Ring and pinky finger numbness and the ulnar nerve: start at the neck

Hey guys, before we start the show today, I want to take you through a offer that I've been working on for a while. You probably heard it already if you're a dedicated listener. It is the premium version of the podcast. It is super helpful if you love case studies. I've had a lot of feedback over the years about, hey, why don't we do more case studies? Well, case studies are hard. They're hard because I got to look back and got to think back of what the person had. And so it's challenging to remember all these stories. And so now what I've decided to do is just record myself monologue format right after I get out of the exam or on the same day as when seeing the person.

So I'm super fresh. And so I get a lot more details. So I think this will help out the clinician listeners out there with their clinical reasoning by learning what I do, or at least maybe improve on what I'm doing. Cause I don't assume that I'm knowing everything and doing everything right either. So if you guys are interested in that and you listened to over 20 episodes, scroll down into your podcast player and click the become a member, it's very affordable. And I know that you'll take advantage and you'll learn from these once a week dissemination of about 15 minutes or so, um, different audio than, than you're going to get in the main podcast.

So we're going to keep it super raw in there and you guys are going to learn a ton. Take advantage of it. Let's get into the show. People who have numbness don't typically have pain. It's just the numbness and they say, Oh, it's just not a big deal. And because pain is such a good motivator for someone to make a change in their life. Um, a lot of times we'll nip problems in the butt when it becomes painful, but when numbness is there, people just let it sit. You're listening to the restoring human movement podcast where movement experts discuss the latest evidence-based practices to help you and your clients move with mastery.

And now your host, Dr. Sebastian Gonzales. Hey guys, it's Sebastian, your host for the restoring human movement podcast. Thanks for joining the movement movement. Here's your first time in the show. Welcome. You've missed a lot and we are into the 200 pluses. I have no idea where we're at anymore because we've done so many of these things and the format has obviously changed over time, but, uh, today's going to be a solo. We're going to solo podcast today. This is going to be something that's super patient friendly. Uh, and I would encourage clinicians to share this with some of your patients as well as the affiliated, uh, podcast that goes along with this.

Uh, so general format is about 45 minutes to an hour long format. Uh, we try to use, uh, layman's terms as much as we can not to get too techie. Um, but the goal is to get everyone to feel better sooner. You know, like I don't see any reason why people should be in pain so long in their life and feel like there's no hope and no one to guide them. And so this podcast is hopefully something that will give you guys some hope that you can get better. You just have to find the right person, the right solution, the right treatment plan, and then you're good to go. So, um, by the way, I guess I should note too that this is a part two to another podcast that I did.

I found the need to do another version of this because that shit, it's only 45 minutes, you know, um, can't get through everything about 45 minutes or so, but this is, uh, the other podcast is only nerve treatment options. It doesn't say part one, but it's part one. Cause this is going to be only nerve treatment options part two. And so I'll quickly frame maybe who might be interested in this. If you have numbness or tingling or, um, uh, kind of prickliness of the fourth and fifth digit on the fingers on either hand, one hand or both, this is something you might want to listen to. There is a lot of conflicting information out there about what to do with this type of thing, as well as there is a lot of, um, I'll just say, um, I don't want to say old information, but there's a lot of information that's incomplete.

You know, I'm going to try this, try to make this as complete as I possibly can. Uh, I won't be going over surgical options cause it's not something that I am an expert in. Um, but I feel very confident that our, at our practice, we can get rid of numbness of the fingers with many, many people, uh, without having to do surgical or medicated options. And so I encourage you to go back and listen to the other owner nerve treatment, uh, options, uh, podcast, which is probably about maybe 20 episodes ago, maybe. So keep scrolling back. By the way, you should listen to all of them. They're all pretty good.

