19 Insanely Effective Treatments for the Ulnar Nerve so you can Sleep Longer

  • Do you have numbness, tingling or burning down into your ring and pinky finger?
  • Does it feel like ants are crawling on your arm?
  • Is it worse at night or while sitting?

If so, you are not alone. These are symptoms of a possible ulnar nerve entrapment (amongst other possible diagnosis), which is often correctable through some of the methods I will go over in this book.

If you need to speak with someone regarding your issue, visit to our Support Center.

Ulnar nerve stretches, Active Release, manual treatments, rehab and flossing are all ways we can decrease symptoms… but let’s not overlook correcting the mechanism of injury (why it becomes compressed in the first place). Some of the chapters focus on correction of movements, posture, positioning and more to decrease ulnar compression.

I’m Dr. Sebastian Gonzales and I spent 10 hours of my life writing this guide so you can learn how to feel better.

Sebastian Gonzales DC

If you are searching for some great and effective suggestions on how to exercise/stretch the ulnar nerve, then you are definitely in the right place!

For more free videos/content/ stretches about ulnar nerve therapy, visit my Youtube and iTune Podcast. 

Before we get started, though, you should know that the ulnar nerve can become entrapped for a variety of different reasons, and the entrapment can be located in a number of different areas!

Knowing your injury will help you to better identify the specific exercises, treatments and stretches that will work best for you!

Through the following links, you can learn about some of the possible reasons/ locations for ulnar nerve compression.

As I was researching this topic through all my typical avenues that publish current medical studies (i.e. Pubmed, Medscape, Google Scholar, etc.), I was unable to find much information.

Surprising, right? Especially since numbness in the ring and pinky finger is actually very common. With that being said, in this article, I am going to cover the best CONCEPTUAL styles of ulnar nerve stretching, exercise, and correction.

I say “conceptual” because I’ve used many of these techniques, however to date, there’s has not been research to validate all of them… see what works for you!

Keep in mind, the location of the nerve compression dictates the correction used.

I won’t be doing over comprehensive examination and tests in this article… unless I add an addendum. In that case, you’ll see it in the table of contents!

Each exercises will have a “READ MORE” area included if you are interested in why we use it and why it is helpful.

DISCLAIMER: See a doctor if you have numbness or tingling of the hand.

Chapter 1: Ulnar Nerve Gliding Exercise

Learn a nerve flossing exercise for the ulnar nerve it’s compressed in the brachial plexus region.

Chapter 2: Activation of Deep Neck Flexors

Learn how to activate the deep muscles of the neck to decrease compression of the ulnar nerve within the neck region.

Chapter 3: Cervical Spine Mobilization or Adjustment

Learn the science of how mobilization/ an adjustment of the neck can decrease symptoms into the hand.

Chapter 4: Mobilize the Midback

Learn how to mobilize the midback and why it can relieve symptoms of numbness into the ring & pinky.

Chapter 5: Myofascial Release of the Upper Trap, Scalenes & Levator Muscles

You’ll see some self-myofascial release methods to do before bed so you don’t wake you with a numb pinky.

Chapter 6: Facilitate the other Shoulder Blade muscles & Levator Muscles

You’ll learn how to move the shoulder blade better and why it can assist in decompressing the ulnar nerve.

Chapter 7: Blow up a Balloon

Sounds RIDICULOUS right? Learn the science of how blowing up a balloon for 5 mins a day can decrease ulnar nerve compression.

Chapter 8: Learn to Sit

We all know it’s important, but did you know improving your sitting posture can even affect the ulnar nerve…

Chapter 9: Adjust your Sleep

Sleeping with numbness in the pinky is extremely frustrating. Learn how to make small adjustments like variables in a science experiment.

Chapter 10: Myofascial Release of the Elbow

The ulnar nerve can be compressed into the medial, posterior elbow at the Cubital Tunnel, these self-myofascial release can assist…

Chapter 11: Taping the Elbow

Elbow clicking go hand-in-hand with pinky finger numbness? It could be the nerve is “loose” within the Cubital Tunnel… let’s tape it!

Chapter 12: “Tab Taping” the Elbow

This is another type of taping that can assist in decreasing “flicking” of the ulnar nerve within the elbow region.

Chapter 13: Self-Massage of the “Inner Triceps”

I say “inner tricep” loosely. The intermuscular region between the tricep and the bicep (inner side) can be a region for nerves and vessels to be “pinched.” (See a doc for this one for sure)

Chapter 14: “Tab Tape” the Tunnel of Guyon (Wrist)

Heard of Handbar Palsy? The ulnar nerve can be compressed in the neck/ shoulder area, the elbow, and the wrist/hand, this taping technique assists in keeping the wrist clear.

