Assess & Address: Ulnar Nerve Entrapment by Whitney Lowe

Pathology Assessment & Evaluation Treatment Massage Techniques

Massage techniques
Massage approaches for these two problems differ due to the nature of the pathology. For example, because Guyon’s canal syndrome results from external forces causing compression on the nerve in the tunnel, massage strategies need to focus on relief of compressive force. The practitioner should avoid any techniques that cause further nerve compression, evident by an immediate increase in symptoms. Massage performed directly over the irritated nerve in the canal may actually aggravate the symptoms and impair the healing process.

Cubital tunnel syndrome, on the other hand, is a condition where compression occurs from muscles, so massage is beneficial. Because the flexor carpi ulnaris is the primary problem, techniques that reduce tension in the flexor muscles of the forearm are most important. In particular, compression broadening (see left figure) and deep longitudinal stripping (see right figure) will help reduce tension in the flexor carpi ulnaris and may help mobilize the ulnar nerve within the cubital tunnel. Caution should be used when performing any massage techniques over the tunnel so that further compression of the ulnar nerve does not occur.

Stretching (mobilizing) the ulnar nerve through the cubital tunnel is important because lack of neural mobility may be a primary cause of symptoms. Neural mobilization procedures are performed by taking the nerve to a stretch position just where pain and discomfort are felt (see Figure 3). Once that point is reached the nerve is immediately returned to a neutral position. The stretch position is not held for as long a period as when addressing muscles. The sequence of stretching and relaxing the nerve is repeated several times to increase neural mobility and decrease pathological compression.