Maybe I'm just biased on this, but part two. So I'll frame this first with, uh, I think you guys. You guys should realize that, um, numbness of the hand is something that a lot of people will ignore for a long period of time. Uh, I try to tell people about this in the very beginning because, um, pain is a very good motivator, but numbness isn't always it. You have to be keen to it. You have to think about, well, is this normal? Is it going away? Um, do I have control over this? And so on. Um, numbness isn't something that tends to freak everybody out, you know, because you're used to like your feet going numb after sitting too long or something.

You get up and walk around, it goes away. And they might say, oh, it's just poor circulation. And that's so that's, I think it's okay for most people if it's intermittent, if it's kind of here and there and, you know, activity dependent, positional dependent, time of day dependent, obviously you should have it looked at. But where we get into the problems is when it becomes consistent. And so when people come in and talk to the, talk to me about their hand numbness concerns, by the way, a lot of times they will have associated elbow, sometimes neck, sometimes shoulder. It's all, that's all the same thing.

A lot of times, um, when I talk to them about it, I tell them, look, you're, you're in a unique situation because, um, you don't really have any pain. And some of you might have pain, by the way, it's, it's not, um, everybody's a little different in this, but people who have numbness don't typically have pain. It's just the numbness. And they say, oh, it's just not a big deal. And because pain is such a good motivator for someone to make a change in their life. Um, a lot of times we'll nip problems in the butt when it becomes painful, but when numbness is there, people just let it sit, which is sad because at some point it can start to deteriorate away from your ability to use your entire limb.

And so I don't mean this as a scare tactic to you guys, but I'm just trying to be realistic with it. Uh, if you look up, um, complications with things like the, like an ulnar nerve issue that goes on for a long period of time, you'll, you'll see a lot of mentions of these. I won't go into full detail of them, but, uh, it is something that's very treatable and you can get better. It's just, uh, just don't wait too long. Just, um, get some help, you know, and we can help you at our office, uh, or we can find someone for you or shoot. There's so many different ways you can get the help that you just listen to your body.

Okay. The three major points I'm going to talk about today, just because there are things that I don't think I honed in too much on the old one on the old podcast about the ulnar nerve was number one, ID the location. Number two is don't miss out on easy first aids and be okay with changing the first aids. Uh, I call this bird nesting a little bit. I'll talk about that when we get to that general, uh, or when we get to that bullet point. And number three is, uh, general physical preparedness matters. Okay. So number one, ID the location. The reason why I'm bringing this one up and emphasizing a little bit more so in this podcast, make it a first and foremost is because I have met in probably a lot of clinicians out there who have met people like this as well.

And it's not the patient's fault. Um, you guys aren't really expected to know, like, I don't know my taxes. It's just, I just pay them and have someone tell me what to do. Um, people have been through the ringer on hand interventions, um, testing of the arm of the nerves of the arm and so on, uh, into the elbow. They've been told they have an elbow problem. Sometimes they've been told they have, you know, an entrapment into the tunnel of guy on or the cubital tunnel or, you know, somewhere out into the arm. Um, and they're thinking that they're going to have some type of large scale, you know, a surgical intervention in this area, which might or might not be relevant, but dependent upon the case.

But my point is many of these people who come in, who are talking about the seriousness of doing something like this, uh, have never had their neck investigated or their shoulder. And the reason why I bring this up is because, so I wrote this large article on our website, which I will link to in, in the, in the description or the notes. And it talks about being able to identify location. Location of the nerve entrapment is, I think we can all agree, probably clinicians can agree that finding the location where the entrapment of the ulnar nerve itself or the contributing nerves to the ulnar nerve is the important part that we really need to do and address it with some type of intervention with whatever will work, whether it being, uh, a position that's comfortable, whether it being changing an activity, whether it be even injecting the area to decrease local irritation, there's whatever it, whatever, uh, location, the location matters.