Chapter 15: Stretching the Forearm

Self-myofascial release of the muscle of the forearm can greatly improve symptoms of an ulnar nerve issue if located at the elbow or wrist.

Chapter 16: Stretching of the Hand Muscles

“Ttight” muscles of the hand can increase the possibility of an ulnar nerve entrapment at the wrist. Here’s some stretches I like…

Chapter 17: Play in the Sand or Rice

Playing the sand can be an extremly benefitial therapy exercise for an ulnar nerve issue in the elbow and/ or hand.

Chapter 18: Start using the Monkey Bars

Say what??!! Yep, go have some fun. Using the monkey bars will assist in building strength within the core, upper back, shoulder, elbow and hand all at the same time… decreasing many reasons for ulnar nerve compression.

Chapter 19: Start Resistance Training

Weight training can assist in building the body as a whole, reducing symptoms of an ulnar nerve compression. I know sounds scary to some of you, but read on for all of the reasons…

Chapter 20: Steps to Treatment of an Ulnar Nerve Compression

Learn about the theory of how to comprehensively rehab and treat the symptoms of an ulnar nerve compression. HINT: This is the most important part for you to read.

CHAPTER 1: ULNAR NERVE GLIDING EXERCISE

Here’s how we do it:

  1. Extend the arm out to the side with the palm face down
  2. Tilt the head as far as possible toward the extended arm
  3. Keeping the shoulder elevated, attempt to place the entire palm of the hand on the head (cupping the ear)
  4. Take a deep breath (a full inhale and a full exhale)

Repeat this 10 times

This style of ulnar nerve gliding will only assist the nerve in gliding in one direction. Going in the other direction is very easy to mess up, and because of that, I have stopped suggesting it.

There are a lot of sources out there on how to glide the nerve in the other direction, but consider this before you consider trying them out: nerves do not like to be stretched, but they do like gliding.

The goal of this form of gliding is to limit the amount of stretch happening on the nerve in both directions at the same time. If we limit this, then we limit the potential for something to go wrong!

Ulnar Nerve Gliding Exercise
Ulnar Nerve Gliding Exercise
Ulnar Nerve Gliding Exercise

Important section (click links to read immediately):

Here’s a great video on the course of the ulnar nerve. Watch this whole video and you’ll better understand the reason why we are attacking the ulnar nerve at different locations in the neck, shoulder, elbow, forearm and hand.

If there’s loss of sensation in ring and pinky finger, the ulnar nerve is being crushed somewhere along it’s course.

CHAPTER 2: ACTIVATION OF DEEP NECK FLEXORS

Here’s how we activate the deep neck flexors:

  1. Start out lying on your back, with your legs in the 90-90-90 position
  2. Take a deep breath in, and then fully exhale to relax
  3. Imagine there is an empty can of Coke placed on its side, right under your neck (just under the base of the skull)
  4. Using the back of the neck, press down against imaginary can of Coke to try and crush it between the floor and the neck

If the ulnar nerve is being compressed from the neck, then activation of the deep neck flexor muscles, such as the longus capitus and the longus coli, can help to alleviate some of the symptoms associated with this kind of compression in a few different ways.

First, it promotes proper stacking of the spine (vertebra, discs, and openings all line up properly).

Second, it decreases the tension of some muscles that can crush the ulnar nerve.

And third, it opens the facet joints of the spine, which in turn, can decrease facet pain and other conditions where the nerve roots become compressed while exiting the spine through the neural foramen. (Jull, J of Musculoskeletal Pain 2000)

Activation of the Deep Neck Flexors of the Neck
Activation of the Deep Neck Flexors of the Neck
Activation of the Deep Neck Flexors of the Neck
Activation of the Deep Neck Flexors of the Neck

References:

Jull G. Deep cervical flexor muscle dysfunction in whiplash. Journal of Musculoskeletal Pain 2000;8(1/2).

CHAPTER 3: CERVICAL SPINE MOBILIZATION OR ADJUSTMENT

Important section (click links to read immediately):

I actually didn’t really want to suggest cervical adjustment in this article, believe it or not. I am a chiropractor by degree, and the reason I did not want to include this is because, often times, chiropractors can get pigeonholed as only neck docs.

However, through my research on how to fully activate the deep neck flexors, I came across an article that discusses the benefits of cervical manipulation in relation to the deep neck flexors, so I decided to include it.

If the idea of a neck adjustment scares you, I definitely suggest taking a look at the research! (Jull, Manual Therapy 2001). I don’t plan on going into sigmas of adjustments in this article. That’s an article in it’s own right.

