More Than Just Another Elbow Tendinopathy: A Case Series of Misdiagnosed Ulnar Nerve Compression and Review of Common Upper Extremity Misdiagnoses in Climbing

Abstract

Climbing is an increasingly popular sport. Yet, we have encountered numerous misdiagnosed climbing injuries, highlighting a gap in climbing-related literature and a need for heightened awareness within the sports medicine community. We present a case series that highlights the clinical manifestation of ulnar nerve entrapment and compression in three patients with initially misdiagnosed and mismanaged elbow tendinopathy. After a correct diagnosis of ulnar nerve pathology was made, each patient underwent a prescribed rehabilitation protocol that focused on nerve motility exercises (tensioning and flossing), resulting in a significant reduction in pain and a successful return to their pre-injury climbing performance. We thus aim to raise awareness of this often-mistreated presentation. Furthermore, we highlight other common upper extremity climbing misdiagnoses and provide relevant clinical recommendations to accurately identify and manage such injuries in climbers.