Okay. Because the intervention will be based upon the location. And so a lot of times when we have people come into our office, we'll screen their neck as well as shoulder, as well as parts into the extremity, the wrist or elbow or hand. If we, if we feel like there's a, um, a part of it in there and, and there can be sometimes, but I, I would just beg you guys don't do anything drastic. If you have not had your neck examined, not even an image, just examined thoroughly stress tested, and then try a couple of weeks of some type of spinal, uh, cervical disc, uh, maybe pinch nerve, radiculopathy, or even shoulder blade stabilization type of intervention.

The reason why I'm begging you guys to do this is because that at least I find in people that come in to see me easily, easily nine out of 10 people that have hand numbness are up at the neck shoulder complex of some type kind of how I mentioned it's, you know, a cervical disc is irritated by the way. It doesn't have to be a positive image to be irritated. Um, a nerve might be pinched up there by the way. It doesn't have to have a positive image to indicate that and, or the shoulder might be partially compromised, at least as things are passing through, not as not saying you need a, uh, a surgery to the shoulder, but these areas, if you do a really nice thorough examination, uh, this should take about, you know, 10 minutes with, if there's no discussing, it'll take 10 minutes or so.

The doctor usually puts their hands on you and pushes some things around, or you could do it virtually a little bit. Uh, if the person's creative and can dictate you through, um, how to put your head, how to move your shoulder and things like that nature. Um, there, they need to gather information from that test to figure out or from those tests to figure out if it's relevant in your case. And what I find is most of the time when we do this type of exam in our office, we see that there's actually a very strong relationship of the hand numbness to the neck or shoulder complex area. Let me give you an example is we've had people come in who have numbness in the hand sometimes at night, but they don't walk in and they don't have it.

And so we'll have them look up and look to the side and kind of squish, like, kind of like you're, you're going as far as you can to the side. We call this a foraminal compression test and they hold it there for like 10, 20 seconds and then their hand gets numb. Right? So that means that we did nothing to the hand, but at least putting your head in a sustained posture or you're not going to do a sustained posture was enough to reveal that this is not just a hand problem. This is also coming from the neck somewhere and not treating it at the neck is going to result in haphazard results. And I guess I should mention too.

Yeah. Can you, can you have a double crush? Probably you probably, maybe, you know, um, I don't remember the last time I've diagnosed anyone with double crush. I know that they're out there, you know, but, uh, I, my personal belief is that you find the hot, the spot of the highest payoff first and then the area of the other area of the, of the stickiness, let's just say it starts to reduce itself too, because, uh, what we kind of think is that the nerves, the nerve swells, it nerves, the nerve swells to, um, according to Shacklock's work, uh, Michael Shacklock's work. I think it's a, I think don't quote me on this, Michael, I think it's four times the size of a normal nerve.

And so we have this nerve that's swollen because one big cell, um, it's trying to slide through tunnels, bony or soft tissue tunnels, such as the tunnel of guy on the cubital tunnel, such as the soft tissues, such as the area into the shoulder, the brachial plexus region or the scalenes. They're, they're moving through these, these normal size tunnels, but it's an abnormal size nerve and it just makes it so it's sticky everywhere. Nerves do slide. They slide up and down the arm as you move the arm. And so they move relatively based upon, you know, the structure surrounding it. So they have to slide.

We know this cause we've seen it on images, but a swollen nerve also is not sense. It's, it's kind of sensitive to, to, to, to tension. Um, and if it's kind of sticking in there a little bit, then it doesn't tend to slide it in at tensions and then we have, you know, problems with stretching into an older nerve stretch and so on. And so my point is make sure you've had your upper extremity, the entire upper extremity as well as the spine, uh, assessed in some way, shape or form. And, um, if you've heard my other, uh, audios, I've discussed that, um, knowing the entrapment site before going into a surgery is super important.

Um, you have to be able to know beyond reasonable depth, that's the area of the problem. And I suggest actually, rather than just like using an image or some type of electrodiagnostic machine, like a zappy machine, um, that does it a conduction velocity rather than doing only that, why don't you just treat, get treated as a neck or a shoulder blade first for like two, three weeks. Um, if it doesn't increase your, your numbness or anything or your hand symptoms and then see what happens. The reason why I suggest that is because, um, a lot of times it's, it's, it's very effective very quickly. We found that people, especially, um, I've had a lot of musicians come in recently.

