I had surgery on my elbow (subcutaneous anterior transposition of the ulnar nerve) one week ago. Posting my experience in case anyone else finds themselves in the same position I was in.

I’m sure it will go smoothly, and the recovery is really not that bad. Just taking it easy then getting range of motion back. You’re be back in no time!

Hey Robert,

I agree with David. He gives really great advice. Post really isn’t that bad as it seems. I don’t even think I had any serious pain, although I did receive a nerve block, but even when it ended, I still didn’t have much pain at all. Keep us updated. There isn’t many positive reviews out there but out of all the ones I’ve found this by far the best one. Good luck! 

Hi Robert,

It would be great if you could let me know how it goes. I've been having this problem for a year and even though it has gotten better I'm still out of the gym and I have pain and discomfort every day. The doctor I'm seeing now have suggested the subcutaneous anterior transposition. He says I won't be able to do much for 6 weeks after the operation and since I have problems with both elbows it'll be 12 weeks or more in total. Have you been told when you can return to work? 

Hi guys,

I'm scheduled to have the subcutaneous ulnar nerve transposition in 4 days on 21 November and I am very nervous and having doubts (i've already postponed once). For all of you that had subcutaneous transposition how has your recovery been? I've been reading so many forums and seems that a lot of people still have tingling or pain down their ulnar side of the arm up to a year after surgery (some longer).

I've had this problem since August 2018 and at that stage it was at its worse - claw pinky and ring finger, had to sleep with straight arms and couldn't even unload the dishwasher. I had nerve conduction studies done and all came back negative. My grip strength is intact as well. I was told to stop yoga, cycling and any weight bearing, flexion/extension exercises on the arm at that point.  I've worked with Exercise Physiologists to try strengthen the lower traps and increase scapular and shoulder mobility, Osteopath doing nerve gliding exercises and see a Myotherapist every month to loosen up the back and pec muscles. I returned to doing Aerial yoga July this year. Since then the pain level has reduced to about 4/10 and the frequency has also reduced - it only flares up when I do yoga that involves lots of weight bearing on the arm (plank, chaturanga), flexing/extending arm. Oddly, in the past month some days I don't experience pain and that's when I have doubts of whether I should go for surgery considering what other people experience post surgery (tingling/pain). My ulnar nerve subluxes pretty easily every single time i flex and extend my arm. My arm also hyperextends to about 20 degrees. Jace - the surgeon told me the same thing - I was born with this thanks to my parents.

I'm so torn right now - it's been over a year putting up with this on/off pain and the reason why I've elected to go for surgery is that I can't deal with the fluctuations anymore and want to get back into some serious yoga, be able to cycle and kayak and do physical activity without any restrictions.

Peter and Robert - did you end up going for surgery?

Thanks,

Bianca

The nerve conduction test should really localize the problem to the elbow area for you to be a candidate for surgery. Another option is a simple decompression of the ulnar nerve without transposing it (like they do for carpal tunnel syndrome)—this seems to work just as well—and if it doesn’t you can still have the transposition. A simple decompression can still be done even if your nerve subluxes. Also, keep in mind that ulnar nerve compression in cyclists typically occurs at the wrist and not at the elbow. That said, the subcutaneous transposition is the ‘standard’ if there is one, and although these types of surgeries aren’t the most effective, they’re usually quite safe. Good luck, you seemed to have tried conservative treatment, so surgery is the next reasonable step. Let us know how it goes. 

I haven't gone for surgery yet. As I understand decompression is standard for cubital tunnel syndrome and transposition is standard for a subluxing nerve. The subluxing of the nerve rarely affects nerve conduction because the nerve isn't compressed. The studies on transposition shows good results if it's a skilled surgeon who's used to doing this kind of surgery.

I've had it in both elbows since August 2018 and I haven't been able to do any exercise involving my arms since then. Worklife is also affected since I'm a physio. 
My main problem is a tight sensation going from the elbow up to my armpit. The nerve subluxes with most movements but it's always done that and I only notice it with outer range movements now. I would've probably gone for surgery but the surgery is rarely performed in Denmark where I live.
I hope you get something out of the answers :-)
Let us know what you decide and how it goes

Peter that totally makes sense, in line with what my hand therapist told me. Which is why my  sports doctor and orthopaedic surgeon suggested transposition as the nerve clearly subluxes - i can feel it pop in and out when i run my finger along the medial epicondyle. My sports doctor also said that my ulnar nerve sits very shallow in the groove and the medial epicondyle protrudes a lot. Weird though that the left also subluxes but is asymptomatic. 

