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 had a very similar experience to you David where the opposite arm also gets very irritated in the ulnar distribution after surgery.  Were you saying that the best thing to do is wait it out and not get surgery on the opposite arm because it will calm down over time?

Yes, I was under pressure of insurance rolling over and the surgery was basically free to get my left done. My left showed no symptoms what so ever until I had my right in the sling for 2-3 weeks. In a panic I had the left done as well. I had outside influence that caused my right arm to need a second surgery but in doing so. My already fixed left arm once again exhibited ulnar nerve pain. Basically toughed it out and by the time my right was in use again my left calmed down. 

For the people affected by this, do you know the cause?

Wishing you all speedy and full recoveries.

Eric Metzgarwrote:

For the people affected by this, do you know the cause?

Wishing you all speedy and full recoveries.

Cause of cubital tunnel syndrome? Many factors go into your ulnar nerve being entrapped. My case it was a combination of unlucky anatomy and stress of climbing too difficult too quickly without building up supporting muscles. Others it can be from blunt trauma, an accident or breaking of an arm or elbow. There are lots of factors that go into irritating or entrapped nerves. 

Hey! I just have a few recovery questions for whoever has had a subcutaneous anterior transposition. I had decompression surgery in May but ended up with instability and my nerve was subluxing, so I just had a revision 2 weeks ago to transpose the nerve. How long did it take to get ROM back? It’s been 2 weeks sinceI had surgery and I can only bend it to 90 degrees. Aside from the pain, I also have extreme sensitivity to touch and cold right now along the new nerve path. Did anyone experience that after and did it resolve in time? Lastly, I have numbness in my elbow to the touch. Did your feeling ever fully come back? Thanks! Appreciate the insight!

Ashley Jwrote:

Hey! I just have a few recovery questions for whoever has had a subcutaneous anterior transposition. I had decompression surgery in May but ended up with instability and my nerve was subluxing, so I just had a revision 2 weeks ago to transpose the nerve. How long did it take to get ROM back? It’s been 2 weeks sinceI had surgery and I can only bend it to 90 degrees. Aside from the pain, I also have extreme sensitivity to touch and cold right now along the new nerve path. Did anyone experience that after and did it resolve in time? Lastly, I have numbness in my elbow to the touch. Did your feeling ever fully come back? Thanks! Appreciate the insight!

ROM for me took around a month after a revision. Can’t say I had sensitivities along the new nerve path but I know nerves can be super sensitive after moves and can take overstimulation to get it back to normal. Means running a cloth, ruff material, ect to get the nerve to settle back down (Based on personal experience, I’m not a medics professional).

I am 2 years out now and the numbness on my elbow has somewhat come back but very very slowly. I still have spots around the scar that don’t have much feeling. It just is what it is and doesn’t hurt, just can feel odd when on arm rests and what not 

David Pagelwrote:

ROM for me took around a month after a revision. Can’t say I had sensitivities along the new nerve path but I know nerves can be super sensitive after moves and can take overstimulation to get it back to normal. Means running a cloth, ruff material, ect to get the nerve to settle back down (Based on personal experience, I’m not a medics professional).

I am 2 years out now and the numbness on my elbow has somewhat come back but very very slowly. I still have spots around the scar that don’t have much feeling. It just is what it is and doesn’t hurt, just can feel odd when on arm rests and what not 

Thanks for the reply! A little unnerving (ha!) to know you didn’t have pain. My pain runs all down the nerve to my wrist. My ROM also has a ways to go still at 4 weeks out. Hopefully my nerve just needs more time to settle down. Anyone else have experience with pain following transposition?

I definitely had increased ulnar nerve pain after my revision submuscular transposition.  Very sensitive all the way down to my fingers.  It took a long time to get better and for awhile any type of significant activity would exacerbate it.  Had to take gabapentin to calm it down.  Eventually got better but took a year.  I guess that is just me. 

Bob Walidawrote:

I definitely had increased ulnar nerve pain after my revision submuscular transposition.  Very sensitive all the way down to my fingers.  It took a long time to get better and for awhile any type of significant activity would exacerbate it.  Had to take gabapentin to calm it down.  Eventually got better but took a year.  I guess that is just me. 