And so it's, it's, it must be, I've never even thought of it until, you know, the, a bunch of them contact. It's like pianist and violinist and celloist and guitarist. And a lot of times these people have this thing. And so, uh, I've noticed that they say it's, you know, it's, it's worse when sitting, but not walking, you know, and, uh, they'll say it's worse when I play. So I just stopped playing completely. And so there, a lot of times they have not been assessed fully. Um, they'll just avoid the activity and I totally get it. They'll avoid, I've avoided activity too. Um, but musicians, I want you to really think, think about this.

Cause, cause I had someone do this the other day is I said, so it doesn't stand, it doesn't bother you to stand, uh, and walk, but you can, but you sit when you play and it bothers you, yes, it does. Well, how long would it hurt or how many, how long many minutes you have to be playing for it to bother you? And they'll say, well, like two and say, great. Why don't you take, pick an instrument? A lot of times musicians, um, will be able to play multiple instruments, obviously pick an instrument that you can stand or walk around with and just try that. Um, or if you have hopefully not a cello, you know, you have guitar, stand up and play a little bit, you know, put your shoulder strap on and just see what happens.

And a lot of times when people do this, they actually feel better. And it's surprising to them. It's not a longterm fix, but it should let them know that there's more than just going on than just how many times they, you know, they, they move their hand across the guitar. It also has to do with their position. So I, I plea with you, don't do anything drastic, like your releases, your, your moving nerves and stuff. And so around until someone's at least looked at your neck. Okay. Um, it's, it's, it can happen very, it can reduce very quick. We had a, we had a musician who was, um, he had a 50% reduction within about a week and a half just for doing a single spinal intervention.

Uh, we had another one who, um, he was able to, um, start playing again after about two weeks of doing two spinal interventions, uh, as well as one first, as well as one corrective exercise. And so, uh, we didn't, we didn't actually have to literally other than examine it. We didn't really have to even lay our hands on them. We just suggest something they do at home. It's very simple. And so, uh, like I said, probably over nine at nine out of 10 people, at least in the populace in the IC, they have hand numbness. It's from the shoulder and neck area period. Okay. It's super easy to address. You don't need surgery to do it.

You don't need medication. In most cases, it's just something you just have to learn how to do. And go to someone who knows how to show you how to do it. Okay. So, um, I mean, I've met people who haven't played their instrument for years because of this issue. And so I couldn't imagine, you know, I really couldn't imagine, like I play baseball and to not play the sport that I like for years because of the fear of something coming back or getting worse. It's terrible, you know? And so it's funny. I have a couple of guys on my team, they have inner elbow pain. And so I've suggested some things that they do and they, you know, they were resting it at the time.

And so I said, Oh, why don't you try this thing? Let's let me send you a video. You know, I sent him a video and, uh, lo and behold, they feel better. You know, after the course of two, three weeks, you know, they're a little hesitant, hesitant to throw hard again, which, yeah, I get it. Cause it's, you know, it's been a little bit of time and it's, it's, uh, but it can reduce very quickly. And the reason I bring up the elbow thing as well as, um, you know, their, their experience is because they, they really did believe that their elbow pain was because of their elbow. And in this case, it wasn't, um, again, there's a strong probability.

A lot of times when people have forearm and especially nerve, like nervy types of presentations, like the numbness or the prickliness or the tingly, uh, that that's, that's, that's nerve stuff, man, that that's probably not going to be like some type of ambient muscle in the forearm or wrist. And so, um, especially forearm wrist, it's like, I think the estimation is like 80% of people who just have forearm wrist pain, not even numbness is still related to neck. And so let's hammer this thing out. Let's get some easy wins. If you guys have been done it yet, you got to have your neck and shoulder looked at.

