Pronator Teres Syndrome

• Pronator Teres Syndrome:

  • aka median nerve entrapment
  • the median nerve can become irritated as it passes through the 2 heads of pronator teres
  • typically occurs in the sporting population as a result of forceful pronation e.g. throwing/racket sports
• Pronator Teres Syndrome / Median Nerve Entrapment:

  • what
  • irritation/compression of the median nerve
  • where
  • where the median nerve passes between the 2 heads of pronator teres
  • how
  • overactivity/hypertrophy of pronator teres
  • forceful/repetitive pronation
  • who
  • athletic population - especially throwing/racket sports
• Pronator Teres Syndrome / Median Nerve Entrapment - Subjective Features:

  • diffuse elbow pain radiating into the forearm
  • carpal tunnel syndrome like symptoms into the hand
  • neuro deficit in median nerve distribution
  • paraesthesia/anaesthesia
  • motor weakness of digit and wrist flexion / forearm pronation
• Pronator Teres Syndrome / Median Nerve Entrapment - Objective Features:

  • upper limb neurological examination
  • motor weakness - wrist and digit flexion / pronation
  • sensory deficit of palmar surface 1st 3 and half digits and the thenar eminence
  • neural provocation testing
  • upper limb neural provocation test 1 (median nerve)
  • clearing tests
  • must clear cervical spine and shoulder
• Pronator Teres Syndrome / Median Nerve Entrapment - Management:

  • education
  • activity modification
  • soft tissue therapy to pronator teres
  • neural tissue mobilisations
  • address muscle strength deficits/functional weakness
  • surgical decompression