I have a very good surgeon - he's worked on athletes like Shane Warne,  Michael Klim and performed surgeries on others I know all which have had good outcomes but for other surgeries. He's also fixed this problem on a whole family of kids who have the same issue. 

It must be very frustrating since you have to use your arms to work with patients. I know the feeling, being so restricted. I've seen pretty much all the specialists and surgery is the last option. 
 
Will keep you posted! 

From having 3 difference surgeries on my elbows (one on the left and two on the right) my suggestion is have the surgery and have it soon ASAP. From my case, the longer you wait to have surgery the more likely you can do permanent damage to the nerve. Once you decompress the nerve it starts to heal but the longer it’s compressed the nerve endings can die and it doesn’t have a chance to heal properly. Not I’m 2 years out of the last surgery and I am climbing stronger than ever! My only suggestion is protect the elbow for a while post surgery. I’m sure if you see earlier posts you’ll notice I had my right elbow struck on accident while it was healing, which caused it to become entrapped again and caused more damage than good which resulted in another surgery to be needed.
Take recovery slow and listen to your doc, trust in their ability to get the job done

Hey guys,
I went for surgery last Thursday, it was a very short  ~1hr procedure, all went well and I'm off work for a week. Started flexing and extending my elbow yesterday very slowly and am seeing my surgeon this coming Thursday for a follow up appointment. Thanks for your advice David, I am taking it slow!

Hi Bianca,

Good to hear the surgery went well. How is the pain level and swelling? I went for another ultrasound yesterday that showed some swelling and thickening of the nerve so I might be a step closer to surgery. 

Peter Rothe wrote: Hi Bianca,

Good to hear the surgery went well. How is the pain level and swelling? I went for another ultrasound yesterday that showed some swelling and thickening of the nerve so I might be a step closer to surgery. 

After each surgery (unfortunately I’ve had three) there was a decent amount of swelling but there wasn’t much pain. It’s more of an uncomfortable feeling over being painful. I know some people are very against surgeries but after my issues, I wish I got it done sooner. 

ALSO! For anyone who had one done recently. All three times I felt the same symptoms in the healthy arm. For me it seemed to irritate my arm after using it for everything while the other was slung. The pain eventually went away as the use of my healing arm increased

Peter Rothe wrote: Hi Bianca,

Good to hear the surgery went well. How is the pain level and swelling? I went for another ultrasound yesterday that showed some swelling and thickening of the nerve so I might be a step closer to surgery. 

Hi Peter,

It's been 8 days since the surgery - the first few days the pain was 5/10 at worse but infrequent and swelling 20-30%. Now it's more 3/10 pain when i do the elbow extension/flexion exercises (started on day 3) but it's more uncomfortable than anything else like David mentioned. I stopped taking pain meds a few days ago and only take ibuprofen when I feel need it which has been once in the last couple days.

I had my follow-up appointment yesterday and the dressing/bandage was removed, it's healed very well so far and no longer swelling, now only wearing a compression sleeve. The stitches were latching on to the dressing so sometimes a little painful.

Let me know if I can be of any more help. Happy for you to reach out to me directly if you want further details :)

David Pagel wrote:

After each surgery (unfortunately I’ve had three) there was a decent amount of swelling but there wasn’t much pain. It’s more of an uncomfortable feeling over being painful. I know some people are very against surgeries but after my issues, I wish I got it done sooner. 

ALSO! For anyone who had one done recently. All three times I felt the same symptoms in the healthy arm. For me it seemed to irritate my arm after using it for everything while the other was slung. The pain eventually went away as the use of my healing arm increased

Thanks fo sharing David. I am feeling it in the left arm like you said.

I was wondering how long you wore your sling for and also when did you start physical therapy. My surgeon said I don’t need to see a physical therapist yet until another 6 weeks. I saw a physical therapist before discharge so doing hand open/close, wrist, elbow flexion/extension exercises until then to increase the range of motion.

Bianca Lay wrote:

Thanks fo sharing David. I am feeling it in the left arm like you said.