Again, you don't need an image to do so, but just find someone who knows how to stress test you. Um, we're always here to help if you want to us to work on it and, uh, get out some easy wins and start doing what you want to do again, you know? So the, the second bullet point was, um, don't miss out on some easy wins or first aid. And so I kind of alluded into that a little bit here. And so the easy wins or first aid, uh, is they're kind of, I mentioned with the guys at baseball, it's like they tried one, one little video and they're like, holy shit, that worked. Oh my God. Like, you know, now what?

Well, you don't always need a first aid after that. Sometimes you just need to, you know, do a, do a little bit of, uh, of super gluing. And so one guy, he, uh, he had some elbow pain in the, he got the elbow pain reduced after throwing quite a bit. It was still there a little bit, but then he said, oh, my shoulder hurts a little bit, you know, oh, that's been bothering me for years and so on. I don't know. Maybe this is just the way it is. Maybe I shouldn't throw anymore. And he starts kind of, you know, kind of doing that thing, which, uh, I totally get it. Like the reason why I bring up the bird's nesting, I know I've mentioned it in another podcast before is bird's nesting.

I try to explain it to the patient as like, when I go fishing, like I tried to learn bait casters recently, which is challenging. It's challenging, especially with the light lure. And so, um, you end up having all these messed up fishing line things that happen and they create a little called bird's nest in the fishing world. And so these bird's nests are not always easy to get out. You know, sometimes you're gigantic. You just start pulling line out to, you know, get to the bottom of it and so on. But if you get one out, you're like, gosh, thank God, like that's good, you know, cause you would have to reline and so on.

It's just a long process. And so sometimes when you try to get them out, you get another bird's nest. It happens. Ideally, you want to be able to get the bird's nest out once and it just, and it just goes away and you're good, but that doesn't always happen. The more complex, the longer that line's been on there, probably the longer, the more complicated bird's nest you're going to have. And so the same thing happens with people who have had, um, numbness or tingling in the fingers, like the ulnar nerve stuff, like, like you guys are probably been Googling even elbow stuff, shoulder blade, neck.

You're going to have other things that happen to, uh, kind of like how I mentioned with, uh, like the baseball guy, he has a little shoulder thing. Normal. It's normal. That's a second bird's nest. It's not a big deal. All we have to do is address this now as that bird's nest needs to be addressed. Sometimes the first aids and easy wins and the things that you get given to you as a quote unquote remedy, uh, change. And so there's a lot of times where I've given people one first aid type of intervention, like a take home activity one week. And then I take, I get rid of it the next week and give them something else to address something else.

It's completely different. And so it's interesting to see the mindset of people sometimes when they go through this and I, and I, and I totally get it. Cause I've done birds. I've had bird's nest. You, when you, when it's getting out, when it's feeling better and that bird's nest is going away, you're like, ah, yes, it's so good. Yes. I'm love. I got another one. I think I'm just going to cut this line. And then you try a little bit and you're like, oh, this one's coming out to it. Here's another one. I'm going to cut this line. You know, every time you hit that major hiccup, it's like, okay, I don't know if this was working.

And so the same thing happens with people with numbness sometimes is it gets out of the hand. It's not numb in the hand anymore, but then all of a sudden they got elbow pain or the elbow pain goes away. Now they have shoulder blade pain and sometimes the neck or, or sometimes their mid back starts to hurt or their lower back. And like, I don't know. I don't, I don't know. This isn't the right, you know, if something feels wrong, things keep happening. It's okay. It's totally okay. You know, bird's nest do happen. Let's just, let's just get rid of it. And so the longer you've had something, the more susceptible you are to having these birds just in my opinion, not to say that you're broken or anything or that anything needs to be fixed.