Thanks - this helps make me feel more hopeful that it’ll eventually calm down! I thinkMine will take a long time too. I’ve actually been on Lyrica for 10 months already but want to come off of it. The pain isn’t constant though, so that’s a good sign! Thanks again!

Ashley- Definitely have alot of hope.  I am in the same boat as you. I had a decompression surgery in December 2018. It didn't work so I had a transposition December 2019. Just within the last 1-2 months it started getting better.  The lesson I have learned is to actively think through that balance of not irritating the nerve so it can heal with keeping active enough to tell the nerve it is going to be used.

I had the same issue in the other arm with just a decompression in late 2017. That took a full two years for that nerve pain to recover. I thought it never would.  I am a cardiologist and I can tell you that no two hearts are the same and heal at different rates (figuratively and literally).

Some people are just slow healers and I guess we just have to be patient and keep thinking positive:)

Bob Walidawrote:

Ashley- Definitely have alot of hope.  I am in the same boat as you. I had a decompression surgery in December 2018. It didn't work so I had a transposition December 2019. Just within the last 1-2 months it started getting better.  The lesson I have learned is to actively think through that balance of not irritating the nerve so it can heal with keeping active enough to tell the nerve it is going to be used.

I had the same issue in the other arm with just a decompression in late 2017. That took a full two years for that nerve pain to recover. I thought it never would.  I am a cardiologist and I can tell you that no two hearts are the same and heal at different rates (figuratively and literally).

Some people are just slow healers and I guess we just have to be patient and keep thinking positive:)

I cannot thank you enough for this reply! I was told that it can take up to a year to fully heal and for the pain to completely to subside, but then I keep reading and hearing about people being able to bend their elbow within weeks of surgery and getting back to being physically active 6 to 8 weeks after surgery. I can tell you right now, with the way I am healing, that is going to be far from my situation. Again, thank you so much for replying! I will just focus on being patient for now and celebrate the little wins. Happy to hear that it has finally settled down for you :)

I had my subcutaneous transposition surgery a week ago, tomorrow.  I've decided to post some videos of my post-op experiences as the weeks/months progress, and here's the first video:

https://youtu.be/Xgcm9N2F99Q

I'm sorry the sound isn't good, and I'll have that remedied for subsequent vids.  I also didn't feel too well and hadn't slept much, here.  

I just got back from my follow-up and will post another video, tomorrow.....take care, all.

Hi everyone, I had a submuscular transposition done 3 months ago. I've only just started getting back into climbing within the last 2-3 weeks. Does anyone find that hand cracks irritate the nerve more so than other types of climbing? Maybe I'm rushing into things to quickly. I'm generally climbing 5.9 and under and only a handful of pitches. Also, my operated arm feels really clunky, it clicks and cracks a fair bit. Im hoping this will resolve (and hopefully not cause any future problems) as I continue to stretch the nerve and muscles over time. What are other peoples experience with this?

thanks guys 

Jay bwrote:

Hi everyone, I had a submuscular transposition done 3 months ago. I've only just started getting back into climbing within the last 2-3 weeks. Does anyone find that hand cracks irritate the nerve more so than other types of climbing? Maybe I'm rushing into things to quickly. I'm generally climbing 5.9 and under and only a handful of pitches. Also, my operated arm feels really clunky, it clicks and cracks a fair bit. Im hoping this will resolve (and hopefully not cause any future problems) as I continue to stretch the nerve and muscles over time. What are other peoples experience with this?

thanks guys 

I'd give it more time if I were you before starting to climb again if it's bothersome at all. I had mine done (subcutaneous) 3 months ago as well and while my surgeon said I can start to use my arm again more, he advised against anything requiring heavy pulling, pushing, or body resistance. He said the nerve needs time to settle into it's new home. I'm seeing a physiotherapist who specializes in arms and hands and he has me doing very light physio work and also advised against anything strenuous for the time being. I'd maybe try that - see a physio who has experience with this specific rehab and see what she/he says about what you should and should not be doing for it right now. I feel as though giving your nerve time to heal and feel better is definitely the priority.

Ashley Jwrote:

I'd give it more time if I were you before starting to climb again if it's bothersome at all. I had mine done (subcutaneous) 3 months ago as well and while my surgeon said I can start to use my arm again more, he advised against anything requiring heavy pulling, pushing, or body resistance. He said the nerve needs time to settle into it's new home. I'm seeing a physiotherapist who specializes in arms and hands and he has me doing very light physio work and also advised against anything strenuous for the time being. I'd maybe try that - see a physio who has experience with this specific rehab and see what she/he says about what you should and should not be doing for it right now. I feel as though giving your nerve time to heal and feel better is definitely the priority.

