Ulnar Nerve Transposition Protocol
Dr. David Lintner
Matt Holland, PT, SCS, CSCS
This protocol is for patients who have undergone ulnar nerve transposition (UNT). The goal of the surgery is to alleviate ulnar nerve symptoms (pain in distribution of the nerve, numbness, tingling, nerve subluxation, and weakness) as well as return the athlete to prior level of function. The patient will wear a splint for the 1st week following surgery and then will wear a hinged brace for the next 2 weeks. For the first 2 weeks the elbow will not be allowed to straighten past 20 degrees in order to maintain the new position of the ulnar nerve. Full range of motion is expected at 3 weeks post op. For throwers the expected timeline to return to playing light catch is 6 weeks following surgery.
**Residual numbness and tingling and/or weakness may lead physician to modify the progression through the rehab protocol.
** If patient had UCL reconstruction in addition to UNT, follow UCL reconstruction protocol.
Week 1-2 Post Op
-Block Extension past 20 degrees (0 deg is straight), Flexion to patients tolerance
-Patient may begin light rotator cuff exercises including: IR/ER with theraband,
-Standing flexion/scaption (maintain 20 degrees elbow extension), scapular exercises and postural education
-Light forearm isometrics for wrist flexion and extension
-Active wrist/finger exercises
-Light gripping exercises
Week 3-4 Post Op
-Full elbow extension expected at week 3
-Progression of rotator cuff and scapular strengthening program
-Resisted forearm and wrist strengthening
-Light biceps and triceps strengthening
-Closed Chain shoulder strengthening with DS2 Platform
-Throwers begin scapular posture training ( prone T, W, V exercises, standing scapular posing, etc)
Week 5-6 Post Op
-Progressive resistive exercises including bicep, tricep, deltoid, trap, pectoralis to restore normal strength
-Following week 6 athlete may begin interval throwing/hitting program if strength, ROM, and healing allow. (Begin only after cleared by Dr. Lintner)