The cervical adjustment has can assist in treatment of people with a degenerative cervical radiculopathy, which you all should read as “hand numbness.” (Zhu, Clinical Rehab 2015)

In my opinion, manual therapy for mobilization of the neck and midback are a must.

There are many ways to skin a cat… if your hand numbness is coming from the neck we need an experienced sports injury provider to get the nerve “unpinched.”

Important section (click links to read immediately):

CHAPTER 4: MOBILIZE THE MIDBACK

Having some issues activating those deep neck flexors?

Try mobilizing the mid-back, or you might even consider shelling out a little bit of cash to see your local chiropractor.

Stiffness in the mid-back, especially the upper-back, can make it darn near impossible to achieve functionality of the deep neck flexors and other muscle groups.

Here’s how we can do this on our own:

  1. Grab a foam roller and place it perpendicularly (to how you will lay your body) on the ground
  2. Lie down onto the foam roller and use it as a fulcrum to roll your body on top of the roller.
  3. Spend about 1 minute on each region that requires mobilization
Mobilization of the Midback
Mobilization of the Midback
Mobilization of the Midback

Increased forward curvature of the mid-back can often be linked to people with lifestyles that are heavily involved with certain technologies and/or social media scrolling (i.e. very sedentary lifestyles that involves a lot of screen watching and sitting).

Forward rounding for a prolonged period of time, even just a few weeks in this case, can lead to compensatory curving of the neck and low-back.

Increased curvature of the neck, specifically, can lead to headaches, tightness, pain, and wouldn’t you know it?: numbness in the arms/hands! I bet you thought we were getting off-topic didn’t you? (Kolar, 2007)

References:
Kolar P. Facilitation of Agonist-Antagonist Co-activation by Reflex Stimulation Methods. In: Liebenson C. Rehabilitation of the Spine, 2nd Edition. Baltimore: Lippincott/Williams and Wilkins, 2007.

CHAPTER 5: MYOFASCIAL RELEASE OF THE UPPER TRAP, SCALENES, & LEVATOR MUSCLES

Important section (click links to read immediately):

Myofascial release of the upper trapezius, the levator scapulae, and the scalenes can assist in decreasing muscle tone, or as many patients refer to it “tightness.”

Each of these muscle groups can have either a direct or an indirect way of increasing numbness of the 4th-5th digits.

The upper trapezius and the levator scapulae muscles have more of an indirect way of creating ulnar nerve compression. The theory is, since these muscles attach the spine to the shoulder blade, they can actually have an affect on shoulder function.

MYOFASCIAL RELEASE OF THE UPPER TRAP, SCALENES, LEVATOR MUSCLES
MYOFASCIAL RELEASE OF THE UPPER TRAP, SCALENES, LEVATOR MUSCLES
MYOFASCIAL RELEASE OF THE UPPER TRAP, SCALENES, LEVATOR MUSCLES

A shoulder with that does not function well, that experiences pain, and/or has impingement or malposition, can begin a pattern of compensatory shoulder motion. This compensation can then lead to dominant activity in the “shoulder/neck” region.

There are some who have theorized that the levator scapulae can even “lay on” the scalene group and increase the scalene tone.

Ulnar nerve compression brachial plexus

So, why are the scalenes important?

The scalene muscles are actually a group of 3 muscles that attach from the neck (cervical spine) to the ribs. The brachial plexus (nerves around the neck) actually pass through these small muscles and can become compressed when the tone of those muscles increases or if the slide between them decreases.

Hopefully this has given you a pretty clear picture as to how the scalene muscles are able to create a direct compression on the ulnar nerve via the brachial plexus.

The following “flip book” style presentation is one way to lightly pressure the scalenes, in an effort to release the brachial plexus. In our facility, I personally treat all muscles of the neck. I don’t allow the patient to do it on their own because there are many veins, arteries and nerves in this location.

With that being said, I do use this self-treatment style on myself when I have arm numbness waking me up… but I also have been trained in anatomy. Use extreme caution. It normally takes me 2 minutes a few times a week and I see great improvement.

MYOFASCIAL RELEASE OF THE UPPER TRAP, SCALENES, LEVATOR MUSCLES
MYOFASCIAL RELEASE OF THE UPPER TRAP, SCALENES, LEVATOR MUSCLES
MYOFASCIAL RELEASE OF THE UPPER TRAP, SCALENES, LEVATOR MUSCLES

This next “flip book” is how we self-treat the upper trapezius and levator scapula around the base of the neck. These muscles attach the shoulder blade to the neck and when “tight” and shortened they can affect the brachial plexus as they exit the neck region.

Spending a few minutes on a lacrosse ball or baseball can help.