It's just that there are other humps that will happen. It happens. So we're, make sure you're working with someone who can help you overcome these birds nest. We're able to do that again, virtually or in person. It's pretty simple. As long as you just do what we tell you to do, you know, to be honest with you and communicate with what, what's, with what's working and what you're feeling. A lot of times the bird's nest, um, funny, I've, I've seen that sometimes a second bird's happens, but the person doesn't mention it. And so they just say, Oh, the hand's better. Cool. Yeah, I'm better. And so, okay, it's great.

So you're going to go play baseball again? No, I don't know. The shoulder, it's kind of like a bum shoulder. You know, when that start a couple of weeks ago, you know, it, it got worse a couple of weeks ago, but then it's always been kind of bad, you know? And so I encourage you to, to communicate with whoever you're working with about those birds nests. It might not change what they're doing at the moment, but it's important information for them to have, because this is, we're building a case. We're building a puzzle. We're trying to solve a puzzle. And it's like, it's kind of reminds me of the movie, like the, like the, uh, Inception.

Sometimes the puzzle changes, you know, in a lot of times when working with people, the puzzle does change slightly. And so we have to dodge and weave a little bit. And so I know that when I'm working with people and Dawne Costantino is too, you'll probably notice that we're asking questions. We're asking, well, what do you mean by that? You know, like what, what does that feel like? When does that bother you? When does that shoulder blade bother you? I know, doc, I know, I know that, I know that you're interested in that. I'm not here for that. I'm here for my hand. I know, I know. I hear you. I hear you, but that's also associated.

It's a bird's nest too. So let me just, just, just let me know what you're experiencing. And so just work with the person on that. Make sure that you're communicating, or if you don't understand why they're asking the questions, you communicate that too. There's nothing wrong with that, but you should be on the same page. So I usually ask those questions because they're associated. Um, and they need to be addressed too. And there's a lot of times what we do for the first bird's nest is not what we do for the second, vice versa. And, um, it's still simple to get rid of. It's just takes a little bit of work on your part is all.

Now, the third part is general physical preparedness matters. And, uh, I like to be honest with people about this and it's not something I address usually on day one, but it's something that I will talk about as, as time goes on. Uh, and they're starting to feel better and they want to know what's next. And, you know, should I be doing this and this to keep it to go, go away? Should I be getting ice to ice every day? No, just, you know, you should just be generally physically, physically prepared. Well, what does that mean? Well, um, the body works as one unit. It's a one, one big machine, you know, um, movement is medicine.

I know that you probably have heard that a lot from people like me and it's the honest to God truth. And, uh, I, to be honest with people or to be honest with you guys, many of the people that I see that have this issue, they're a lot of them are sedentary people. I'm not saying they're overweight. I'm saying they're sedentary or they've currently changed their physical activity, um, to become more sedentary or they might have spiked in a different way. Like all of a sudden they started doing more overhead lifts or whatever they decided to do. They've changed something. And so sedentary is at least at the, I guess, let's just say the, I don't want to say the lowest form of general physical preparedness, but sedentary doesn't mean there's anything wrong with you.

There's nothing physically wrong. It's just deconditioned. And so we can change that just by having you do some general exercise, um, nothing even fancy, just stuff that is high reward, low risk exercise with or without weights to get it. So your body starts to kind of self lubricate again, if you will, and it self supports, it makes it to the body becomes resilient. And that way that when you're doing mundane stuff, such as like all of a sudden you're sitting a little bit more now, it doesn't bring your elbow or hand problem back. Now, the other people in this, which is again, they're physically active, but they've changed something recently.

Those are ones that we might have to tinker with a little bit more and they might say there, oh yeah, well, I'm generally, I'm physically prepared. Look at me. I have pecs. I have, you know, I have biceps and I have, um, you know, I, I, I, I, I wear yoga pants whenever, whenever they say it doesn't necessarily like, so there's general physical, physical preparedness, but also too, there's, there's generally well-rounded or non asymmetrical. Everyone's going to be a little, a little bit asymmetrical, but, um, I think our, our training or physical activity, our exercise, our weight training should be in an effort to create a situation that is a quote unquote, our optimal situation for us.

