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Date of last update: 10/01/2017.

Forum Name: Joint surgery

Question: Post Ulnar release surgery still having same pains.. WORRIED

 Mark the bowler - Tue Apr 21, 2009 3:53 pm


I have a long story but I'll just touch on the key points and try to keep it as short as possible. I am a 33 y/o amatuer bowler. On no medications, no allergies, very active.

April of 2008- During bowling my shoulder was sore so I ask a friend to hold my hand as I lightly lean back to stretch my shoulder. Being the jokester that he is, he violently yanked my arm straight down with full force. From my elbow to my fingers was numb for a couple of mintues but went away. No pain, or loss of mobility. Continued to bowl. Over the next few weeks I noticed a little discomfort in my elbow. No pain just a little sore but it got progressively worse. The season ended in June and by then I had to take 800mg of Ibuprofen to bowl 3 games. The discomfort turned into a sharp pain. So I took 2 months off from bowling to let it recoop.

September 2008- Tried to bowl again. This time the pain was unbearable. The pain was only in my elbow. It did not shoot down my arm to my fingers. It would only hurt when I went full extension at a fast rate with weight in my hand (bowling ball). I buprofen didn't work. I knew something was wrong. Went to a orthapedic surgeon who requested an MRI. MRI results came back.... a inflammed ulnar nerve with a bone spur present. My ROM was fine, my strength was fine. No tingling in my forearm or hand. Just pain in the inside of my elbow.

October 08-December 08- The surgeon recommened PT. Did 6 weeks. Ultra sounds and light weights. Bowling was strictly prohibited. After 6 weeks the pain was still there. Doc referred me to a neurologist and they did a nerve conduction test. Results were that the signal was slowing down in the inner part of my elbow where the pain was coming from. So I opt'd for surgery.

12/17/08- Surgery done. 45 min outpatient surgery. I have a 5" scar on the inner part of my elbow. Doc said when he went in, that the spur wasn't causing any issues but it was just soft tissue. So he removed tissue, released the nerve, but left the spur. Why he left it there I don't know.

April 09- After 7 weeks of PT post-op I still have the same pain. The intensity is the same. I still have my full range of motion and strength. The doc says now that he believes that my elbow is hyperextending cause the pain. So he gave me a brace to limit my ROM (mainly extension). While this does stop me from going full extension, without the brace I'm still at square one. I'm starting to believe that the surgery may have not been the right thing to do and that I might be stuck with this pain for the rest of my life.

So I'm wanting a second opinion on what I should do/try. I've even contimplated acupuncture. Should I get another MRI done? Could it be that they may have overlooked a torn ligament or cartiledge? I'm worried that I won't be able to bowl with my 14 month old son when he bowls for the first time or play catch with him.

Thanks for any help.
 Tom Plamondon PA-C - Mon Apr 27, 2009 7:55 pm

User avatar Hello,
Sometimes cubital tunnel (tunnel at the medial elbow where the ulnar nerve travels into the lower arm) release or decompression fails.
It would good to know the neurological status of the ulnar nerve at this point... another nerve conduction test.
The question at this point is whether the pain is due to nerve inflamation or continued entrapment or is it from other elbow problems.
Sometimes the release of the ulnar nerve fails and surgeon may need to relocate the ulnar nerve - another surgery.

This would be worthwhile getting a second opinion and discussing your treatment options.

Take care and let us know how it goes.
 Mark the bowler - Thu Jul 30, 2009 11:41 am

Thanks Tom,

I saw a different doctor who wants me to have another NCT done next week. He did mention maybe a transposition of the nerve could resolve my issue. He didn't mention which one (submuscular or subcutaneous). I really don't want my muscle cut. Which one is more common and has a higher success rate?

 Tom Plamondon PA-C - Sun Aug 02, 2009 9:37 pm

User avatar Mark,
My understanding of the procedures are limited. From what I know, the submuscular may be used in more severe cases except if there are calcium deposits in the tissue (heterotopic ossification) then do the subcutaneous.
The subcutaneous procedure usually has good results - one study reported 92% of recipients satisfied with results.
Take care.
 Mark the bowler - Wed Aug 19, 2009 11:48 am

Thanks again Tom.


My 2nd opinion doctor referred me to a hand/upper extremity specialist. After he reviewed my MRI and took a few xrays of my elbow he thinks that the pain is not directly related to the ulnar nerve. He thinks its the menial head triceps. He referred to it as "snapping". Although during his examination I couldn't replacate the pain but he said being there is no pain/tingling in my fingers during flexon that its not the nerve but more my tricep. He believes that during extension its rubbing over the menial head. Does this make sense?

Appreciate your replies. Thanks.


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