Male patient aged 44 with pain on the medial side of the right elbow and on the ulnar side of the forearm. The problem has been present for a couple of years, but it always gets worse during the summer. Last winter was also painful, but symptoms were not constant, more following the activity level. Loss of strength in the forearm and grasping followed the pain. Symptoms started to present on the left side this year. Very active person who competes on high level endurance races cross country.
During examination we quickly found out that the ulnar nerve was very tight and that the nerve itself bounced anteriorly and posteriorly during extension and flexion of the elbow. Increased tightness of the ulnar nerve was palpated by the medial elbow/forearm when shoulder external rotation and abduction were introduced (more stretching of the nerve). Patient reported increased symptoms when ulnar nerve was tested. Patient presents restrictions in shoulder external rotation and abduction (more active than passive).
We began ART treatment on surrounding structures following the ulnar nerve from the subscapularis to the flexor carpi ulnaris. First we increased the shoulder’s ability to rotate externally and abduct (releasing restrictions). Then we released the flexor carpi ulnaris muscle. When this was done, we introduced ART treatment for the long tract of the ulnar nerve.
The same initial tests were retested after 20 min. of treatment. The patient’s symptoms were not possible to reproduce at this time.
We concluded that the repetitive motion of the cross country pattern during summer skiing (ski on wheels), probably caused to much of vibrations along the arms when he pushes with the poles (this is the only technique used during summer). These vibrations are produced as the pole hits the ground with a force of push from the skier, and then travels along the chains all the way up to the neck.
4 ART treatments with specific exercises solved this common Nordic ulnar nerve problem.