Yeah sure, thanks Ashley I think you're right. I need to definitely scale it back a bit. I hope your recovery is going well. 

This past Tuesday was 12 weeks out from surgery, and it's a mixed bag for me.  I'm doing my absolute best to try and embrace that it takes a much longer time for this to heal than the in-situ release I had done years ago, but I continually get frustrated.  Part of me wishes I had left it alone and accepted *good enough*.  

I'm a thin guy, and I'm still wondering if subcutaneous transposition was the best path for me.  My doctor and his PA insisted they had dealt with thinner folks who had no problems with sensitively/etc., but when I look down and see the bulge of that nerve on the inside of my elbow, it's always a bit disconcerting; I always have a slight anxiety about bumping it.  It absolutely affects me when I'm finding a comfortable sitting/laying position on the couch/bed.  

I have essentially all of my ROM back, but I still can't do much of anything that requires real effort.  That gray line of not-too-much and enough-to-keep-the-nerve-active is so fuzzy.  Hearing that some of you are climbing after two or three months just blows my mind based on what I'm feeling, though I'm obviously happy for all of you. (I'm just extremely jealous)

I went to a physical therapist that was nearby and had a good reputation, but the activities during each hour were strangely unassociated with the elbow for much of it.  I understand that the shoulder needs to be worked since it hasn't had to do much in months, but almost nothing was done in each session for strengthening the elbow and surrounding area.  I'm switching therapists and have my first appointment, next week.

Ashley, it looks like you and I had our surgeries done around the same time, so I'll be keeping up with your progress.  For those of you who had the subcutaneous version of this surgery, how were things for you at three months?  My elbow (olecranon area) is still slightly swollen, which I'm told does stick around for months.  Oh, and the hand weakness is *real*.  After very light drumming motions with a stick, I'm quite sore.  

Anyway, Happy New (ulnar) Year to all of you!

Sorry to hear of some difficult recoveries. Last weekend was my 6 week post-op on ulnar nerve transposition and carpal tunnel surgery and I was able to climb some steep 5.9 sport. Still have much less hand/arm strength but that should come pretty quick. The only thing holding me back now is safety - not really sure how much and how long I can hold on - and a lot of scar sensitivity from the CTS. Not nearly as bad as my bunionectomy, I couldn't put rock shoes on for 6 months

Here’s my experience so far with ulnar nerve and carpal tunnel issues: I have gone to a surgeon for bilateral ulnar nerve inflammation and beginning bilateral nerve damage from carpal tunnel, and he was pretty bad. He scheduled a subcutaneous so I mentioned that I’ve heard submuscular is better for climbers and then he just said “you’re probably right. You also don’t have any subcutaneous fat. We’ll do submuscular.” I decided he wasn’t conscientious enough to do it right. He was also very wrong about the carpal tunnel surgery and I’m glad I didn’t let him do it. He scheduled the regular carpal tunnel release in which they sever the ligament above the nerve. He reassured me there would be no loss in hand strength from that. However, after reading a lot of studies at home, I found out that there is indeed permanent hand strength loss after carpal tunnel release compared to a healthy hand (just not compared to a highly nerve damaged hand right before surgery). Turns out there are multiple different proven techniques for repairing the ligament so your muscles do not shorten. The ligament is also important in carpal bone stability and is one of the pulleys for your finger tendons. I highly recommend anyone with carpal tunnel look into that before agreeing to the regular surgery. I ended up deciding to look for a plastic surgeon who did a hand fellowship who could do the ligament reconstruction and would actually know the research. All the while I was keeping my elbows straight at night, and stopped exercising my wrists like I had been. The hand pain went away, so I never got any surgeries. I still have the ulnar nerve issues, but so far keeping my elbow straight at night has stopped any worsening. My issue has not to do with inflammation, but my nerves snapping over my elbow bone every time I bend it. It’s audible when I do a push-up. I still presumably have the wrist nerve damage too, but I haven’t had pain again. I should probably still have it tested again to make sure it’s not progressing. I don’t have carpal tunnel braces, so I need to get some. I really hate the idea of getting the ulnar nerve surgeries, cause I’ve already been off climbing more than a year due to breaking my foot and having surgeries. I don’t want another really long recovery, arm scar tissue, and loss of function, but I probably will have to get it sometime. Just sharing in case my story with my doctor could be helpful to someone, and cause I’m gonna be dealing with this issue.
TLDR: Do your own research using published  papers online, not websites. If you’re skinny, subcutaneous may not be best. If you’re getting carpal tunnel surgery, find someone who will reconstruct the ligament because you will lose pinch strength & wrist stability otherwise.

