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Kin 3K03: Sports Injuries (Entrapment Neuropathy & TFCC Summary)

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Krista M Baker

Sports Injuries: Kin 3K03 ENTRAPMENT NEUROPATHY & TFCC - Entrapment neuropathy is usually a compromise of blood supply, which results in tissue death of nerve. - We can compress the nerve several ways: -hypertrophy of muscles around nerve -nerves that don’t have a lot of anatomic space to grow (swelling will squeeze the nerve, especially in forearm) -area can be damaged which compresses the nerve temporarily Entrapment Neuropathy - Common for mountain climbers, wheelchair athletes and paddling sports (kayak, rowing), sports that involve direct compression (cyclists that have their hands compressing handlebars for hours) Median Nerve o Travels anterior to the elbow, between 2 heads of pronator teres (vulnerable anatomical spot b/c as pronator teres hypertrophies, it will compress this nerve) o Carpal Tunnel is the next vulnerable spot (tight space for median nerve to pass through) • Recognition? o Sensory aspect: altered sensation (tingling/numbness) in lateral 3 fingers (thumb to middle finger) on palmar side of hand.  Sensory symptoms will reflect the point at which the nerve is being choked (i.e. if nerve is choked at elbow, then everything below will feel tingling (hand/fingers/forearm), but if nerve is choked at carpal tunnel, only the fingers/hand will feel tingling. o Motor aspect: weakness in thumb flexors (makes it difficult to grab things), index and middle finger flexors: if choking of the nerve is more proximal (at the elbow), then pronation and wrist flexion may become weak. • ROM: pronator teres exercises will squeeze the median nerve, therefore pronator teres syndrome will be aggravated by pronation exercises. End range wrist flexion and extension will irritate the median nerve as these ranges of motion will decrease the space of the carpal tunnel. Ulnar Nerve o Travels along medial epicondyle of humerus through cubital tunnel o Doesn’t pass through carpal tunnel but rather tunnel of Guyon (ulnar tunnel). • Recognition? o Sensory aspect: altered sensation in ring and pinky fingers (digits 4-5 palmar side), ulnar side of hand ulnar side of forearm. Tingling/numbness anywhere through forearm to hand to fingers 4- 5.  If nerve is choked at cubital tunnel, then tingling/numbness in the forearm and hand will occur, but if nerve is choked at the tunnel of guyon, altered sensation should only show up in hand
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