- Dr. Brian Abelson
Ulnar Nerve Entrapment - Cyclists Neuropathy
Updated: Nov 1, 2022
Ulnar Nerve Entrapment is also known as cyclists neuropathy or handlebar palsy. Ulnar nerve entrapment can cause weakness, numbness, tingling and pain in the forearm and the 4th and 5th fingers of the hand. In severe causes it will also cause muscle atrophy. (1; 2)
Ulnar nerve entrapment usually occurs at either the elbow (Cubital Tunnel Syndrome) or less commonly at the wrist (Guyon’s Canal Syndrome). (3) Entrapment at the elbow is usually due to keeping the elbow in a fully bent position, or from leaning on a surface, for a long period of time. Entrapment at the wrist is primarily from direct pressure, such as leaning on the handle bars of a bike. (1; 2)
It is interesting to note that approximately 60% of the patients who suffer from Golfer’s Elbow also experience compression of the ulnar nerve. In addition, 70% to 90% of patients with Thoracic Outlet Syndrome also have problems with the ulnar nerve. (4; 3)
PHYSICAL EXAMINATION
The videos below demonstrate some of the some procedures we use in evaluating a cases of ulnar nerve entrapment.
Elbow Examination - Orthopaedic Testing
This video goes through inspection and observation, palpation, Active and Passive Ranges of motion, and orthopaedic examination of the Elbow. This video is available for the public on Feb 17/2023
Wrist & Hand Examination
This video goes through inspection and observation, palpation, Active and Passive Ranges of motion, and orthopaedic examination of the wrist and hands. This video is available for the public on Feb 24/2023
Upper Limb Neuro Exam
The upper limb neurological examination is part of the over all neurological examination process, and is used to assess the motor and sensory neurons which supply the upper limbs. This assessment helps to detect any impairment of the nervous system. It is used both as a screening and an investigative tool. (Note: This video will be available for the general public on Oct 7th/2022)
Peripheral Vascular Examination - Key Points
A peripheral vascular examination is a valuable tool used for ruling out signs of vascular-related pathology. The detection and subsequent treatment of PVD can potentially mitigate cardiovascular and cerebrovascular complications. In this video we go over some of the common procedures we perform in daily clinical practice. This video is available for the public on November 14/2022.
RECOMMENDED ORTHOPAEDIC REFERENCE BOOKS
Orthopaedic Physical Assessment – David J. Magee https://amzn.to/3zgu0za
Dutton'sOrthopaedic: Examination, Evaluation and Intervention, Fifth Edition https://amzn.to/3st1AOv
MANUAL THERAPY AND EXERCISE FOR ULNAR NERVE ENTRAPMENT
We have developed several MSR treatment protocols for releasing Ulnar Nerve Entrapment.In addition, we have developed very effective ulnar nerve flossing exercises (to encourage movement of new fibres through secondary tissues) which we often prescribe to our patients.
The following three videos demonstrate some the procedures and exercises that we prescribe to our patients with Ulnar Nerve Entrapment. (Tip: These are only some of the procedures we use or prescribe to our patients with ulnar nerve entrapment.)
MSR Nerve Release - Neck to Shoulder
In this video we focus upon releasing the nerves from the neck to the shoulder (cervical plexus to the neurovascular sleeve) using MSR procedures. The ulnar nerve originates in the upper shoulder (brachial plexus) and descends down the medial aspect of the upper arm.
MSR - Ulnar Nerve Release
In this video we focus on releasing the ulnar nerve using Motion Specific Release procedures. Ulnar nerve entrapment can occur anywhere along its pathway. Some of the more common entrapment sites are: the intermuscular septum, medial epicondyl, epicondylar groove, cubital tunnel, and the Canal of Guyon.
Ulnar Nerve Flossing Exercises
If you have an Ulnar Nerve Entrapment, use the following exercises to successfully floss, mobilize, and release the ulnar nerve from its surrounding tissues.
CONCLUSION
We have found that the most effective methods for addressing Ulnar Nerve Entrapment use a manual therapy (such as MSR) in combination with a customized program of exercises that are designed to meet the specific needs of each individual patient.
If you think you may be suffering from Ulnar Nerve Entrapment, then come see our skilled and experience practitioners at Kinetic Health. They will take the time required to run you through a series of orthopaedic and neurological tests to ensure you actually have this condition.If you do, then we will offer you a customized program of manual therapy procedures combined with effective exercises that will help you to resolve this problem.
DR. BRIAN ABELSON DC.
Dr. Abelson believes in running an Evidence Based Practice (EBP). EBP's strive to adhere to the best research evidence available, while combining their clinical expertise with the specific values of each patient.
Dr. Abelson is the developer of Motion Specific Release (MSR) Treatment Systems. His clinical practice in is located in Calgary, Alberta (Kinetic Health). He has recently authored his 10th publication.
Make Your Appointment Today!
Make an appointment with our incredible team at Kinetic Health in NW Calgary, Alberta. Call Kinetic Health at 403-241-3772 to make an appointment today, or just click the MSR logo to right. We look forward to seeing you!
References
Nerve injuries about the elbow. Hariri S, McAdams TR. s.l. : Clin Sports Med. , 2010, Vols. 29(4):655–675.
Peripheral nerve entrapment and injury in the upper extremity. Neal SL, Fields KB. s.l. : Am Fam Physician, 2010, Vols. 81(2):147–155.
Abelson, B., & Abelson, K. Release Your Kinetic Chain: Exercises For the Shoulder to Hand: Activating Your Arm's Kinetic Chain! Calgary, Canada : Rowan Tree Books, 2010.
DM, Donahue. Cervical ribs and NTOS. [book auth.] Thompson RW, Freischlag JA, Donahue DM, Jordan SE, Edgelow PI (Eds) Illig KA. Thoracic Outlet Syndrom, 1st edition. London : Spinger, 2013, pp. 85-8.