[jimacp]

Has anyone had problems with ulnar nerve entrapment/irritation?  What were your symptoms and how did you deal with it?

I've been feeling tenderness inside my elbow, slight tingling down the underside of the arm to the pinkie, and occasionally numbness to the underside of my forearm and hand after sleeping with my elbow bent.  Seems to be exasperated by weighted pull-ups, less by lock-offs and not at all by deadhangs on my door frame.  I stretch my forearms most days though probably pay less attention to my shoulders. 

Any thoughts?

[Bonjoy]

I had a problem a few years ago. It went away when I learned to change my sleep posture. Sleeping with tightly bent elbows seemed to make it worse and i'd often wake up with two numb fingers on each hand. Once I got used to sleeping with straighter arms the problem cleared up.

[Houdini]

He he

More like a farmer sowing seed than a squirrel w/ a nut.

[Bonjoy]

That's right! Strew the seeds and prosper

[account_inactive]

I've had this as well.  I developed some scar tissue in my back which cause the ulna nerve to shorten and refer pain through the elbow.  It took a while to diagnose as most physios said it was tendinitis.  It obviously wasn't as I'm too lazy to over train

A combination of manipulation, acupuncture and stretching helped

[jimacp]

Found the previous post on farmers and squirrels...  a little surreal but got the point across.  Sleep posture could be part of it, last night i concentrated on sleeping like a farmer (as far as you can concentrate in your sleep) and felt better this morning. 

That it can be brought on by back problems is interesting too.  I think that my shoulder posture has taken a step for the worse in the last couple of months.  Perhaps this is behind a shortening.  It certainly feels like this could be the issue; i feel the nerve twinge when i bend my elbow or rotate my wrist at full arm stretch, as you might imagine if the nerves been pulled tight over the elbow.

Thanks for the feedback guys.  I've booked a physio appointment, will see if she can pin point something specific.

[rc]

I'm currently following physio advice to deal with ulnar nerve problem.
Cause(s):
1. common climbers "rounded shoulders" (hunchback). Imbalance due to overuse of certain muscle groups while others quietly gave up yonks ago without me noticing.
2. exacerbated by shocking posture while working at computer for hours
Not sure sleeping with bent arms is a real cause for me, more it just doesnt help.

What to do
1. Nerve glide exercises http://www.handhealthresources.com/Solutions%20Pages/Exercises.htm hold the position for 5 secs where you feel the tension (I get mild 'fuzzing' in the ulnar nerve). Repeat 5 times on each arm. Do this twice a day. If nerve kicks off and tingling doesn't calm after 30 mins you pushed too far.
2a. Stretches to open up your shoulders - not sergeant major posture, but more aligned. Roll up a towel and lie on your back on it (with it along your spine). Careful of stretches that aggravate the nerve - some 'standard' shoulder stretches make it worse for me.
2b. Stretches to relax the muscles where this nerve runs around neck and shoulders - pain may be in elbow/hand but for me the causes are all back/neck problems.
3. Aim for longer term better posture by sorting out the balance of muscles in your upper body - go to pilates or something.

Of course - what you have may be a lot different. This is the programme I'm on after finally finding a decent physio (it was the 5th one I saw).
Best news (for me) - I was reassured that climbing was not a problem - probably helped set me up for these problems, but I could sort it out while continuing to climb.
Hope it sorts out soon!

[Jaspersharpe]

I'm currently following physio advice to deal with ulnar nerve problem.
Cause(s):
1. common climbers "rounded shoulders" (hunchback). Imbalance due to overuse of certain muscle groups while others quietly gave up yonks ago without me noticing.
2. exacerbated by shocking posture while working at computer for hours

I had exactly the same thing a few months back. Thought that climbing was fucking up my elbow and lower back and it turned out that it was the above. The hunchback thing was (my physio said) due to me having really strong stomach muscles (as climbers tend to) and using them to bend rather than my hips/lower back muscles (as you say these had become redundant). Really interesting stuff. All I had to do was change my posture at work and consciously use my hips when bending and the problems went in a couple of weeks. Same as you I didn't have to stop climbing at all and was actually encouraged not to stop.

