GB2462637A

GB2462637A - A padded cycling glove with a recess to reduce pressure on the ulna nerve

Info

Publication number: GB2462637A
Application number: GB0814888A
Authority: GB
Inventors: Kevin Timothy Crowley
Original assignee: Individual
Current assignee: Individual
Priority date: 2008-08-15
Filing date: 2008-08-15
Publication date: 2010-02-17
Anticipated expiration: 2028-08-15
Also published as: GB2462637B; GB0814888D0

Abstract

A glove 26 has padding 40 on the wrist that forms a recess 44 centred on a point 24 between the ulna and pisiform when viewed from the palmar side of the hand. Hence any pressure applied is directed away from nerves in the ulna canal. The glove may be used to help avoid the onset of ulna nerve syndrome (AKA cyclist's or handlebar palsy) and to alleviate symptoms if it does develop. It should be usable while cycling, and while driving, motorbiking, performing gymnastics, using a computer mouse etc. Preferable features include: the padding surrounding the recess and being at least 6mm wide; the padding being thicker toward the arm than toward the hand, at least some of the padding being at least 5mm thick; and the recess having a diameter of at least 15 mm. Also claimed is a kit for making the glove to fit a specific wearer.

Description

TITLE

Gloves for use by cyclists and others

DESCRIPTION

This invention relates to gloves.

The invention was conceived as a glove for use by pedal cyclists due to a problem which can arise in particular when riding a pedal cycle. However, the glove of the invention can also be used to effect in other circumstances, such as when riding a motorcycle, driving an automobile, performing gymnastics, writing or using a computer mouse.

Ulnar nerve syndrome is a condition common in cyclists, in which case it is often referred to as cyclist's palsy or handlebar palsy. The condition is well summarised in an internet blog entitled "Cyclist's Palsy" by Dr Murray Heber at highperformancesports.blogspot.com/ 2006/03/cyclists-palsy-cyclists-palsy-or.html, which states: "Cyclist's palsy, or sometimes called Handlebar palsy is a relatively common condition for road cyclists and mountain bikers. This palsy is a nerve injury at the wrist and until recently, has not been receiving much attention in the literature. First reported in European literature in 1896 by Destot, the condition got very little attention until it appeared in North American literature in 1975 by Eckman et al. Eveiz then, the only published research were case reports which dealt strictly with findings in individual cases and no research was done to examine the exact mechanism or location of the nerve injury. More recent research has been designed to look closely at the Ulnar and even Median nerves at the wrist and look at the effect of cycling on nerve conduction. Below is a summary of the research done to this point in time. (Akuthota V, Plastaras C, Lindberg K, Tobey J, Press J, Garvan C. The Effect of Long-Distance Bicycling on Ulnar and Median Nerves: An Electrophysiologic Evaluation of Cyclist Palsy. American Journal of Sports Medicine. 33 (8), 2005, pp 1224-1230; Padua L, Insola A, LoMonaco M, Denaro FG, Padua R, Tonali P. A Case of Guyon Syndrome with Neuropraxic Block Resolved after Surgical Decompression. Electroendephalography and Clinical Neurophysiology. 109, 1998, pp. 191- 193 Cap itani D, Beer S. Handlebar Palsy -acompression syndrome of the deep terminal (motor) branch of the ulnar nerve in biking. J Neurology. 249, 2002. pp. J44]4445* McIntosh KA, Prestoiz DC, Logigian EL. Short-segment incremental studies to localize ulnar nerve entrapment at the wrist. American Academy of Neurology. 50 (1), 1998. pp. 303-306.) "The Ulitar nerve is a branch of the brachial plexus that provides sensation and motor supply to the upper extremity. The Ulnar nerve specifically is responsible for providing sensation and motor innervation to the medial (or inside) of the forearm and hand. The brachial plexus comes out at the neck, between muscles known as the scalenes, and then traverses the length of the arm before crossing the elbow after which it divides into its respective terminal branches. After passing the elbow, the ulnar nerve divides and gives off 2 sensory branches which supply sensation to parts of the back of the hand and the little finger and half of the ring finger. At the wrist, the ulnar nerve enters the hand by passing through Guyon s Canal. This is a tight tunnel that is formed between 2 of the bones in your wrist (the pisiform and hamate bones) and the ligaments that join these bones together (pisohamate ligament). Either within or just beyond the canal, the ulnar nerve divides again in to two motor branches which supply some of the muscle in the hand and fingers. These branches are the branch to the hypothenar and the deep motor branch of the ulnar nerve. These innervate the muscles that help move the little finger and thumb respectively.

