Expert: Dr. Victor Dolan, DC, DACBSP - 4/21/2008

Question
QUESTION:  MY RIGHT ELBOW CLICKS AT AROUND 90 DEGREES. IT BEEN SAID THAT MY ULNAR NERVE SUBLUXATES FOR WHATEVER REASON. SOME SUSPECT ITS DUE TO MCL LAXITY OR BROKEN BANDS OR SHALLOW CUBITAL TUNNEL. WHAT CAN WE DO? oh and i am 17 years old, male.

ANSWER: Hello Sam.  Sorry to hear of any health problem in anyone, particularly a young man of 17.

First of all, how debilitating is this?  We all have clicks, pops, slips, etc in our bodies.  We all have peculiarities ('abnormalities'); some we can live with, some we can't.  Some need a vitamin, some need a therapy, some >pops<  need surgery.  If you are asking, this must be troublesome to you.

Nerves, tendons, muscles, long body parts,  often run through tunnels or canals.  Sometimes the tunnels are too tight or the canals to shallow.  When that happens a nerve or tendon can slip out of place and 'subluxate'.  Often these tendons or nerves are held in place by ligaments.  When these nerves or tendons 'subluxate' they stretch the protective, guiding ligaments.

This may be a particular problem idiosyncratic to you.  This may have happened no matter what you do, or what you do not do. This may be something that you did not 'help along' by doing some activity- ie sports.  If you know what causes this to happen, perhaps you can 'heal' this problem through the 'PRICE' method. Protect, Rest, Ice, Compression, Elevation can work wonders IF you are patient, and IF you do not re-injure (re-subluxate) the nerve.

Perhaps a Doctor of Chiropractic (one with a sports injury practice, or an orthopedic chiropractic practice: DACBSP or DACBO chiropractors), Physical Therapist, or Physiatrist MD could be of help.

Depending upon the severity of the injury, the chronicity of injury, you may need surgery.  If this has been going on a long time, or happens ALL the time- regardless of the movement you make, then surgery may be the only answer.  If this is recent, only happens on certain movements, then perhaps conservative approaches could help.

Depending upon severity, a DC, PT, or perhaps an MD could palpate and assure the nerve is in the proper groove.  If not, perhaps a gentle movement or manipulation could place the nerve in the correct sulcus, the correct groove.  Once in place, it has to be held there, Taping or bracing (to P protect and C Compress the area), rest (R), ice (I) the area.  This could be successful, but would take time, patience and discipline on your part.

If this is troublesome enough, however, then surgery would be the alternative.  Probably an orthopedic surgeon would be the doctor of choice.  Orthopedic doctors often specialize, whether it be hand/ foot/ shoulder/ knee/ elbow/ hip.  Look for an Ortho that specializes in the elbow if possible.

Whether you go the conservative or surgical approach, the nerve slips and causes you pain/ dysfunction and damages a ligament in so doing.
You should take some nerve and ligament supporting nutrients to help you heal.  Vitamin C, calcium, magnesium, glucosamine, chondroitin,  B complex are among the nutrients you should consider.

My home computer is down, sorry it took a while for me to get to the computer and answer you.  As always; this article is for discussion purposes, general information and education. Proper evaluation and treatment must be performed by the treating health professional.

Thanks for the question, good luck, and wishing you good health naturally,

Victor Dolan, DC, DACBSP
http://www.DocDolan.net
http://www.GoodHealthNaturally.info









---------- FOLLOW-UP ----------

QUESTION: THANKS FOR THAT. FIRSTLY ITS NOT A SOUND. IT FEELS LIKE A CLICK, SNAP OR POP. SOMETHING MOVES UNDER THE SKIN. I CAN FEEL IT. IT DOESNT HAPPEN IN MY NON DOMINANT HAND. I HAVE HAD THIS FOR THE LAST FEW YEARS BUT NOW IT HAS GOTTEN SLIGHTLY WORSE. I LIVE IN THE MALDIVES. WE DONT HAVE CHIROS HERE AND THE 3 ORTHO DOCS HERE ARENT OF MUCH USE EITHER AS THEY R DEAD AGAINST SURGERY AS THEY PROBABLY DONT KNOW HOW TO OPERATE AND BECAUSE I DONT SHOW ANY SYMPTONS OF ULNAR NERVE PROBLEMS, YET. COULD BUILDING UP THE MUSCLES OF THE FOREARM, BICEPS AND TRICEPS HELP? WHAT SHOULD I DO?

Answer
Hello again Sam, thanks for more info.

Well, if the orthos do not want to operate, perhaps they can recommend a physical therapist to help.

The ortho or PT could palpate, make sure the nerve is in the proper placement, and then, as we discussed- PRICE.  Protect it with a brace or taping, rest it to let it 'settle', ice it to combat inflammation- and also tighten the tissue and let it 'settle', compress it with that brace or tape, and let's skip the elevation.

If you are going to work out for this problem, you want to work out in a way to improve this problem, rather then aggravate the problem.

You want to stop the slipping, click.  Just working out will not stop that.  Re-placement in the proper position, support in the proper position, and then training to hold it in place would be good.  Since there are no DC's available, then certainly a PT to help you along this path.

And the vitamin supplements would be helpful, along with the above treatment.

Thanks again, good luck,

wishing you Good Health- Naturally,

Vic Dolan, DC
http://www.DocDolan.net