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Guyon’s canal syndrome and its Physiotherapy Management

What is Guyon’s canal syndrome?

Guyon’s canal syndrome affects the wrist. The Ulnar nerve is entrapped at the wrist in the Guyon’s canal (ulnar canal) as a result of repetitive compression, prolonged wrist flexion, trauma, swelling, fractures, and vascular pathologies caused by direct pressure on a bike or cycle handlebar, weight lifting, excessive gripping, twisting, or repetitive wrist & hand movement. Guyon’s canal syndrome can affect high-performance athletes like professional cyclists/cricketers/golfers/weight lifters.

When a golfer’s club strikes the ground instead of the golf ball, or when a cricket player’s bat hits the ground, the hamate bone in the wrist might fracture. A broken hamate bone can also compress the nerve inside Guyon’s canal.

Symptoms are:

  • tingling/numbness/ in the fingers 4 & 5, weak grip strength, pain, and sensitivity on the ulnar side (inner) of the forearm, wrist & hand muscle atrophy, clawing of digits 4 & 5.

Physical Therapy Management of Guyon’s canal syndrome?

  • Latest technology used for pain management- shock wave therapy, Tacar therapy, High-intensity laser therapy, combo therapy, etc.
  • Other tools used are- Kinesio taping, and Dry needling.
  • Instrument-assisted Forearm release technique.
  • Wrist flexor massage- Place a massage ball on a sore point on your forearm with your elbow bent and palm facing up. Flex your wrist up and compress the ball before gently extending your wrist down. This may also be done with a straight arm.
  • Ulnar Nerve Flossing.
  • Ulnar nerve gliding- two times/day and hold for 30 seconds for 3 repetitions with a one-minute break in between each repetition.
  • Tendon gliding.
  • Strengthening the grip and wrist muscles.
  • Wrist muscles strengthening-
    • Wrist extension with the dumbbell in hand and elbow bent and supported over the table.
    • Forearm pronation & supination with dumbbell & elbow bend & supported.
    • Tyler twist with a Rubber bar (flex bar).
    • Eccentric wrist extension and flexion.
  • Wrist splints: Splints protect the wrist from bending and retain it in a neutral posture. Use them when sleeping.
  • Kinesio taping applied by a physiotherapist may support your wrist.

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