Our sedentary people, they might just be generally deconditioned. You can literally almost have them do anything and they'll be become more generally physical prepared than they were prior. Now, other people, sometimes they're really good at compensating. And these are the people who are probably really physically fit, but they continue to have these problems too, is because their body has become really good at compensating and it's put down layers of adaptation. That might be in the form of soft tissue, muscle, tendon, bone, whatever it might be, cartilage, um, whatever. Um, your body spent a lot of time creating the situation.

And now that, so this is an adaptation that's happened over time, a couple of years, 10 years, whatever we don't know, or I don't know. Um, but the training that you have now should be based upon the reverse adaptation you're trying to make or the adaptation that would be optimal for your situation. Sedentary, again, you can almost do anything, you know, reasonably speaking, don't spike their activity too much. Like, I don't think you should go out and do like, you know, barbell squats, you know, to a hundred today when you haven't done anything in a while, just, just start with sitting up and down in a chair, get up and down from a chair 25 times a day, you know, easy, easy stuff.

And then start to scale it appropriately. The other people, they would probably, we'd have to look at, to see what their program is. And then we'd have to plug in the holes of their program and just allow the body to adapt over time. Now, does this mean that they're still going to be numb during this period? No, they won't be, um, reducing numbness or pain in the hand or the elbow or in the arm, neck pain, shoulder pain, whatever's associated with this, probably this ulnar quote unquote problem that you have, um, should be reduced by the means of identifying the location and using the easy first aid to step one and two I talked about earlier.

Number three is when people are 80% better or more, and then we can start loading their body in a favorable way to make it so that they can, um, basically make it. So this is a return. Now, can we actually confirm that this will make it so things won't return? No. Um, I, in my personal opinion, things will come back a little bit. It's normal. It doesn't mean it'll be the same intensity and duration. You won't have it for 10 years, you know, at the same intensity. Uh, but it might come back a little bit. We, we kind of know from, um, uh, looking at some of the research that, uh, past injury or past problem is, is a good indicator of future problem in the same area or the same on the same thread.

And so expect it, but if you know the right first aids and easy ones to do, you can get rid of it much quicker and then you can just get back into, to loading or, or the general physical preparedness aspect. So in this regard, I mean, like when I see people who haven't been doing much and they're generally sedentary, um, I, I don't want them to think that I'm asking them to be, you know, get a raging six pack. I'm just asking them to do something. Um, you know, I have a friend who he was talking about his, um, he was talking about his girlfriend and he's like, Oh, she, like she, she, uh, she hurts after work and during work, you know, what should she do?

What treatment should you do? Uh, you know, do you guys do any physical activity at all? Like this, does she, no, does she work out? No. Does she swim? No. Does she walk? I mean, yeah. Back and forth to the car and maybe you guys just go on a walk, you know, walk every night whenever you feel to walk on a lunch break, this just kind of greases the body up, you know, and it builds resiliency. Like walking, I've suggested some people walk. I know that they, not everyone likes the suggestion because it seems too easy. It is easy. It's simple. Do it. Um, like we, we know that with, um, deep vein thrombosis, like the, the blood clots in the leg, we have people in airplanes move their feet and that's to stimulate the pumping response that happens when you walk.

That's why people who are bedridden for a long period of time sometimes are in danger of having that too. Walking moves fluid and so stagnant fluid creates problems. Uh, it also too helps build support within the, uh, the core area a little bit. It makes the shoulders move. It also greases those joints up real nicely. It'll also make it to the, the mid back is slightly extended as well as the neck will produce, um, a different position than it will when you're seated. And so it's an easy way to drive movement gently into the areas of the body that we would do in rehab anyways. And so, I mean, if you want the easiest rehab you can possibly do for many different problems is if it doesn't hurt to walk, go walk unless you walk too much and then go sit more.