"It is within Guyon s Canal that the ulnar nerve is thought to get injured with cycling and depending on the exact point of injury, 5ymptoms may vary from person to person. Since the sensory branches of the ulnar nerve are given off before or early into the canal, sensory loss is not found in all cases and is in fact a rare finding in cyclist's palsy. The most common finding is that of weakness and clumsiness of the hand and thumb. Often people who develop this condition complain of numbness or tingling in the hand that goes away within a day or two but then they have persistent weakness with pinching and fine finger movements such as playing the piano.

"The reason for the above symptoms is simple. While cycling, the position of the hands while holding the handlebars places pressure on the ulnar nerve in the canal. With either multi-day road cycling events or a single day of mountain biking, that pressure combined with vibrations from the road or trails is enough to damage the nerve and causes what is called a neuropraxia. A neuropraxia is a focal injury to a nerve that does not allow for conduction of a nerve impulse past the site of injury. The nerve functions normally both proximal and distal to the site of injury, and it is because of demyelination (loss of the protective nerve coating) at the site of injury that the nerve stops working and the muscles beyond that point get weak.

"The good news about this type of nerve injury is that it is self-limiting, meaning that the nerve will regenerate on its own and function of the muscles will be restored. In a review by Cap itani and Beer (2002), they found that within 3 months of the onset of symptoms and stopping the mechanism of injury, all motor function in the hand was restored to normal. It is important to know about this condition so that you can take steps to avoid it. A study by Akuthota et al found that long-distance bicycling caused a slowing of nerve impulses along the deep branch of the ulnar nerve in all of the cyclists in the study. They didn t necessarily damage the nerve to the point of neuropraxia, but they did damage it enough to slow the conduction velocity. This shows how all long-distance cyclists are at risk of developing this condition. This same study also showed an exacerbation of Median nerve symptoms in a cyclist wit/i carpal tunnel syndrome. This was due to wrist position on the handlebars. If your hands are on the handlebars in such a way that the wrist is held in extension, this can exacerbate carpal tunnel symptoms.

"Tips to avoid placing too much stress on the hands and the Median and Ulnar nerves are.

* Wear padded gloves and/or ride with padded handlebars to minimize the vibration forces on your wrist and hands.

* Avoid direct pressure over the area of Guyon s canal by avoiding resting the medial aspect of your wrist on the handlebars.

* Avoid letting your wrists rest in excessive extension.

* Make sure you have a proper seat height and sitting position. This will help minimize the amount of weight you place on your wrists.

* Select a proper choice of handlebar. The type of handlebar can also affect the amount of pressure you place through your wrists.

* More specifically for mountain biking, it is important to have good shocks on the front forks of your bike. They help to absorb and dampen the repetitive vibrations and impact on your wrist while on rough terrain.

To summarize, research has shown that long-distance bicycling slows the conduction time in the deep motor branch of the ulnar nerve which supplies the muscle in the thumb used for pinching and grasping. Research has also shown pre-existing nerve palsies, such as carpal tunnel syndrome, can be aggravated with long distance cycling. Furthermore, it has been found that cyclist's palsy can be brought on by a single day of mountain biking. It is important to know the signs and symptoms of this condition so that it can be easily identified and a proper diagnosis established without having to go for numerous tests and possible surgery which can lead to lost days of work and loss of income. It is also very important to find a healthcare professional who can identify this condition and who knows how it is best treated. As previously mentioned, Capitani et al found that within three months, all or near all of the lost motor function was restored. Interestingly, Padua et at published a case of cyclist's palsy that was treated by surgically releasing the ulnar nerve in Guyon s canal. The patient was sent for surgery after the symptoms persisted for one month. It was reported that three months after surgery the patient recovered most of the motor function to the hand. Knowing the natural history of the cyclist's palsy, one may be able to avoid unnecessary surgical intervention that will only serve to lengthen the recovery period. An accurate diagnosis is typically made by having a histoiy of cycling, hand muscle weakness or clumsiness with no sensomy loss. The diagnosis is confirmed with nerve conduction studies that show a decrease or loss of nerve conduction past Guyon s canal.

