This post is part of our ongoing series to educate fans about the injuries to their favorite athletes and when they might expect them to return to play. If you have questions about your sports injury, call us at 201-962-9199 or learn more about our Sports Medicine or Sports Rehabilitation services in Bergen County, NJ.
Mets Pitcher Jacob deGrom’s Ulnar Nerve Injury
Jacob deGrom is just one of the Mets electric young pitchers to suffer a significant injury this year. The biggest concern a pitcher has when they experience elbow pain is damage to the ulnar collateral ligament, which would require Tommy John surgery. He avoided that fate, but Jacob deGrom does have an injury to his ulnar nerve, which will require surgery.
WHAT IS ULNAR NERVE ENTRAPMENT?
Have you ever hit your “funny bone”? It’s obviously not very funny, but that does give you an example of what deGrom is experiencing. When you hit your funny bone, you actually are hitting your ulnar nerve. The nerve passes through a space known as the cubital tunnel along the middle part of the elbow.
Ulnar nerve entrapment is simply compression of the ulnar nerve, usually within this cubital tunnel. Common causes of this compression is from keeping the elbow bent for long periods of time (e.g. during sleep), leaning on the elbow, and fluid or cysts within the cubital tunnel.
WHAT ARE THE SYMPTOMS OF ULNAR NERVE ENTRAPMENT?
- Numbness of the ringer finger and pinky
- Tingling of the same fingers
- Weakness of hand grip
- Wasting or reduction of the hand muscles
HOW IS ULNAR NERVE ENTRAPMENT TREATED?
Avoidance of situations that compress the ulnar nerve is the most important part of treatment. At our Sports Medicine clinic in Ramsey, NJ this is usually accomplished with increased awareness and bracing. Your doctor should tell you to avoid the most common situations that result in compression of the ulnar nerve. For most people, that occurs while driving or using a computer. For people who drive a lot, they should be reminded to not rest the elbow on the door. For those patients who spend a lot of time on the computer, proper ergonomics should be encouraged. That includes keeping your elbows bent to 90 degrees and not resting your arms directly on your elbow.
Bracing is usually recommended at night because you are not able to control the position of your arm while sleeping. The brace is simple and comfortable. The brace keeps your elbow fully extended to prevent bending it and causing compression of the ulnar nerve.
If these conservative treatments do not work, surgery is usually recommended. Typically there are two options. The first is a cubital tunnel release where the ligament that forms the “roof” of the tunnel is cut. The goal of this procedure is to relieve the pressure of the nerve while leaving it in is natural location. The other surgical treatment option is called an ulnar nerve transposition. This is when the ulnar nerve is moved from its normal anatomic position and placed in front of the cubital tunnel.
With Jacob deGrom, we’ve been told that the ulnar nerve compression is the result of scar tissue that has developed following his Tommy John surgery a number of years ago. Obviously this isn’t a common cause for nerve entrapment in the general population, but the issues are the same. Hopefully the procedure he requires will be less invasive that the ulnar nerve transposition, but any surgical procedure would end his season. Fortunately, the recovery time is significantly less than Tommy John surgery. This will allow him to rehabilitate and return to baseball during spring training.
At Progressive Spine and Sports Medicine, we specialize in physical therapy and nonsurgical pain management, and ulnar nerve entrapment is just one of the many injuries we diagnose and treat in our Ramsey, NJ medical center. For more information, please see our full list of our nonsurgical services, or to schedule a consultation, contact us today.
We look forward to being your #1 solution for nonsurgical pain treatment.`