Cubital Tunnel Syndrome Part 2

Confidently overcome your carpal tunnel syndrome
by changing how you use your hands and wrist

Most people use their hands throughout most of the day, especially for work-related tasks. But in some professions—like assembly line work and jobs that use vibrating hand tools—the repetitive motions involved can actually damage the wrist over time and lead to a painful condition called carpal tunnel syndrome (CTS). This is a condition caused by compression of a nerve in the wrist that leads to symptoms in the hand and wrist, but it can be managed by making some simple changes to the way movements are performed.

The carpal tunnel is a space at the base of the palm that contains several tendons and the median nerve, which provides sensation to the fingers. If these tendons thicken or any other swelling occurs in the area, this tunnel narrows, which puts pressure on the median nerve and leads to CTS. For this reason, CTS is considered a nerve compression syndrome, and it’s by far the most common type, affecting about 5% of the population.

Symptoms usually start with a burning or tingling sensation, but eventually pain, weakness and/or numbness develop in the hand and wrist, and then radiate up the arm. As CTS progresses, symptoms usually get worse when holding certain items, and hand weakness and numbness may occur more frequently if this pressure on the nerve continues.

The greatest risk factor for developing CTS is any task that requires repetitive hand motion, awkward hand positions, strong gripping, mechanical stress on the palms, or vibration. CTS can therefore occur in any line of work that involves one or more of these components. Office work and repetitive typing may be a potential cause, but the chances of developing CTS are three times higher in assembly line work like manufacturing and meatpacking. Other professions that have a high risk for CTS include sewing, baking, cleaning, sports like racquetball and handball, and playing string instruments like the violin.

Education and exercise to combat CTS

The best way to deal with CTS is to learn how to avoid movements that will make the compression worse, and then address the damage present with exercises and pain-relieving interventions. Our physical therapists recommend the following:

  • Education
    • Change your wrist positions and avoid bending your wrist for too long
    • Use proper neck and back posture, and avoid slouching
    • Keep your wrists straight when using tools and also while sleeping
    • Try to avoid flexing and extending your fingers and wrists repeatedly
    • Minimize repetitive, strong grasping with the wrist in a flexed position
    • Take frequent breaks to rest your hands and wrists
    • Modify your tools to make a more comfortable grip
    • Use anti-vibration gloves or wraps when using vibrating tools
  • Ice/heat to relieve pain
  • Strengthening exercises for the wrist, hand, and fingers
  • Stretching exercises for the wrist, hand, and fingers
  • A night splint to reduce discomfort

If you’re dealing with any hand or wrist symptoms that sound like CTS, it’s probably time to see a physical therapist for a structured treatment program that will target your impairments and teach you how to preserve your wrist from future issues.

Cubital Tunnel Syndrome and Other Nerve Compression Syndromes

Conditions resulting from pressure on nerves can be treated with specific exercises

The nervous system is the line of communication spans the entirety of the body and allows for all of its movements and functions to take place. But when a nerve is damaged and unable to transmit its message properly, it can lead to communication issues and a range of possible symptoms that can make movement more difficult.

This is the case with nerve compression syndromes, which is a group of disorders that occur when a nerve is squeezed or compacted by another structure in the area. Nerve compression syndromes involve the peripheral nerves—those outside of the brain and spinal cord—and are usually caused by repetitive movements that eventually impinge upon the nerve. There are several different types of nerve compression syndromes, with carpal tunnel syndrome being the most common, followed by cubital tunnel syndrome.

The cubital tunnel is located in the elbow and contains the ulnar nerve, which supplies sensation to the ring and little fingers. The ulnar nerve travels from the neck down to the hand, and it can be compressed—or pushed on—by other structures at any point along the way. But the most common place this occurs is behind the inside part of the elbow, where the cubital tunnel is located.

The result of this compression of the ulnar nerve is cubital tunnel syndrome. Symptoms typically include pain, numbness, tingling, and weakness in the arm and hand, which is particularly concentrated in the ring and little fingers. Cubital tunnel syndrome is also caused by daily habits like leaning on the elbow for long periods of time, sleeping with the arms bent, or from direct trauma to the ulnar nerve, like hitting your funny bone.

Other nerve compression syndromes include the following:

  • Cervical radiculopathy: results from compression of one of the nerve roots in the neck when it splits from the spinal cord; symptoms include a burning pain in the neck and down the arm, and weakness, numbness, and/or tingling in the fingers
  • Lumbar radiculopathy: occurs due to compression of a nerve root in the lower back when it branches away from the spinal cord; symptoms include pain, numbness, weakness, and/or tingling down the leg and sometimes into the foot
  • Piriformis syndrome: a rare condition occurring when a muscle in the buttocks (the piriformis) puts pressure on the sciatic nerve; the most common symptoms are tenderness in the buttocks and pain traveling down the thigh, calf, and foot
  • Other: Guyon’s canal syndrome, radial nerve compression syndrome, and thoracic outlet syndrome; symptoms typically include aches and pains, tingling or numbness, weakness, and reduced flexibility