While laying on your back, place the ball as far up the shoulder as you can while still keeping pressure… if you go too far the ball will slip out. Note, the hip drive toward the sky… without lifting the hips, you will not feel a thing.

MYOFASCIAL RELEASE OF THE UPPER TRAP, SCALENES, LEVATOR MUSCLES
MYOFASCIAL RELEASE OF THE UPPER TRAP, SCALENES, LEVATOR MUSCLES
MYOFASCIAL RELEASE OF THE UPPER TRAP, SCALENES, LEVATOR MUSCLES
CHAPTER 6: FACILITATE THE OTHER SHOULDER BLADE MUSCLES

As discussed in the previous section, some muscles of the shoulder girdle and the neck can begin to feel tighter (increased muscle tone). However, the increased muscle tone will almost never occur without some related function being inhibited within the group of scapular positioner muscles.

Often times, the lower and middle trapezius, as well as the serratus anterior need to “woken up.” They likely become “turned off” when other muscles dominate the motion of the shoulder blade.

A great way, I found, to be able to contract those muscles in unison is to perform some of our floor “core” exercise series. If these exercises are unsuccessful in improving the way that the ulnar nerve compression feels in any specific case, we often find that the exercises are not being performed correctly.

External cues that are given by a sports injury provider to a patient/athlete are often necessary in order for you to be able to remember how to perform them on your own.

Learning to apply these cues on your own is not a one-shot deal… It’s a process! Similar to playing a guitar: you have to learn to play cards before you can carry a tune.

Right now, all of this might be starting to sound pretty complicated, but don’t stress out! To help make the process easier, I have provided my favorite exercise for ulnar nerve compression and facilitation of the shoulder girdle below!

What is this wonderful exercise? It’s called the birddog.

Here’s how it is done:

  • Starting on your hands and knees, position yourself with the shoulders directly over your hands and your hips directly over your knees
  • Find a neutral position for your low back
  • Arch the back up, then arch it down, and then find the halfway point between those two extremes
  • Exhale deeply to compact the trunk
  • Make a double chin to pack the neck
  • Pack the shoulders by pressing the ground away from you through your hands
  • The movement will begin with the arms
    • Reach one arm out straight ahead (parallel to the ground, just like superman) and make a tight, angry, Hulk-like fist while contracting the entire shoulder/upper back
FACILITATE THE OTHER SHOULDER BLADE MUSCLES
FACILITATE THE OTHER SHOULDER BLADE MUSCLES
  • Hold the position for a few seconds and then alternate to the other arm
    • All parts of the low back, mid back, and neck should remain still throughout each repetition.
      • A cue that we often use: imagine a hot cup of coffee on your back. Your movement should be stable enough for the coffee not to spill on you!
  • Now we incorporate the legs: from the starting position, remove one knee from underneath you by driving the heel straight back to make yourself as long as possible.
    • The leg should run straight out, parallel to the ground, and directly in line with the torso. There should be changes in the spine, no rotation of the hips, and the pelvis should be facing directly down at the ground at all times.
FACILITATE THE OTHER SHOULDER BLADE MUSCLES
FACILITATE THE OTHER SHOULDER BLADE MUSCLES
  • Every rep should now incorporate one arm and one leg from opposite sides (i.e. the right arm will raise up as the left leg goes up), and the body should remain in its proper position the entire time.
  • Hold both limbs up at the top for 10 seconds before gently back down to the starting position and then switching arm and leg.
FACILITATE THE OTHER SHOULDER BLADE MUSCLES
FACILITATE THE OTHER SHOULDER BLADE MUSCLES
CHAPTER 7: BLOW UP A BALLOON

Just as we mentioned in the scalene section, the scalene muscles can often crush down on the nerves of the brachial plexus, which can then lead to direct compression.

Some of you might be wondering why these muscles become so tight in the first place! Well, figuring that out requires a little bit of thought in regards to what they attach to. The scalenes attach from the cervical spine and run to the rib cage. These muscles can be used as breathing muscles, especially in “chest breathers.” Small muscles like the scalenes are not designed to take on such a tedious and demanding job like breathing, and for that reason, they tend to become “overworked.”

Believe it or not, there are correct ways to breathe. Even better, there are great methods for learning how to breathe properly. Learning to breathe properly is as simple as blowing up a balloon, literally!

Blow up a Balloon Breathing

Spending 5 minutes a day blowing up a balloon with deep forceful exhales is one of the easiest ways to learn.

Try blowing it up with as few breaths as possible.

I know, I know. This probably seems like a fairly ridiculous suggestion. BUT, this simple technique is training you to use the deep core muscles, the diaphragm, and the pelvic floor in your breathing. I promise, this method of breathing is much better for you.