I was wondering how long you wore your sling for and also when did you start physical therapy. My surgeon said I don’t need to see a physical therapist yet until another 6 weeks. I saw a physical therapist before discharge so doing hand open/close, wrist, elbow flexion/extension exercises until then to increase the range of motion.

I can’t remember how long after surgery I had PT, but it was mainly just range of motion. For my following 2 surgeries I honestly didn’t even go to PT. It was just gently pushing the flex to get more motion and that was it 

Bianca Lay wrote:

Hi Peter,

It's been 8 days since the surgery - the first few days the pain was 5/10 at worse but infrequent and swelling 20-30%. Now it's more 3/10 pain when i do the elbow extension/flexion exercises (started on day 3) but it's more uncomfortable than anything else like David mentioned. I stopped taking pain meds a few days ago and only take ibuprofen when I feel need it which has been once in the last couple days.

I had my follow-up appointment yesterday and the dressing/bandage was removed, it's healed very well so far and no longer swelling, now only wearing a compression sleeve. The stitches were latching on to the dressing so sometimes a little painful.

Let me know if I can be of any more help. Happy for you to reach out to me directly if you want further details :)

Thank you Bianca! 

And good to hear you're doing well :-)

I just had surgery two and a half weeks ago. Relocation of the ulnar nerve and removal of cyst in my wrist one the same arm.

Surgery went well. The facility was super nice and the nurses and doctor great. After surgery I threw up like crazy. It was very painful and I slept on the the couch.

Next day I got a full arm cast. Ouch. Everything was swollen and the cast was terrible but also felt like a secure protection. I had to keep it for 2 weeks. I took a few iboprofen here and there but only two days were bad with shooting pain. My Nerv was not happy for a few days. 

Two days ago it got removed. My elbow is still pretty bad swollen and bruised. The doctor had me move it slightly but I wasn’t that successful. He said it’s normal and I should start moving it in the shower when everything is warm. I got an electric pillow for knees and elbows and started heating it up and moving slightly. My extension is pretty good (almost straight) but I can’t pass 90degrees towards the shoulder. It’s bad pain! And it’s difficult. Every movement required concentration. 

Next week we start PT and I am excited to go there. Everything is healing good and my tingling has gotten much better. I keep you posted a out my progress.

I can say after my second surgery of my right elbow (relocation and moving it into my muscle) I had intense swelling. My arm looked like my thigh! Didn’t have the pain but that all depends on how entrapped and irritated your nerve was before the surgery. It’s just getting used to the new position.  

Bianca Lay wrote:

Thanks fo sharing David. I am feeling it in the left arm like you said.

I was wondering how long you wore your sling for and also when did you start physical therapy. My surgeon said I don’t need to see a physical therapist yet until another 6 weeks. I saw a physical therapist before discharge so doing hand open/close, wrist, elbow flexion/extension exercises until then to increase the range of motion.

Hi Bianca,

How's the arm doing now? I'm scheduled for surgery on June 4th and I'm starting to get a bit nervous and doubting whether I should go through with surgery or not.

Peter

Hi,
I have a subluxing ulnar nerve on my left arm. I’ve had it for a couple years, but until a couple months ago it’s actually started to be a pain. It is an on and off pain usually when I workout is upper body, like push ups and triceps it hurts. It’s looking like I’m going to get the surgery, but my main concern is the recovery time. I’m a swimmer and I really don’t want to miss that much. How long after the surgery can I get back into the pool and swim at my full potential?

Landry Hillwrote: Hi,
I have a subluxing ulnar nerve on my left arm. I’ve had it for a couple years, but until a couple months ago it’s actually started to be a pain. It is an on and off pain usually when I workout is upper body, like push ups and triceps it hurts. It’s looking like I’m going to get the surgery, but my main concern is the recovery time. I’m a swimmer and I really don’t want to miss that much. How long after the surgery can I get back into the pool and swim at my full potential?

My guess would it is going to be more of the scar healing over the mobility that will limit getting back in the pool. I believe I was almost back to full climbing after about a month, but would consider swimming to be much less impactful and strenuous than pulling on crimps. Best thing to do would be to ask your doc what his thoughts are. Every elbow is different but as a whole the procedure is pretty quick recovery.