[The Sausage]

i'd say going to a physio is e right thing to do (but then i would...) however, have they been recommended to you? have you used them before? do they know anything about climbing? the problem with any peripheral nerve irritation/injury is that there is usually a multi-factoral cause. nerves are very sensitive and a bit of minor irritation at points along them can cause a flare up at any one of a few usual spots, usually where the nerve passes through a tight area. so, the problem is not necessarily related to the point at which you feel the pain/numbness/pins and needles.
the most likely underlying cause is poor neck/back posture, exacerbated by working on a computer (as jasper says) and driving. this situaton basically iriitates the nerve, but may not in itself lead to any symptoms. the irritation sort of primes the nerve to injury, so then if you get a bit of inflammation around the medial epicondyle of the humerus (where the flexor tendons of the finger muscles attach), you reduce the space for the nerve to slide in, further irritating the nerve and potentially leading to pain/numbness/pins and needles. often nerve symptoms come about at night due to the fact that your blood pressure is lower while you sleep, so any compression on the nerve will be more of an issue with regard to the nerve getting adequate blood supply; this may be compounded by sleeping position, but again just because that is when you get you symptoms, it doesn't mean it's the root cause. Doing a full pull up with hands facing forward puts the ulnar nerve on a stretch, so again it will highlight that there is a problem, rather than it being the cause of the problem.
Your physio should look at your neck position. he/she should try to put the nerve on a stretch with your neck in different positions to see if that alters your symptoms. you could try this yourself - put the affected arm into a kind of "biggles glasses" position, but with your palm flat against your cheek with fingers pointing down and thumb at the front - does this bring on your symptoms? try pulling your chin to your neck (tucking it in). does this chage your symptoms? i would imagine with a bit of postural re-education you'll be well away.
just to relate to jasper's last point: the reason that the classic climbers' posture can affect the nerves of the upper limb is that what happens at one point in the spine will affect its position at other points. so, we (as climbers and desk dwellers) end up in a C shape from the lower back to the base of the neck. now, in order to look forward, which we need to, we have to introduce a very tight bend in the lower cervical spine - the base of the neck. this causes compression on the nerves as they exit between the vertebral bodies and run out to the upper limbs. if all this is right, and you were my patient, i would start by teaching you how to sit up from your pelvis, how to keep your pelvis in the right position while you go about your everyday business, and to develop a system of reminders so you develop an awareness of when you are falling into your old bad habits. however, advice given over a computer without any objective assessment should not be followed, so get your self to a decent physio.
are you taking any anti-inflammatories? along with rest, they should be the first point of call for any injury. there is no spare space inside the body and any inflammation will cause further irritation to the affected tissues. i would say you could do any training that doesn't bring on your symptoms. avoid very deep locks.
hope my end-of-the-week ramble makes some sense
good luck

[Houdini]

After I've had an eye transplant I'll reply to Sausages' post, but before that I'd like to point out that Sausages' paragraph-free post was MURDER to read.

[The Sausage]

mmmm, know what you mean. got onto a bit of a just-got-in-from-work tirade and spat all that out. oh well.

[Houdini]

OK.

Paragraphs aside.  Sausage has sound advice.  Namely, what is your neck doing?  I'm 2 years into a cervical herniated disc injury: at worst numb swearing fingers, tingly forarm/bicep.  Not good.

Solution?  Surgery or management.  I've taken management.  My nerve is radial not ulnar but trapped is trapped.  Surgery is complex and often damaging, forget it.  Learn to manage your injury.  Surgery is a shit option than can damage more than cure.  Too dodgy, and staff dependent.  Fuck their shaky hand alcoholism . . .

Sleep.  Pay attention to your posture.  Beware what your neck does when it rests.  Don't sleep on the trapped side.  Open your skeleton.  Avoid sleeping on your back and a crook-backed neck.  Sleep sideways-on always,  Perhaps w/ a small cushion between your legs.  For comfort: you will move less.

Stretches.  Useful to me:  Face wall, palms on wall w/ bent arm.  Lean in, push back till arms straight.  Hold, repeat.

Also, stand straight; turn damaged side-hand around so palm is opposite - not against thigh.  Pull shoulder down.  Raise arm 30° out from body;  stretch neck 30° opposite from this direction.  Hold.  Repeat.  Works for me, but really this is a radial stretch, and I think something all climbers should do.  Biggles is a fab stretch, do always.