5 minutes of this balloon breathing right after 5 minutes of midback mobilization could, quite truthfully, change your life.

Blow up a Balloon Breathing
Blow up a Balloon Breathing

Important section (click links to read immediately):

CHAPTER 8: LEARN TO SIT

Learning how to sit properly is another simple way that you could change your life. Sitting properly allows the spine to form normal curves all the way up to the neck, and this will improve ulnar nerve compression.

An easy way to learn proper sitting is by perching and breathing. Aside from sitting in a car, this can be done in almost any setting: working, watching TV, eating dinner, etc.

How to Sit Properly

Here’s how to practice

  1. Sit down, with the butt at the edge of the chair or bench
  2. Widen the stance of the feet, so that the thighs are further away from each other and not touching (Think the opposite of the saying, “sit like a lady”)
  3. Hinge the body from the pelvis, so that the chest is over your hips
  4. Activate the deep flexor muscles (use the methods described earlier)
  5. Keep the spine long, as if a string attached to the top of your head was pulling you straight up to the sky.
How to Sit Properly
Did you notice that deep breathing is a major step here? Better get out to the store and buy that balloon! This breathing is crucial in improving core function.
How to Sit Properly
How to Sit Properly

Important section (click links to read immediately):

CHAPTER 9: ADJUST YOUR SLEEP

I can’t even begin to count the amount of times that I have been woken up to numbness in my right hand. This only ever happens to me when I sleep with my arm over my head.

How do I know?

Because as soon as I wake up and bring my arm down to my side, the numbness goes away and everything returns to normal within minutes.

Adjusting Sleeping Position

I have no idea how long my hand was actually over my head before I woke up and felt the numbness, but what I can tell you is that my ulnar nerve entrapment is definitely increased in this position.

My first suggestion is to figure out what triggers your compression during sleep, and to stop sleeping that specific way. This is a chance to form new habits!

This simple change can also help entrapments in the elbow, the arm, and the wrist, not just the spine and shoulder.

Adjusting Sleeping Position
Adjusting Sleeping Position
CHAPTER 10: MYOFASCIAL RELEASE OF THE ELBOW

For the following suggestions, let’s assume that the ulnar nerve is compressed below the shoulder and above the wrist.

Myofascial release of the muscles, tendons, and fascia surrounding the elbow, can greatly improve an ulnar nerve compression in the elbow. It’s not uncommon for some of the local soft-tissue to become inflamed. This can happen for a variety of reasons, but whatever the reason, the ulnar nerve typically gets caught up in the mess.

Some locations that I like for myofascial treatments are:

  • The wrist flexors (the common flexor group and the flexor carpi ulnaris)
  • The triceps (using a barbell)
  • The pronator teres

Let’s start with the wrist flexors.

Look through this like a flip book and you should get the idea.

Myofascial Release of the Elbow
Myofascial Release of the Elbow
Myofascial Release of the Elbow

Now the pronator teres.

Look through this like a flip book and you should get the idea. This muscle runs more in a diagonal from the inner elbow.

Myofascial Release of the Elbow
Myofascial Release of the Elbow

Now on to the flexor carpi ulnaris.

Look through this like a flip book and you should get the idea. It is located on the “side” of the forearm, hence the fist placement.

Myofascial Release of the Elbow
Myofascial Release of the Elbow

Now on to the triceps.

Look through this like a flip book and you should get the idea.

Myofascial Release of the Elbow
Myofascial Release of the Elbow
Myofascial Release of the Elbow

Important section (click links to read immediately):

CHAPTER 11: TAPING THE ELBOW
Stretchy tapes, such as Rock Tape, Kinesiotape, KT tape, Spider Tape, and so many others, can be used to stretch the fascia around the cubital tunnel. While I was unable to find any studies that help to substantiate my claim that this is useful, I will say that throughout my career, I have found this to be an easy and effective way to emphasize movement of the ulnar nerve above and below the tunnel.
cubital tunnel ulnar nerve

Think of the nerve as a single piece of fishing line. If the line gets stuck in one place on the reel/pole, then the glide is reduced throughout the entire line. This is the idea of a “double crush syndrome,” where the nerve can become trapped in more than one location.

Applying stretch tape to an elbow in extension and using 50% stretch, will create a “tugging” sensation when it is left on for more than one day. If the skin does not become irritated, I have even left tape on for up to 4 days.

Some patients feel better with the tape, and then there are others that do not. Worst case scenario, the tape is easily removed and it barely costs anything. There is low risk and the potential for great reward with taping.

My normal recommendation for how to tape this condition is to surround the path of the ulnar nerve with a criss-cross pattern. I don’t split the ends or cut them up into a bunch of pieces. I mainly focus on cleaning up the ends so that the tape will last more than a day.