"Key Concepts to Remember: * Take preventative measures to decrease your risk of developing this condition, such as padded gloves, type of handlebar, shocks, etc. * Have your seat height and position assessed by a professional to make sure it is customized to your height.

* If symptoms of hand weakness and/or clumsiness develop after a long ride, be sure to seek appropriate medical attention from someone familiar with this type of injury.

* If you develop symptoms, avoid cycling and other positions that place pressure over Guyon s canal in order to give the nerve time to recover.

* Long-distance cycling can aggravate pre-exi sting palsies such as carpal tunnel syndrome." Once the condition has developed, its symptoms can be exacerbated for example when driving an automobile with the wrists resting on the rim of the steering wheel, or when writing or using a computer mouse with the wrist resting on the desk.

Many brands of cycling gloves are currently on the market. Generally, they are all of similar design and incorporate padding over the carpals and outside metacarpals of the hand.

This padding may be made from various materials, but generally has a constant thickness.

An aim of the present invention, or at least of specific embodiments of it, is to provide a glove which is better able to prevent the development of the ulnar nerve condition discussed above and/or is better able to alleviate the symptoms of the condition if it does develop.

It should be noted that, in this specification, the term "glove" is intended to be given a broad interpretation encompassing: gloves with, with partial, or without fingers and thumb; and mittens with, with partial, or without finger pouch and thumb.

In accordance with a first aspect of the invention, there is provided a padded glove having, as is conventional, a palm portion and back portion which, in use, extend around the palm and back of the wearer's hand, a thumb portion which, in use, is engaged by the wearer's thumb to register the glove with respect to the wearer's hand; and a wrist portion which, when the glove is so registered with the wearer's hand, covers at least the palmar side of the wrist of the wearer, the wrist portion being provided with padding. However, unlike known gloves, the glove of the first aspect of the invention is characterised in that the padding forms a recess which, when the glove is so registered with the wearer's hand, is generally centred on a point between the wearer's ulna and pisiform when viewed from the palmar side of the wearer's hand. Accordingly, in use, if pressure is applied to the palmar side of the wrist in this general area, the pressure is mainly taken by the wrist in the area covered by the padding, with reduced pressure or no pressure being applied in the region of the recess.

It will be appreciated that the glove will need to be a reasonably good fit for the size of hand of the wearer in order to achieve the desired effect. In order to alleviate this need, or to enable the invention to be applied with good effect to gloves which are very elastic, in accordance with a second aspect of the invention, there is provided a kit for making a glove assembly, the kit comprising: a glove having a wrist portion which, in use, covers at least the palmar side of the wrist of the wearer; padding; and means for attaching the padding to the wrist portion of the glove so that the padding forms a recess, wherein the padding can be attached in a position such that, when the glove is worn by a particular wearer, the recess is generally centred on a point between the wearer's ulna and pisiform when viewed from the palmar side of the wearer's hand. A user can therefore put the glove on their hand and then attach the padding in the correct position suited to their size and shape of hand relative to the glove.

In the glove or kit of either aspect of the invention, the padding preferably completely surrounds the centre of the recess.

The glove, or the glove assembly when assembled, is preferably devoid of padding at the bottom of the recess.

The padding, when uncompressed, preferably rises to a height of at least 5 mm (and more preferably at least 8 mm) above the bottom of the recess. The padding, when uncompressed, preferably rises to a greater height above the bottom of the recess to the forearm side of the recess than to the finger side of the recess. The padding, when uncompressed, preferably rises at least in some places to a height of at least 10 mm (and more preferably at least 12 mm) above the bottom of the recess.

The recess preferably has a diameter of at least 15 mm (and more preferably at least mm).

The padding preferably has a width of at least 6 mm around the recess.