And that just complicates the issue a little bit, but, um, make things simple. Okay. We talked about identifying the location. We talked about not missing out on the easy wins and we talked about being generally physically prepared. Uh, I don't need you guys to do anything extreme. A lot of times when you come see us, uh, in our office for ulnar nerve issues. Um, and again, if you wanted to go into full detail, much more detail of entrapment sites and other considerations with it, you should be listening to the podcast that I did prior. Uh, and, and I, again, I, it's, it's intended to be done.

Listen to that one prior in case it seems like I'm missing things on this one. It's because I am. So, um, if you're struggling with this, reach out to us. Uh, we are open to helping people virtually or in person. Uh, it's not complicated to address these even virtually. Um, I know it, it's, there are some people who are not able to come in. That's okay. Um, however, we are, uh, we do inform people that doing things virtually doesn't substitute for doing a full physical exam. What I really like most people to do, quite honestly, is if they feel like they really can't make it in, just try to come once.

If you come once, I can do a baseline exam or Dawne Costantino can do a baseline exam to do all the neurological orthopedic testing, stress testing. And we get a good idea of what, what, where you're at right now. And so we can do some of those tests via virtual as well as, or your healthcare provider can too. And so there's good information we can still get on virtual, but it's, it's, it's incomplete compared to what we could get if we were in person. It doesn't mean we can't start people out on care that way. It's just, it's, it's just ideally if we were to get all of our ducks in a row in the beginning, that'd be perfect.

That way we can just, um, there, there won't be any, any yeah, buts at least in our mind as we're directing people into, uh, what to do. Um, so yeah, I hope it's helpful to everybody. Um, by the way, if you are working with someone for your issues, for your own nerve, I suggest you give every provider of any type, at least two, three weeks to prove that they're doing the right thing or not. Okay. I think I personally think every intervention, uh, usually about two, three weeks is enough to tell if something's going right or wrong, or at least not working at all. Um, obviously there's other interventions could take longer.

I know a lot of the functional medicine, nutritional based interventions could take longer. And so I might be sticking my neck out in that regard, but in the musculoskeletal world that is, that is, is purely a little bit more mechanical based and, and, and it triggers with certain movements and so on. It's not a consistent thing. A lot of times, uh, two, three weeks is fair enough to, to, to see that we can make a change. If you've had consistent numbness, this is going to take longer. It's going to take longer. Um, and hopefully you're not to that point already, but make sure that, that when you talk to your healthcare provider about that, when you're having consistent numbness or a consistent tingling that, um, they give you a rough timeline.

It takes a little bit of time for the nerve to regenerate itself back. And so, um, unfortunately that is the case. And, uh, I try to be honest with people about that when they, or I am honest with people about that when they come in. Uh, luckily I've, I get much more people, uh, many more people who are, uh, intermittent based and, uh, maybe it's just me asking the universe to send people who are in that condition because I can help them a lot better. Um, or maybe it's just haphazardness. I don't know. Either way, we'd love to help you all go to p2sportscare.com, which is in the link description.

Uh, you can check us out there and any types of, uh, tools and services that we have. Uh, also, if you are out of the area and, and we can't help you and you want to see someone local to you, we might just know somebody there. So, um, reach out to us anyways, make us your first contact. We'd love to help you out in any way that we can. Um, just go into the link in the description, by the way, if you're a healthcare provider and you've been listening to this, hopefully you resonate with everything that, that I've said, and you can share this with some of your clients and, uh, share them with, with your fan base and, and people that know your tribe and people who, who on your Instagram and Facebook and so on and so on.

So, uh, thanks for being part of the movement, everybody. Uh, again, if this is something that you think someone else would enjoy, please go down to subscribe. And I would love if you guys reviewed the show. It's the only way that I know if I'm, if I'm doing anything good in this world is if you guys review the show or else I'm just talking alone into a mic. I should just have more interviews, more interviews, love the interviews because I get to learn a little bit more. So cool. Uh, enjoy guys. And thanks for being part of the movement.