Be aware that there are some tapes that are heat-activated and will therefore need a lot of rubbing over the surface of the tape in order to activate the adhesive.

If you have more questions about specific brands of tape, please visit their respective websites for more information.

Important section (click links to read immediately):

CHAPTER 12: “TAB TAPING” THE ELBOW
Tab taping is a style of taping that I use when attempting to change the position of a structure that has become out of place. In the case of ulnar nerve entrapment, the ulnar nerve could be subluxing out of the cubital tunnel (the inner side).
cubital tunnel ulnar nerve
Tab Taping Elbow

Here are the steps that I like to take:

  • Clean the skin before placing a layer of cover roll
  • Form a tab of leukotape and then add it directly medial to the “funny bone”
  • You can feel the groove located here is you focus on finding it
  • Have the patient bend their elbow until they feel pain or symptoms of discomfort in the hand
  • Pull the tab in both the medial and lateral direction to see if one of those decreases the symptoms
  • Pulling laterally, or outwardly, will probably have the better effect
  • Fix the tape down in the direction of symptoms relief and comfort.

Tab taping cannot be done with anything other than Leukotape and cover roll. Any other kind of tape will not have the right effect.

CHAPTER 13: SELF-MASSAGE OF THE “INNER TRICEPS”
The bundle of nerves passes right on the inner part of the arm between the biceps and the triceps, just before it passes the elbow. This area can feel “tight” while bringing the arm over the head and while extending the elbow. This tightness is something that I have personally experienced, and I can personally attest that this tactic actually works for relief!
Self-Massage of the “Inner Tricep”
Self-Massage of the “Inner Tricep”
Self-Massage of the “Inner Tricep”

Being light, but still firm, the areas in front and behind the nerve should be massaged with the bar to try and free-up from any restrictions of slide. This doesn’t even need to be super specific!

Think of this as constantly freeing the bristles of a paint brush as it dries. Lightly freeing-up the motion of these areas over time, can assist in ulnar nerve glide, especially if this movement is part of the issue.

CHAPTER 14: “TAB TAPE” THE TUNNEL OF GUYON (WRIST)

This is going to be very similar to the elbow.

So, instead of boring you with the whole process, I’ll spare my fingers and your brains, and just show pictures. Remember to pull the tab into the position of comfort and lock it down.

Tab Taping Cyclist Palsy
Tab Taping Cyclist Palsy
CHAPTER 15: STRETCHING THE FOREARM

Muscles of the forearm control the wrist and the fingers. Occasionally stretching these muscles in order to attain normal, human range of motion is great, especially when excessive use is a factor. Examples of excessive use include typing, construction, factory work, massaging, etc.

Here are three stretches that I would suggest:

The first one is for the wrist flexors and the elbow pronators. It looks like this.

Forearm stretch
Forearm stretch
Forearm stretch
The second stretch is for the wrist extensors and the elbow supinators. It looks like this.
Forearm stretch
Forearm stretch
Forearm stretch
The third stretch is for the ulnar deviators and It looks something like this.
Forearm stretch
Forearm stretch
Forearm stretch

Lastly, for those of you who like to watch videos, I made this video of all of my favorite forearm/ hand stretches to address an ulnar nerve compression in the elbow or wrist. These stretches are not a “fix all” but when they are needed, they work extremely well.

I normally suggest my patients do this circuit 10 times a day for 30 seconds per stretch, especially of they are using their arm and hand a lot.

Important section (click links to read immediately):

CHAPTER 16: STRETCHING OF THE HAND MUSCULES
The hand contains muscles and tendons that can be stretches similarly to the way that Yoga Toes stretch the muscles and tendons of the feet, but the hand isn’t quite as simple as the feet. Here is a great stretch that I use personally!
Stretching Hand Muscles
Stretching Hand Muscles
Stretching Hand Muscles
Stretching Hand Muscles
Stretching Hand Muscles

I really don’t think it has a name, and it is extremely difficult to teach unless I perform it on someone in person.

When you succeed in finding the sensation that we are looking for, you will definitely know it. My suggestion is to take a look at these pictures a few times before you try it out. When you get it right, your hand is going to light up… kind of like your mouth would if you bit into a ghost pepper. Maybe not that extreme, but you get the point.

CHAPTER 17: START PLAYING THE SAND… OR RICE

This type of hand/wrist therapy is actually kind of fun. Grab some kind of box (an empty shoe box works great) and fill it up with sand.

Put a bunch of small random household items (paper clips, buttons, marbles, anything that won’t poke you really) in the sand and mix up the contents so that most of the objects need to be dug out.

