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Jessica Hammock - Cubital Tunnel Syndrome
Jessica Hammack was thrilled when she was recruited to play softball for Parkland College in Champaign, IL. The 20-year-old had played softball throughout high school and was ready to step up her game at the college level while pursuing her dream of obtaining an associate’s degree in early childhood education.
“I had a lot more softball practices in college than in high school,” she recalls. “Practices were every day and my hand and arm started to feel numb. At times, I could actually feel a snapping sensation in my elbow along my ulnar nerve.”
She tried to shake it off and continue to play softball, but when the pain increased and her hand went ice cold to the touch, she took action. Sent by her team to a local physician, Hammack was diagnosed with cubital tunnel syndrome, a nerve compression condition impacting the tube where the ulnar nerve travels to and over the elbow.
Upon her doctor’s recommendation, Hammack underwent a procedure called subcutaneous transposition, which released the pressure on the ulnar nerve by moving it out of the cubital tunnel. Told she might be back playing softball by summer, Hammack was disappointed when relief never came despite extensive rest and rehabilitation.
Eager for a second opinion, Hammack came to Washington University Orthopedics and Barnes-Jewish Hospital and met with orthopedic surgeon Christopher Dy, MD, MPH. Dy specializes in nerve conditions and injuries in the hand, arm and brachial plexus. He scheduled Hammack for a nerve conduction test and electromyogram (EMG), which together measure how well specific nerves can send electrical signals to the muscles. The test confirmed what Hammack suspected — the first surgery had minimal effect on the damaged nerve. Left untreated in its current condition, Dr. Dy said the nerve could become permanently damaged.
“It just kept getting worse and worse,” she says. “I was told not to throw a ball and to rest my arm, but even running and hitting were hard to do. The doctor kept telling me to be patient but after awhile, I couldn’t even hold the key to my apartment, cut my own food or write during classes.”
“He was so careful and paid so much more attention to my concerns and symptoms than anyone had before,” says Hammack. “I really trusted that he knew what to do and how to fix the problem and that he would do his best.”
Dr. Dy recommended revision cubital tunnel surgery, performing a procedure called submuscular transposition. A delicate and complex surgery, the procedure had to be done carefully to relieve the pressure without negatively impacting the transposed nerve. Dr. Dy moved the ulnar nerve into a more protected environment by plaing it underneath the muscles of the forearm. He and Hammack also discussed the possibility of a more complex procedure involving the transfer of a healthy nerve to stimulate recovery, but Dr. Dy didn’t think it would be necessary after analysis of the preoperative nerve test.
Almost immediately after the surgery, which took place in December 2015, Hammack noticed her pain level was minimal. She was placed into a custom-made splint to heal and then prescribed a graduated rehabilitation program to regain strength and mobility.
“Before the surgery, I couldn’t open water bottles, but now I can,” she says with delight. “The therapist at the Milliken Hand Therapy Center gave me lots of exercises to do at home, so I kept up the rehabilitation for months. Now I can lift small things and I have hardly any discomfort.”
Hammack has now transferred to the University of Illinois to pursue a bachelor’s degree in early childhood education. Although she has stopped playing softball, she says living pain-free is the best result.
“I just have to say that Dr. Dy is phenomenal,” she says. “He listened, he was tremendously skilled at surgery, and he’s a great doctor. I know that he always does the best he can for all of his patients.”
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