Also, forgot to mention, I know this isn’t what this thread is about but if you have beginning carpal tunnel and not too bad nerve damage yet, you can try other things like platelet injections and active release therapy (by someone really trained and licensed, not ur average pt) to break up the scar tissue causing pressure on the nerve. Basically, if you’re getting the ulnar nerve surgery, don’t just throw in carpal tunnel surgery cause your doctor suggested it, especially if it’s a mild case.

Burrishwrote:

This past Tuesday was 12 weeks out from surgery, and it's a mixed bag for me.  I'm doing my absolute best to try and embrace that it takes a much longer time for this to heal than the in-situ release I had done years ago, but I continually get frustrated.  Part of me wishes I had left it alone and accepted *good enough*.  

I'm a thin guy, and I'm still wondering if subcutaneous transposition was the best path for me.  My doctor and his PA insisted they had dealt with thinner folks who had no problems with sensitively/etc., but when I look down and see the bulge of that nerve on the inside of my elbow, it's always a bit disconcerting; I always have a slight anxiety about bumping it.  It absolutely affects me when I'm finding a comfortable sitting/laying position on the couch/bed.  

I have essentially all of my ROM back, but I still can't do much of anything that requires real effort.  That gray line of not-too-much and enough-to-keep-the-nerve-active is so fuzzy.  Hearing that some of you are climbing after two or three months just blows my mind based on what I'm feeling, though I'm obviously happy for all of you. (I'm just extremely jealous)

I went to a physical therapist that was nearby and had a good reputation, but the activities during each hour were strangely unassociated with the elbow for much of it.  I understand that the shoulder needs to be worked since it hasn't had to do much in months, but almost nothing was done in each session for strengthening the elbow and surrounding area.  I'm switching therapists and have my first appointment, next week.

Ashley, it looks like you and I had our surgeries done around the same time, so I'll be keeping up with your progress.  For those of you who had the subcutaneous version of this surgery, how were things for you at three months?  My elbow (olecranon area) is still slightly swollen, which I'm told does stick around for months.  Oh, and the hand weakness is *real*.  After very light drumming motions with a stick, I'm quite sore.  

Anyway, Happy New (ulnar) Year to all of you!

    

Try not to get discouraged. I'm also a thin person and am noticing changes slowly, but just remember that this is short term pain for long term gain. Just think about how great it'll be when this fully heals. I could not have dealt with "good enough" for the rest of my life after in-situ! When you say "bulge" are you referring to the inflammation? I'm 4 weeks ahead of you and I still have visible inflammation, which I was told will likely hang around for 6 months or so and just to be patient and work on draining it.  I also have sensitivity still but again, it can take up to a year to settle down so I'm just trusting the process and each month the sensitivity does improve. I was told to use different materials and temperatures to help desensitize the area. 

I think that healing at this rate is more common than being able to climb 6 or 8 weeks post-op. I was told not to do anything like that until a minimum of 3 months after and even then, I was told to take it easy. Even at 4 months post op, there's no way I would climb  right now because my body needs more time. Just have to be patient!

My PT does a lot of work on the shoulder and neck while giving me exercises for my elbow and arm strength. I also had pretty bad muscle wasting in my hand (and arm in general), so he had me order this hand putty and instructed me to use it for a minute at a time a few times a day until I build strength up and then I can use it for slightly longer each time. It has been a game changer and my hand muscles have improved significantly! I highly recommend it. Play with it like you would a stress ball in the palm of you hand and also squish it around with just your fingertips. Make sure you order "soft" as there are different consistencies. It might feel too hard at first but it softens up with the oils on your skin the more you use it. Also, only use a small piece each time and don't overdo it. Start easy I hope this helps!