Get your hand in there and start searching for the items in the sand, moving the hand around from the wrist and not from the shoulder, and pull the items out one-by-one as you find them.

Or if you don’t mind being less entertained by a game, you can get right down to it with “Rice Grabs,” which works extremely well.

Here’s a video on a circuit of “Rice Grabs.”

There are a couple ways that this can help you.

First, the resistance that the sand provides for the hand and wrist as you search for the items, will help in the rehab.

Second, you may not know it, but you are actually gliding the nerve through the Tunnel of Guyon when you do this. There is a saying that we use in our field: “Movement is Medicine.” This rehab technique is a perfect example of that.

CHAPTER 18: START USING THE MONKEY BARS

Sounds fun, doesn’t it? It doesn’t necessarily need to be monkey bars, but there should be some kind of hanging aspect.

I know that some of you might be reading this, and immediately think that it’s going to be impossible. I know it can be nerve-wracking to think about, but in a lot of cases of an ulnar nerve compression, the upper limbs need to be strengthened!

Here’s a fun video 🙂

Hanging is one of the best ways to start that strengthening process. Hanging requires strength from the hand, the arm, the elbow, the shoulder, the shoulder blade, AND the spine. There is a huge amount of contraction required of hanging from a bar, especially when engaging the core and legs.

How would I do it? Like this:

Use the Monkey Bars

1: Step up to meet whatever bar you are using, that is able to support your weight (be careful using in-door types of pull-up bars since they are not always secure). Grip the bar fully with the hands, hold on, and allow the weight to fully hang down, stepping off whatever you might have used to step up to the bar.

2: Try to pull the bar towards you without bending the elbows. This will help to engage your shoulders and arms.

3: Now, point your toes about 2-inches in front of you. Point the toes with some gusto. Think of a hunting dog pointing in the direction of the game for the hunter.

4: Hold this position for as long as you can. Over time, you should try to increase the duration of the hang.

CHAPTER 19: START RESISTANCE TRAINING
For a lot of you, this may not be the answer you were hoping to hear, but to be very honest, this is probably the most valuable and most important suggestion contained in this article.
Resistance Training Ulnar Nerve Therapy

A lot of the suggestions I have made here are suggestions for “pain management.” What makes this suggestion so much more significant than the others is that it has the power to stop the ulnar nerve symptoms from ever coming back!

Sure, I acknowledge that there are some cases of ulnar nerve entrapment that can occur on a person who does resistance training, BUT these cases are pretty rare. Those who choose to not strengthen their bodies, will see their bodies degrade at a much more rapid pace as they age, and they will encounter more nerve compression over time.

Resistance Training Ulnar Nerve Therapy

Interested now?

If yes, you are probably wondering where to even begin. The various other suggestions I made above are a great place to start! Blowing up a balloon, hanging on the monkey bars, do the bird-dog, learn to sit!

Beyond all of the suggestions listed above, there is an online course that I am putting together that will specifically address this. Once it goes live, you can find it at this LINK.

I would go further, but from here on out, videos will best address these topics.

A RECAP

Now that we have covered some of today’s best ulnar nerve therapies, it’s time to consider the possibility of ulnar nerve pain being present on both sides. What do you do if the pain is in both arms/hands?

If this sounds like you, then there is a strong possibility that the cause resides in the spine and upward. While the chances of having compressions on both sides that are equal in nature and intensity is very rare, you should seek care and opinions from a doctor if those symptoms are present.

BONUS CHAPTER 20: STEPS TO TREATMENT OF AN ULNAR NERVE COMPRESSION

1: Find the site of compression

Think of a nerve as a garden hose. Any kink in the hose will affect the water flow, regardless of its location. When considering ulnar nerve compression, it works much like the garden hose, but there are a few sites on the nerve that have high probability of becoming entrapped:

  • At the spine (the nerve root)
  • At the brachial plexus (the neck region)
  • At the brachial sleeve (the arm)
  • At the cubital tunnel (the elbow)
  • Within the forearm muscles
  • At the Tunnel of Guyon (the wrist)

There are also a few other reasons that could be the cause of “symptoms of an ulnar nerve compression.” Be warned, most of these are probably going to scare you, so seeing a doctor to confirm the cause is a good place to prevent any unnecessary panic attacks.

I once had a patient experiencing numbness/pain in the ring and pinky fingers at night. In his case, the cause was a tumor in the spine.

Ulnar Nerve

Another young man came in and presented with bilateral (both sides) numbness and pain in his hands/fingers. This is one of the major signs (bilaterally present symptoms) of spinal cord compression.

