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Old 01-23-17, 01:59 AM
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Originally Posted by itchyjoe View Post
Those who have a mild case, I suggest lots of hyper-extension stretching and wearing a bike glove at night with a tongue blade inserted thru the affected finger outlet extending to the palm.
It'll be interesting to see if this works. My consultant told me that hyper-extension stretching may be counter-productive as the tendons have a tendency to contract as a result.

He also said that for a splint to work you'd have to wear it for 20+ hours a day, which would probably be as inconvenient as having a bent finger!

On the plus side, he also said the waiting list for the operation wasn't long and to talk to my GP when I found it difficult to do everyday tasks (e.g. put a glove on) and I'd go straight back on the waiting list.
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Old 02-06-17, 10:45 AM
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Just visited the Duputren's specialist at a local hand speciality clinic. X rays were taken and I spent about 40 minutes with the doc talking about the causes, treatment, and prognosis for me. I emphasized that I spend 12-15 hours a week on the bike and a major concern for me is how this condition might affect cycling. After examining the X-rays and palpating the nodules he commented that about 70% of patients he sees with nodules like mine never progress to contractions, but he also emphasized that so little is known about the causes of the condition that it is hard to predict. However, it was his opinion that it would not progress and if it did it would not adversely affect my cycling. I asked about wearing gloves and he said if it made me feel better or relived pain, go ahead, but there is no evidence he knows of that suggests that progression can be inhibited by wearing gloves. He also said that he has had success with needle ablation (using a need to break up the nodules) and some with surgery, although he noted that patients requiring surgery usually have more than one procedure. So, all in all I am hopeful that this will not progress to contractors and if it does that it is not likely to affect cycling.

I also mentioned to him that in both thumbs, but especially my left one, I have pain in the joint at the base of the thumb that is often painful while cycling. He examined the X-rays and observed "significant" arthritis in the trapezium area at the thumb base and suggested traditional treatments for arthritis: Voltairen gel (unfortunately I am allergic to something in the gel, ibuprofen, tylenol, etc...). He also said he has had success with a surgical procedure that removes the trapezium bone and if the pain becomes a problem, then that is an option. Over the past five or six years I have had enough surgeries that I am not eager for another, especially since it would require a significant recovery time and then more time to rebuild conditioning on the bike.

Aging is a *****.......
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Old 08-04-17, 10:47 AM
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rayhosler
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Hurts on long rides in dirt

I've had Dupuytren's for at least seven years, although didn't notice it until four years ago. Had needle aponeurotomy a year ago on the left hand, pinkie, and now it's back to where it was before. Right hand also has an issue in the right index finger. Both hands have nodules in the palm and they can hurt on long rides in the dirt. Gloves help. Needle treatment is the least invasive, but probably the least effective. Xiaflex injection with needle more effective, but your results will vary and recovery time is a lot longer than needle alone, and more side-effects. Sigh.
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