Physical therapy and exercise can help reduce symptoms

If you begin to notice symptoms that suggest a nerve compression syndrome is present, physical therapy is often the best option available to manage your condition. A typical physical therapy treatment program may include bracing or splinting, modalities like ultrasound and electrical stimulation, and advice on how to make modifications to your lifestyle and posture. Another important component of treatment is exercise, particularly nerve gliding exercises, which help to maintain the health of nerves and restore their mobility if it has been lost. Below are four examples of nerve gliding exercises that can address cubital tunnel syndrome by targeting the ulnar nerve:

Physical therapists can provide you with a specific set of exercises for your condition and guide you to ensure you’re performing them correctly. They can also educate you on how to avoid certain movements that will further irritate your nerves in order to alleviate your symptoms.

Baseball Injury Specialists in Visalia

Baseball can put extreme stress on the shoulder and elbow and sometimes, and maybe you are a player looking for a baseball injury specialist in Visalia. If so, we read on to learn more about how we can help.

Every year, approximately three million children play baseball in the U.S., and many continue to play on through their adolescence into high school. Due to the mechanics involved in baseball, strain on the elbows and shoulders is unavoidable, and injuries are therefore more common in these areas than anywhere else in the body. Young players of all positions are at risk for getting injured, but the risk is significantly higher for pitchers. In fact, research has shown that as many as 45% of pitchers under the age of 12 already experience pain in their elbow on a regular basis.

Most of this pain is due to performing the same motions repeatedly, which is referred to as overuse. One of the most common causes of elbow pain in young athletes is a condition called little league elbow—or medial epicondyle apophysitis—an overuse injury to one of the growth plates on the inside of the elbow. Little league elbow is most commonly seen in young pitchers and occurs because the growth plates are weaker than the muscles that attach to them. As a result, the stress placed on the growth plates from repetitive throwing can cause them to become inflamed, and the result is pain and swelling that makes it challenging to throw normally.

Other common overuse injuries of the elbow in youth baseball include the following:

  • Ulnar collateral ligament (UCL) injury: often results from pitchers throwing too often or too hard, and can range from minor damage to a complete tear
  • Flexor tendinitis: inflammation of the tendons of the elbow that attach to the upper arm bone (humerus), which leads to pain on the inside of the elbow
  • Valgus extension overload: a condition in which the protective cartilage on the bony point of the elbow (olecranon) wears away and a bony growth develops
  • Ulnar neuritis: irritation of the ulnar nerve, which stretches around the bony bump at the end of the humerus; the result is numbness, tingling, and pain

Since these elbow injuries result from overuse, the best way to prevent them is to ensure that young athletes are training within their limits and not pushing themselves too far. Parents and coaches can do their part by monitoring participation levels and pitch counts for young pitchers, and encouraging rest and recovery when it’s needed. Another key component of injury treatment and prevention is physical therapy. A physical therapist can provide a specific prevention program for young players, which will include stretching and strengthening exercises individualized to their specific needs and based on any weaknesses that might be present.

One, study published in 2017 shows just how effective physical therapy can be for baseball-related elbow injuries and why it should be the treatment-of-choice for these patients. The study, which focused on UCL injuries in throwing athletes, concluded with the following statement:

Non-operative management of sprains of the medial UCL of the elbow should be considered as first-line treatment in the majority of cases. After adequate rest, a structured return-to-sport interval-training program is crucial for successful return. Prevention of further injury may be provided by evaluating the athlete’s throwing technique and training regimen.

Our physical therapists are trained to help with both of these recommendations: they can provide a return-to-sport training program that is personalized for each athlete, and they can also evaluate the athlete’s throwing technique and guide them with prevention techniques that will reduce their risk for future throwing-related injuries.

To learn more or book an appointment with one of our clinical specialists, click here for additional contact information.

Tennis Elbow Treatment in Hanford

Looking for Tennis Elbow Treatment in Hanford?  Try these things first to avoid the treatment altogether – read on…

Tennis is a great form of physical activity that works many parts of the body due to its demanding dynamics, but just like every other sport, it also comes with a risk for injury. The most common injury in the sport is called lateral epicondylitis or epicondylalgia, which is usually referred to as tennis elbow. Tennis elbow can be a truly bothersome injury, but there are several ways to prevent it from happening and address the symptoms if it does.

Tennis elbow is an overuse injury, meaning it results from performing the same movements repeatedly for a long period of time. Athletes who play tennis and other racquet sports therefore have a particularly high risk for developing tennis elbow, but it can occur in anyone who performs repeated movements that involve the elbow.

The lateral epicondyle is the bony bump on the outside of the elbow. When the arm is overworked, a muscle in this region gets weakened, which eventually leads to microscopic tears in the tendon that attaches to the lateral epicondyle. This results in inflammation of this tendon—called lateral epicondylitis—which leads to symptoms like pain, a burning sensation in the outer part of the elbow, and weakened grip strength.

