Exercises to Relieve Pronator Syndrome Pain

Pronator syndrome occurs when the median nerve becomes compressed where it passes through the elbow. The entrapped nerve becomes swollen and inflamed. Patients typically experience an aching pain along the forearm and may have tingling and weakness in the thumb and index finger. Pronator syndrome may also cause numbness in the hand.

Individuals who have diabetes or hypothyroidism have a higher risk of developing pronator syndrome. You may also develop this condition as the result of repetitive pronation, where you turn the palm to face the floor, while the fingers are flexed around an object. The following exercises target the nerves and muscles associated with this issue to help relieve pain and increase strength and mobility.

Pronator Teres Stretch

Stretching the pronator teres in the forearm will help lengthen this muscle and prevent muscle tightness associated with pronator syndrome. There are a few ways that you can focus on this muscle.

If you have a circular 5 kg to 10 kg weight, you can use this to stretch the pronator teres. Extend your hand in front of you with the elbow bent at a 90-degree angle. Set the weight on your upturned palm so that most of the weight sits on the thumb side. This stretches the forearm gently with a particular focus on the short ulnar head of the pronator teres. Hold this stretch for 30 seconds. Take a short break, and repeat the process five times.

You can also stretch the pronator teres with nothing more than a door frame. Stand with your back to the doorframe and extend your arm behind you at about a 75-degree angle, so your hand extends out from the point midway between your hip and shoulder. Grasp the doorframe with your thumb pointing down. Roll your bicep upward, so you’re stretching your elbow and forearm. Hold this position for 10 to 30 seconds.

Flexor Stretch

Extend your arm in front of you with the elbow straight and the palm facing outward, as though you’re signaling for someone to stop. Rotate the arm from this position so that the fingers are facing downward. Take the opposite hand and use it to gently pull your fingers backward, toward your body. Hold this stretch for 20 to 30 seconds. This will help stretch the flexors, addressing muscle tightness in this part of the arm.

Nerve Flossing

Nerve flossing, also known as neural glides or nerve gliding, helps the nerves to move smoothly and freely within the arm. To perform a median nerve glide:

• Extend your arm away from your body. Bend the elbow at a 90-degree angle with your forearm extended upward. Form a fist with your hand.
• Extend your fingers, so they’re pointing straight upward, and extend your thumb so that it’s pointing inward toward your head.
• With your fingers straight, bend the hand back as though you’re holding a tray.
• Rotate your hand and forearm so that your fingers are facing forward.
• Straighten your arm, lowering it gradually and extending it in front of you, as though you’re setting a tray down.

Repeat this motion smoothly four or five times. Do not overexert yourself with this motion if it’s too painful.

Standing Palm Press

Stand an arm’s length away from the wall with your feet spread slightly apart. Extend your arm at a 90-degree angle from your body. Press your hand into the wall with your palm flat and your fingers pointed upward. Keep your shoulders back and hold the stretch for five deep breaths.

Rotate your arm, so the fingers point downward. Keep your shoulders flat. Hold this stretch for another five deep breaths. If you can do so comfortably, you may increase this stretch by tilting your head away from the extended arm. This exercise stretches the muscles and nerves through the forearm.

Supinator Strength Training

The supinator is a muscle on the inner part of the forearm near the elbow. You can strengthen this muscle and help relieve pronator syndrome pain with this exercise.

• Hold a hammer in the affected hand, and extend your arm away from your body.
• Drop the head of the hammer to the side so that your forearm twists slightly and your knuckles face down.
• Return the hammer to the vertical position.

Repeat this motion 15 times.

Standing Curl and Press

With two weights, you can gently exercise the muscles in your shoulders, arms, and hands. This brief exercise will help increase strength and mobility.

• Stand with your legs shoulder-width apart.
• Hold a small dumbbell in each of your hands.
• Turn the hands, so they’re facing your legs.
• Curl your arms up to your shoulders.
• Rotate your hands, so they’re facing the shoulders.
• Extend your arms upward, and press the weights over your head.
• Rotate your hands again so that they’re facing inward toward each other. Hold this position for a moment.
• Lower the weights to the shoulders, then back to your sides in the starting position.

Repeat this exercise 10 times per session.

Myofascial Release

Myofascial release exercises help release tightness, tension, and sensitivity in the myofascial tissues. To address the tissues surrounding the pronator teres muscles, extend your arm slightly, keeping the elbow bent and the palm facing upward. Place your thumb near the elbow on the inside of the forearm. Keeping your thumb in place, rotate the arm, so your palm faces downward. Feel for the pronator teres muscle that’s activated by this movement. This spot will feel tender.

Once you’ve located the sore spot in this area, press down with your thumb for five seconds. Stop if you trigger tingling or numbness. Maintaining pressure on this spot, rotate the forearm so that you’re turning your palm upward and downward 10 times. Move your thumb further up the forearm to locate other tender spots along this muscle, and repeat the exercise.

If you’re experiencing severe pronator syndrome pain, speak with a doctor about these and other exercises that may help. Contact our team at The Hand and Wrist Institute in Dallas, Texas, to discuss both non-surgical and surgical interventions that can help relieve your discomfort and effectively treat pronator syndrome.

Image by Jossuha Théophile is licensed with Unsplash License

Dr. John Knight

Dr. Knight is a renowned hand, wrist and upper extremity surgeon with over 25 years of experience. Dr. Knight is a Board Certified Orthopedic Surgeon and Fellowship trained. Dr Knight has appeared on CNN, The Doctors TV, Good Morning America, The Wall Street Journal, The Washington Post, Forbes, The Huffington Post, Entrepreneur, Oxygen network and more.