Treat the "Cause" Not the Symptoms of Cubital Tunnel Syndrome

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In many cases, Cubital Tunnel Syndrome is a Repetitive Strain Injury (RSI) that occurs when the ulnar nerve becomes impinged at or below the elbow joint. The ulnar nerve is responsible for mediating muscle movement in the forearm and hand, and consequently, damage to the nerve undermines functioning throughout the arm, wrist, hand and fingers.

Symptoms of Cubital Tunnel Syndrome:
Signs and symptoms of Cubital Tunnel Syndrome are characterized by numbness, pain, loss of grip-strength and tingling in the ring and pinkie fingers. Although potentially debilitating, the condition can be quite responsive to early intervention and treatment.

Causes of Cubital Tunnel Syndrome:
Cubital Tunnel Syndrome is usually caused by two situations: The first being overly tight, restrictive flexor muscles impinging the nerve directly, and the second, by the shifting of the elbow joint, causing impingement of the nerve within the joint itself.

  • Muscle Impingement: In this situation, the forearm flexor muscles originating at the medial epicondyle run the length of the forearm to the wrist, hand and fingers, with the ulnar nerve lying beneath.  As the flexor group becomes hypertonic (tight) from repetitive overuse, it compresses the ulnar nerve 1-2" below the medial epicondyle where the flexor group is quite large and prominent. These tight muscles not only compress the ulnar nerve, but also restrict blood flow.
  • Joint Impingement: Although this injury is a joint imbalance, it is still the result of a muscle imbalance, due to the flexor muscle group being overly hypertonic, causing a shifting of the joint which pulls the elbow joint off-center and impinges the ulnar nerve within the Cubital tunnel. (Same area as the “funny bone”)

 

The tasks that most often cause this disorder usually involve a lot of grasping; for example, using hand tools like hammers and power tools or working at a desk and using a keyboard and mouse. Another factor for those working at a desk is the pressure on the elbow joint from resting the elbow/forearm on the hard surface of the desk. In this case, use of a soft towel underneath the elbow can provide significant relief.

Treatment of Cubital Tunnel Syndrome:
Rest may be helpful for providing temporary relief; however, it is unlikely to provide long-term relief. Cortisone is another treatment that may provide temporary relief, but with poor long-term success.  Surgery is also an option, with the attempt to re-route the ulnar nerve.  The outcome of this procedure has poor success and is very painful. Optimally, treatment should be conservative, addressing both the strong and weak musculature that is involved.

Current information from leading medical experts suggest that strengthening and stretching Flextend exercises can assist in eliminating the muscle imbalance that exists in and around the elbow joint, correcting the muscle imbalance and creating equal tension between the agonist and antagonist muscle groups. This eliminates the compression of the ulnar nerve beneath the flexor group or within the offset elbow joint caused by the hypertonic flexors and restores balance, support and provides a safe, effective way to eliminate Cubital Tunnel Syndrome altogether.
 
Author: Jeff P. Anliker, LMT, BD