The good news for patients with tennis elbow and looking for tennis elbow treatment in Hanford, it usually heals on its own with some basic remedies, as approximately 80-95% of patients will have a successful outcome and don’t need surgery. But there are also plenty of ways to prevent tennis elbow from occurring in the first place.

To reduce your risk for tennis elbow, follow these tips:

  • Learn to use your shoulder and upper arm muscles to take the strain off your elbow
  • Stick to the middle of your range of motion during strokes, and avoid bending or straightening your arm all the way
  • Make sure your racquet is right for you; lighter weight, larger grips, and softer strings may reduce the strain on your tendons
  • Take breaks from tennis to play other sports throughout the year to avoid overuse
  • Try to maintain adequate fitness and flexibility levels with conditioning exercises
  • Avoid repeating any one type of stroke, and practice a range of strokes instead

If symptoms of tennis elbow are noticed, however, patients should see a physical therapist first and fast. Therapists are experts at identifying the cause of the pain, and from here, can design a personalized treatment program that alleviates symptoms and restores any function that may have been lost. The benefits of seeing a therapist can be illustrated in the findings of a study published in 2016, which compared the cost-effectiveness of physical therapy to steroid injections, another popular treatment for tennis elbow. The study’s conclusion reads:

Physical therapy was a cost-effective treatment for tennis elbow…A combination of steroid injections and physical therapy was ineffective and cost-ineffective. Physical therapy, not steroid injections, should be considered as a first-line intervention for tennis elbow.

So for all the tennis players out there, keep these tips in mind to keep your risk for tennis elbow at a minimum. And for any elbow-related pain that you do experience, be sure to see a physical therapist right away before it progresses any further.

Click here for Contact Information for our Hanford Office

Tennis Elbow or Golfers Elbow – Natural Treatment is our Expertise


Do you know someone that is looking for tennis elbow treatment in Visalia?  How about a golfers elbow treatment in Visalia? We understand.  Elbow pain is a common complaint in avid tennis players and golfers, but some simple strategies from a physical therapist can correct these problems

Tennis and golf are popular recreational sporting activities that attract participants in many age groups, but they seem to be especially popular with older adults. This may be due to the more leisurely nature of the two sports compared to some others, and the fact that golf also doubles as a social engagement as well. Another unfortunate similarity that these two sports share, however, is that regular participation in either one can lead to elbow pain that can make it difficult to play. But the good news is that some basic changes and physical therapy can help correct these issues.

Golfer’s elbow is a condition that results from the repeated bending of the wrist that is necessary in a golf swing. This damages the muscles and tendons of the medial epicondyle—a piece of bone on the inside of the elbow that allows the forearm, wrist and hand to bend and move in several different ways—and eventually leads to inflammation. It is especially common in golfers because gripping or swinging clubs incorrectly or with too much force can take a toll on the structures within the elbow over time.

Similarly, tennis elbow is another type of overuse injury that involves the lateral epicondyle, a bony bump that is located on the outside of the elbow. In this case, the tendons that attach the forearm and wrist muscles on the outside of the elbow once again become inflamed due to repeated use of the arm and elbow. The culprit of tennis elbow is overuse, and while the motions of racquet sports like tennis are largely influential in its progression, any activity that involves repetitive and vigorous use of the forearm muscle can lead to it.

In both conditions, symptoms like pain, tenderness, swelling, weakened grip strength and a burning sensation on either the inside or outside of the elbow are indicators that tennis or golfer’s elbow may be present. These symptoms often develop gradually and are worsened by activities that involve the forearm, and if left unchecked, can go on to make many basic activities that require gripping or grasping a major challenge.

This is where physical therapy comes in. Since both of these injuries are due to overuse, in most cases they can be minimized or stopped from progressing further with some training adjustments and proper conditioning. To treat and prevent tennis and golfer’s elbow, physical therapists recommend the following:

  • Always warm up and stretch before playing, and cool down afterwards
  • Be sure you’re using proper footwear and equipment
  • Maintain adequate fitness and flexibility levels with conditioning exercises that are specific to the physical demands of tennis and golf
  • Perform strengthening exercises, especially for your arms and core muscles
  • Have an expert evaluate your gameplay to ensure your techniques are being executed correctly; focus on improving areas that need work

Physical therapists can also create a personalized treatment program if either of these injuries fails to improve with the initial changes made. A recent study looked into whether one intervention used by physical therapists—joint mobilizations—were beneficial to patients with tennis elbow, and the conclusion they arrived at stated the following:

There is compelling evidence that joint mobilizations have a positive effect on both pain and/or functional grip scores across all time frames compared to control groups in the management of tennis elbow

This shows why any tennis players or golfers dealing with elbow pain should strongly consider seeing a physical therapist, as doing so will help these athletes return to the activities they love for years to come.

There’s no need to continue to suffer.  If you are seeking out an expert in (lateral epicondylitis) tennis elbow treatment in Visalia, give us a call.  Click here to visit our contact page.  We have two offices and both are equipped with expert staff that can treat golfers elbow in Visalia too.