(.

1. Ulnar Neuropathy in a Collegiate Track Athlete: A Case StudyBecker MC, (Gray CE, MS, ATC): Ithaca College, Ithaca, NY Treatment: She was referred to the team physician who completed a physical exam and made a diagnosis of ulnar neuropathy. The athlete was treated conservatively with a dosage of prednisone, 2 tablets per day for five days, neural glides and modalities combined with a decrease in repetitions during pole vaulting to prevent exacerbating her symptoms. After the spring season she was referred to an orthopedic surgeon. Electrodiagnostic testing found a left proximal ulnar nerve mononeuropathy at the elbow, with a conduction block, consistent with cubital tunnel syndrome. Surgery was performed to decompress the nerve and stabilize the triceps insertion. A simple in situ decompression was performed; the fascia over the cubital tunnel and flexor carpiulnaris was incised in conjunction. There was no transposition of the ulnar nerve. Postoperative management consisted of a period of rest to let the incision heal and then the introduction of active range of motion exercises and activities of daily living as tolerated by the patient. The patient returned to school at the conclusion of summer and began hand therapy to restore tone and strength to the intrinsic muscles of the hand. Rehabilitation in this case is not to correct trauma caused by the surgery, but to correct the muscle wasting that occurred as a result of the nerve compression. Background: A 20 year old female collegiate track athlete was evaluated in the athletic training room for numbness and tingling in the ulnar distribution of her left hand, and decreased grip strength. She was a competitive gymnast until her sophomore year and now pole vaults during the track seasons. At age 13 she subluxed her elbow and chipped the medial epicondyle of her humerus. There was no previous history of neck, shoulder or wrist pain or trauma, and there was no noted mechanism of injury MOI) prior to the onset of her symptoms. She recalls typing at her computer and her arm feeling like it fell asleep Uniqueness: Ulanr neuropathy is more commonly seen in males and individuals over the age of 35. Because onset of this injury is somewhat slow it is unique to see this in a younger patient, especially without a known MOI. (. Conclusion: Because of the anatomic positioning of the ulnar nerve it is subject to entrapment and injury by a wide variety of causes. It is important that the clinician and patient work together to identify the cause of the neuropathy so that the patient has a positive outcome without long term deficiencies. • Differential Diagnosis: • Cervical disc disease • Brachial plexus injury • Thoracic outlet syndrome • Epicondylitis • Ulnar artery aneurysms • Wrist thrombosis • References upon request: • Stern Mark, Steinmann Scott P. Ulnar nerve entrapment. http://emedicine.medscape.com/article/1244885-overview. Updated September 21, 2009. Accessed October 7, 2010. • Guardia Charles F, German Stephen, Azevedo Christina. Ulnar Neuropathy. http://emedicine.medscape.com/article/1141515-print. Updated June 10, 2010. Accessed October 7, 2010. • Polatsch Daniel B, Melone Jr. Charles P, Beldner Steven, Incorvaia Angelo. Ulnar nerve anatomy. In: Hand Clinics: The Ulnar Nerve.Vol 23(3). Philadelphia, PA: Saunders, Elsevier;2007:283-289. • Posner MA. Compressive ulnar neuropathies at the elbow: I. Etiology and diagnosis. J Am AcadOrthop Surg. Sep-Oct 1998;6(5):282-288. • Szabo R, Kwak C. Natural history and conservative management of cubital tunnel syndrome. In: Hand Clinics: The Ulnar Nerve.Vol 23(3). Philadelphia, PA: Saunders, Elsevier;2007:311-318 Department of Exercise & Sport Sciences