The cubital tunnel is located in the elbow and is a 4-millimeter passageway between the bones and tissue.

It encases the ulnar nerve, one of the nerves that supplies feeling and movement to the arm and hand. The ulnar nerve runs from the neck to the shoulder, down the back of the arm, around the inside of the elbow and ends at the hand in the fourth and fifth fingers. Due to the narrow opening of the cubital tunnel, it can be easily injured or compressed through repetitive activities or trauma.

According the Postgraduate Medical Journal, cubital tunnel syndrome is the second most common peripheral nerve entrapment syndrome next to carpal tunnel. It can cause symptoms in the arm and hand including pain, numbness, and muscle weakness, particularly in the areas controlled by the ulnar nerve like the ring and pinky finger.

Causes of compression include daily habits like leaning on your elbows for long periods of time, sleeping with your arms bent, or repetitive movement of the arm. Direct trauma to the inside of the elbow, like when you hit your funny bone, can also cause symptoms of ulnar nerve pain.

Conservative treatments to reduce pain include use of nonsteroidal anti-inflammatory medications (NSAIDs) like ibuprofen, heat and ice, bracing and splinting, and other physical therapy modalities like ultrasound and electrical stimulation.

Certain exercises like nerve gliding exercises for the arm and hand can also help decrease pain associated with cubital tunnel syndrome.

Purpose of Nerve Gliding Exercises

Inflammation or adhesions anywhere along the ulnar nerve path can cause the nerve to have limited mobility and essentially get stuck in one place.

These exercises help stretch the ulnar nerve and encourage movement through the cubital tunnel.

1. Elbow Flexion and Wrist Extension

Equipment needed: none

Nerve targeted: ulnar nerve

  1. Sit tall and reach the affected arm out to the side, level with your shoulder, with the hand facing the floor.
  2. Flex your hand and pull your fingers up toward the ceiling.
  3. Bend your arm and bring your hand toward your shoulders.
  4. Repeat slowly 5 times.

2. Head Tilt

Equipment needed: none

Nerve targeted: ulnar nerve

  1. Sit tall and reach the affected arm out to the side with elbow straight and arm level with your shoulder.
  2. Turn your hand up toward the ceiling.
  3. Tilt your head away from your hand until you feel a stretch.
  4. To increase the stretch, extend your fingers toward the floor.
  5. Return to starting position and repeat slowly 5 times.

3. Arm Flexion in Front of Body

Equipment needed: none

Nerve targeted: ulnar nerve

  1. Sit tall and reach the affected arm straight out in front of you with your elbow straight and arm level with your shoulder.
  2. Extend your hand away from you, pointing your fingers toward the ground.
  3. Bend your elbow and bring your wrist toward your face.
  4. Repeat slowly 5-10 times.

4. A-OK

Equipment needed: none

Nerve targeted: ulnar nerve

  1. Sit tall and reach the affected arm out to the side, with elbow straight and arm level with your shoulder.
  2. Turn your hand up toward the ceiling.
  3. Touch your thumb to your first finger to make the “OK” sign.
  4. Bend your elbow and bring your hand toward your face, wrapping your fingers around your ear and jaw, placing your thumb and first finger over your eye like a mask.
  5. Hold for 3 seconds, then return to starting position and repeat 5 times.

Warnings

Always consult your doctor before beginning a new exercise program. If these activities cause an intense shooting pain, stop immediately and discuss with your doctor.

These exercises may cause a temporary tingling or numbness in the arm or hand. If this feeling persists after rest, discontinue and seek help. In some cases, cubital tunnel syndrome is not alleviated by conservative measures and surgery may be required.

Takeaway

Nerve gliding exercises may help decrease pain associated with cubital tunnel syndrome. Repeat these exercises once a day, three to five times per week, or as tolerated.

A 2008 study looked at the efficacy of neural mobilization in randomized controlled trials and found that eight out of the 11 studies reviewed reported a positive benefit. Although promising, no final conclusions were made to support its use, due to the lack of quality and quantity available research at this time.