[webbo]

can you post a picture of the biggles thing cos several glasses in i'm fucked if i know what you mean.

[The Sausage]

jesus, i can only just about type. post pictures indeed. what's this , the 21st century?

make an OK sign out in front of you (with both hands) with your thumb and index finger. Bring the O's towards you like a pair of specs. Just before they reach your face, flip 'em over so your thumbs make the top of the specs, and your fingers point down (kind of cradling your chin). This is the classic Biggles pose - you must be foreign. Anyway. for the stretch, do exactly that, but flatten your palms against your cheeks, ie forget about the specs.

The most important advice is get yourself SEEN to. Advice over the interweb ain't nothing to rely on...

[Houdini]

Fuck ya lightweights!



WOW I'm pissed.  The point is to pull the elbows back when in this pos.

[Houdini]

PS Everything I've been adviced at 40 quid an hour I could've found on net.

[The Sausage]

PS Everything I've been adviced at 40 quid an hour I could've found on net.

You can find any advice you want on the 'net; it's matching the advice to the problem that's the important bit. I've said it before, we spend money on all sorts of old shit, but spend it on keeping our bodies functioning properly? god forbid... 

[webbo]

i can't actually do that biggles thing.i would need someone to lift my elbows up and on my left arm it really pulls what i've got left of my bicep.

[Houdini]

... but spend it on keeping our bodies functioning properly? god forbid... 

This doesn't hit home w/ me as I use a physio quite regularly.  I've also paid to see people who have done nothing for me at all. 

Actually the best cash I ever spent on my body was the least.  Thai massage in Thailand.  Just the ticket for getting through a long & physical trip.

Now if you'll excuse me I've got to paint the wall behind the computer (3rd time) after chucking a glass of pinot noir down it last night.  I went for the Hammer House of Horror bleeding wall look, again . . .
 

[Jaspersharpe]

PS Everything I've been adviced at 40 quid an hour I could've found on net.

You can find any advice you want on the 'net; it's matching the advice to the problem that's the important bit. I've said it before, we spend money on all sorts of old shit, but spend it on keeping our bodies functioning properly? god forbid... 

I've been to the physio twice in the last year with the back/elbow thing and then a shoulder problem shortly after. Total cost - £75. Total time off climbing - nil. Success rate of treatment - 100%.

£75 is fuck all to keep your body running correctly but as mentioned, you need to see the right person. For every physio who knows their shit and understands climbing there is probably another who will take your cash and put a fucking ultrasound machine on you for half an hour. It's easy enough to get recommendations though isn't it. 

[Houdini]

Absolutely.  There's always something that can be done if you've a muscular problem.  Nervous tension is different and one chiropractor I paid to see actually refused to touch me but was full of advice I already knew. 

What's key is learning how to change your bodily habits. 

[SA Chris]

Sleep.  Pay attention to your posture.  Beware what your neck does when it rests.  Don't sleep on the trapped side.  Open your skeleton.  Avoid sleeping on your back and a crook-backed neck.  Sleep sideways-on always,  Perhaps w/ a small cushion between your legs.  For comfort: you will move less.

And get a decent memory foam mattress. These things do wonders.

[webbo]

as i may have mentioned before.if i do all the recomended exercises for all my various niggles,i have to get up 2 hours before i go to bed in order to get them all done.

[jimacp]

Thanks guys, lots of great info, one of the best informed group of forum users around.  I dread to think what useless nuggets of irrelevance UKC would have generated for the same question.   

I've tried 'the biggles' and 'tipping the waiter'.  The latter hit the spot directly so might be on to something.  My shoulder slump has been developing steadily as i've bouldered more; further evidence of this being tight muscles above the collar bone and occasional pains just below and between the shoulder blades.  No doubt these symptoms, along with the elbow problems, are all tied into the same posture related problem. 

Next week i'm going to make an appointment with a physio who's helped me out with finger injuries before.  She's a climber so has a good understanding of the sport.
 

[Houdini]

Weird, so that's what I do?  Tipping the waiter!  I just logged on as I thought I had described it wrong:  it's pull arm down then rotate hand not the other way as described.