The material of the padding may be of any type conventionally used in gloves, but preferably is not excessively compressible, and preferably is elastic, i.e. it regains its original shape after pressure has been removed from it.

A specific embodiment of the present invention will now be described, purely by way of example, with reference to the accompanying drawings, in which: Figure 1 is a drawing of a person's left hand viewed from the palmar side, showing the outline of the hand, the bone configuration and the main nerves; Figure 2 is a drawing, taken from the same direction as Figure 1 but on a larger scale, showing the outline of the hand fitted with a glove embodying the invention; Figure 3 is a slice view of the hand and glove, taken on the section line 3-3 shown in Figure 2; Figure 4 is a slice view of the hand and glove, taken on the section line 4-4 shown in Figure 2; Figures SA-E are developments of layers of padding used in the glove; and Figure 6 shows the layer developments overlaid.

Referring to Figure 1, the ulnar nerve 10 extends along the ulna 12 and crosses the wrist 14 passing through Guyon's canal between the pisiform 16 and hamate 18 carpals and on to the little-finger 20 and ring-finger 22. Most readers will note that if pressure is applied, for example with the tip of their other thumb, to their wrist 14 on the palmar side near the distal end of their ulna 12, there is a particular point indicated by the circle 24 at, or a few millimetres beyond, the distal end of the ulna 12 where the pain sensation is greater. This point 24 will be referred to for the remainder of this description as the "Sensitive Point." Referring now to Figures 2 to 4, a partially fingered cycling glove 26 embodying the invention has a palm portion 28, back portion 30, a partial thumb portion 32 and partial finger portions 34 formed by various panels of conventional materials sewn to one other in a conventional manner. For example, the palm portion 28 and the inner side of the thumb portion 32 may be made of suede leather, whereas the back portion 30 may be of a stretchable woven synthetic material. Inserts of an absorbent material such as terry cloth may be provided on the outer side of the thumb portion 32 and on the back portion 30 which the wearer can use to mop their brow or wipe their nose.

The palm portion 28 and back portion 30 extend downwardly to a wrist portion 36, the back of which my be provided, in a conventional manner with an adjustable strap (not shown) to assist in holding the glove 26 in position on the wearer's hand 38.

An arrangement of padding 40 is provided on the palmar side of the wrist portion 36.

The padding 40 has the shape of an annulus 42 in the centre of which a recess 44 is formed.

The padding 40 is positioned on the wrist portion 36 so that when the glove 26 is fitted to the hand 38, the centre of the recess 44 is aligned with the Sensitive Point 24 as defined above.

In one example, as shown, the padding 40 is provided by five layers of padding material 46A-E which are bonded to each other in a stack, the stack being bonded to the wrist portion 36 and covered with a thin protective layer 48 of leather stitched to the wrist portion around its periphery and also at the bottom of the recess 44. The shapes of the layers 46A-E are shown in Figures 5A-E, respectively, and in Figure 6. The lower layer 46A has the shape of a triangle with rounded corners, a re-entrant side and a hole 50A towards the opposite corner. Two wings 52,54 are therefore formed, one 52 of which provide a thin layer of padding across the carpals and the other 54 of which provides a thin layer of padding along the proximal end of the little finger's metacarpal. The next two layers 46B,C are both egg-shaped and have holes 50B,50C slightly off-centre, the layer 46B being slighter larger than the layer 46C. The next layer 46D is C-shaped, and the top layer 46E is shaped like a thick rounded bracket "(". When the layers 46A-E are stacked and bonded together, as shown in Figure 6, the holes 50A-C in the lower three layers 46A-C are aligned to define the lower portion of the recess 44, and the upper two layers 46D,E partly encircle the recess 44.

In an example of the padding 40, each layer 46A-E has an uncompressed thickness of about 2.4 mm so that the height of the recess 44 varies between about 7 or 8 mm to the hand side where it is three layers thick and 12 or 13 mm to the forearm side where it is five layers thick. The diameters of the holes 50A-C in the lower three layers are about 20 to 25 mm, so that the diameter of the recess 44 is also about that size. The widths W of the layers 46B,C around their holes 50B,C vary between about 9 mm and 14 mm for the layer 46B and between about 8 mm and 12 mm for the layer 46C. The widths W of the layers 46D,46E are about 7 mm.

