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Nerve Entrapments

This section shows you MAR® and IAR® for the most common upper extremity nerve entrapments. These are involved in at least 50% of cases in this region and are among the most underdiagnosed and under treated conditions in the human body. 

 

Upper extremity nerve entrapment locations:

  1. Nerve Roots with Scalenes
  2. Neurovascular Bundle with Subscapularis
  3. Median Nerve
    • with Pronator Teres
    • with Flexor Digitorum Superficialis
    • with Carpal Ligament
  4. Ulnar Nerve
    • with Flexor Carpi Ulnaris
    • with Hypothenar
  5. Radial Nerve with Posterior Forearm

 

Nerve entrapment is suspected when the first order history is consistent with nerve adhesion and confirmed with positive exam findings. Particularly palpation of adhesion with diagnostic passes using the following protocols.

MAR: Nerve Roots at Scalenes

Cervical nerve roots can become adhered to the middle and anterior scalenes. This can contribute to any upper extremity nerve symptom and alter cervical biomechanics and load. 

MAR: Subscapularis with Neurovascular Bundle

The neurovascular bundle can become adhered to the subscapularis. This can contribute to many upper extremity nerve symptoms and alter shoulder biomechanics and load.  

Median Nerve

Median Nerve entrapments can cause symptoms:

  1. Aching and/or burning anywhere along it’s course (including cutaneous nerve branches)
  2. Pain/Tenderness/Hypertonicity to any of the structures it supplies (medial elbow/flexor group)
  3. Numbness/tingling/decreased sensation to the palm of the hand and first 3 1/2 digits.

Starting proximal and working distal the most important median nerve and related entrapments are:

MAR: Median Nerve at Pronator Teres (Model)

MAR: Median Nerve at Pronator Teres

MAR: Median Nerve at Flexor Digitorum Superficials 

IAR: Median Nerve at Transverse Carpal Ligament 

Ulnar Nerve

Ulnar Nerve entrapments can cause symptoms:

  1. Aching and/or burning anywhere along it’s course (including cutaneous nerve branches)
  2. Pain/Tenderness/Hypertonicity to any of the structures it supplies (medial elbow/flexor group)
  3. Numbness/tingling/decreased sensation to the hypothenar palm and medial 1 1/2 digits.

Starting proximal and working distal the most important median nerve and related entrapments are:

IAR: Ulnar Nerve at Flexor Carpi Ulnaris

IAR: Ulnar Nerve at Hypothenar

Radial Nerve

Radial Nerve entrapments can cause symptoms:

  1. Aching and/or burning anywhere along it’s course (including cutaneous nerve branches)
  2. Pain/Tenderness/Hypertonicity to any of the structures it supplies (extensor group)
  3. Numbness/tingling/decreased sensation to the dorsum of the hand and dorsum of the lateral 3 1/2 fingers.

Starting proximal and working distal the most important median nerve and related entrapments are:

IAR: Radial Nerve with Extensors

There you have it. You can effectively treat the 8 most important and common nerve entrapment sights in the upper extremity. 

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