The individuals involved in these cases both asked, “Hey, can you just treat it?” Of course, my answer was no. These cases both needed to referred out.

Moral of this story: you should know, with certainty, what is creating the symptoms. If you don’t, the muscles of the hand can end up wasting away, or even worse.

2: Decrease local irritation

Decreasing irritation of the region of nerve compression can be helpful in decreasing “flare-ups.”

In most cases, people are pretty aware of what activities or motions will trigger their symptoms. I’m never one to encourage a mindset of “avoidance,” but in this case, while we attempt to fully address the reason for the nerve compression, holding off on those activities or motions might be a good idea.

If you’re thinking something along the lines of, “It happens when I drive. How can I not drive?” or some other activity that seems unlikely to stop entirely, then a little more effort is going to be necessary from you!

Ulnar Nerve

I strongly encourage my patients to break down every activity into its separate movements or components, and to find the EXACT reason for the flare-up. Here are some modifications you can make while driving, for example, that may surprisingly decrease symptoms in that activity:

  • Place a towel on your arm rest
  • Switch the dominant hand you use for driving
  • Practice deep breathing for the first 5 minutes of your drive
  • Adjust your seat settings for better posture
  • Activate the deep neck flexors for the first 5 minutes of your drive
  • Change from an overhand grip on the steering wheel to an underhand grip (only if you are still able to drive like that

It might actually surprise you how dramatic of an effect even just one of these exercises can have for you.

Not willing to give it a shot?

As much as I would love to believe that people are always willing to do what it takes to make themselves healthy and the keep themselves healthy, unfortunately that is not always the reality.

If you are unwilling to try this out, then, to be blunt, that is completely on you. Showing resistance to being part of the solution, often times is an issue of mentality. If you are reading this, and you are dealing with someone who is simply refusing to try anything new for the condition, you might want to ask them why.

I have found, on more than one occasion, that some people have been experiencing an injury for so long, that it has become a huge part of who they are, a huge part of their identity. I know this might sound preposterous, but it’s more common than a lot of people think. If it is an issue of mentality, the underlying mental barriers need to be addressed before anything else.

3: Decrease activity creating compression (till under control)

This is very similar to the previous suggestion, but it has its key differences. Think of this as a hobby related change.

It is not uncommon for ulnar nerve compression to present itself in overhead athletes, such as tennis players, baseball players, volleyball players, and more. However, the “hobbies” that need some adjusting are not just limited to sports and exercise.

handlebar palsy ulnar

This compression can present in writers, woodworkers, typists, and many more. Any activity that typically increases your ulnar nerve symptoms, needs to be decreased to some degree.

Can’t stop?

Ask yourself why?

For example, why do you play tennis?

Is it for the exercise?

Then you can easily change your exercise routine and maybe choose to run for a few weeks while you work on your ulnar nerve problem.

Do play tennis to spend time with your spouse? Explore some other fun options of spending time with each other.

It may strike you as inconvenient, or maybe even “not worth it,” but thinking outside the box will help you find a suitable and enjoyable substitute, and this modification of activity is usually not forever.

4: Increase nerves ability to slide through

After the symptom-inducing activities and the irritation to the region of compression have stopped, we can start getting the nerve to glide freely. This can be done with nerve gliding techniques, or… wait for it… by moving your body.

That’s right! The body is a beautiful thing. When it moves optimally, nothing will pinch, crush, ache, or go numb. If you want to start with just the nerve gliding techniques, head back toward the top of this article using THIS LINK, and perform the nerve gliding exercises.

BUT, if you want to do the BEST thing for you, start to move better. The process for this is an entirely other 30-page article, so in order to make it easier for everyone, I created a video course. As soon as it goes live, you will be able to access it.

5: Improve postural control, breathing patterns, movement patterns etc.

If you got through that last section, you’ll remember that I mentioned moving better as a way of decreasing nerve compression. Think about it! When’s the last time you heard about a baby having ulnar nerve compression? I know that I never have!

DNS Breathing

Sure, you can find some other reason to avoid the real answer… the answer that requires change… but look around. Take a look at your friends and family. I’ll bet that most of you can easily name at least 10 people in your lives who are older than you, and who do not have ulnar nerve issues.

Learning to move better is a process. Just like with any new subject or discipline, you have to start with the basics.

The foundation of healthy movement is having a properly functioning core. Achieving a functioning core starts with proper breathing. I know it sounds like a lot of BS, but really! Can you remember the last time you were exhausted from running?

When you stopped, you probably bent over, hands on the knees, and proceeded to breath hard for another few minutes. No amount of core exercise can train you to control your abdominal region when your breathing is labored. That is unless we learn to breathe.

Here’s a video on a quick breathing life-hack.

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