The layers 46A-E may be formed of any suitable material that is sufficiently soft to provide comfort, that is sufficiently hard to prevent excessive compression of the padding 40 during normal use and that retains its shape and resilience despite prolonged use. Various grades of rubber or synthetic rubber may be used, or various grades of the padding "gel" that is conventionally used in cycling gloves.

In use, when pressure is applied by the wrist against a support surface, such as a bicycle handlebar grip, the recess 44 acts to space the Sensitive Point 24 of the wearer's wrist 14 from the support surface so that no significant pressure is applied directly to the Sensitive Point 24, or, if very large overall pressure is applied by the wrist as a whole, the recess serves to reduce the amount of pressure which is applied to the Sensitive Point 24.

It will be appreciated that many modifications and developments may be made to the embodiment of the invention described above.

For example, the padding 40 may be formed from a single piece of material rather than layers 46A-E, for example by injection moulding, and in this case the protective layer 48 may possibly be omitted.

The padding 40 may be applied to the inside, rather than the outside, of the wrist portion 36 of the glove 26.

Also, the glove 26 may be supplied as a kit with the padding 40 separate from the remainder of the glove 26, with some means, such as adhesive or Velcro�, for the user to attach the padding 40 to the glove 26 and with instructions explaining how the user should correctly attach the padding 40 in the proper location.

The glove 26 may, of course, be provided with other conventional padding, for example across the distal ends of the metacarpals.

It should be noted that the embodiment of the invention has been described above purely by way of example and that many other modifications and developments may be made thereto within the scope of the present invention.

Claims

CLAIMS1. A glove (26) having: a palm (28) portion and back portion (30) which, in use, extend around the palm and back of the wearer's hand; a thumb portion (32) which, in use, is engaged by the wearer's thumb to register the glove with respect to the wearer's hand; and a wrist portion (36) which, when the glove is so registered with the wearer's hand, covers at least the palmar side of the wrist of the wearer, the wrist portion being provided with padding (40); characterised in that: the padding forms a recess (44) which, when the glove is so registered with the wearer's hand, is generally centred on a point (24) between the wearer's ulna (12) and pisiform (16) when viewed from the palmar side of the wearer's hand.
2. A kit for making a glove assembly, the kit comprising: a glove having a wrist portion which, in use, covers at least the palmar side of the wrist of the wearer; padding; and means for attaching the padding to the wrist portion of the glove so that the padding forms a recess, wherein the padding can be attached in a position such that, when the glove is worn by a particular wearer, the recess is generally centred on a point (24) between the wearer's ulna (12) and pisiform (16) when viewed from the palmar side of the wearer's hand.
3. A glove or kit as claimed in any preceding claim, wherein the padding completely surrounds the centre of the recess.
4. A glove or kit as claimed in any preceding claim, wherein the glove, or the glove assembly when assembled, is devoid of padding at the bottom of the recess.
5. A glove or kit as claimed in any preceding claim, wherein the padding, when uncompressed, rises to a height of at least 5 mm above the bottom of the recess.
6. A glove or kit as claimed in any preceding claim, wherein the padding, when uncompressed, rises to a height of at least 8 mm above the bottom of the recess.

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7. A glove or kit as claimed in any preceding claim, wherein the padding, when uncompressed, rises to a greater height above the bottom of the recess to the forearm side of the recess than to the finger side of the recess.
8. A glove or kit as claimed in any preceding claim, wherein the padding, when uncompressed, rises at least in some places to a height of at least 10 mm above the bottom of the recess.
9. A glove or kit as claimed in any preceding claim, wherein the padding, when uncompressed, rises at least in some places to a height of at least 12 mm above the bottom of the recess.
10. A glove or kit as claimed in any preceding claim, wherein the recess has a diameter of at least 15 mm.
11. A glove or kit as claimed in any preceding claim, wherein the recess has a diameter of at least 20 mm.
12. A glove or kit as claimed in any preceding claim, wherein the padding has a width of at least 6 mm around the recess.
13. A glove, or a kit for making a glove assembly, substantially as described with reference to the drawings.