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Return to Hypertrophy: Ulnar Nerve Protocol

An 8-week evidence-informed training plan to rebuild muscle while managing ulnar nerve entrapment and C8-T1 radiculopathy symptoms.

Return to Hypertrophy: Ulnar Nerve Protocol

Goal: Rebuild muscle tissue and strength without irritating the ulnar nerve or cervical spine. Timeline: 8 Weeks Focus: Neutral grip loading, controlled eccentrics, thoracic mobility, and nerve health.

The "Why"

Ulnar nerve entrapment (cubital tunnel) and C8-T1 radiculopathy share a common enemy: compression and traction.

  • Compression: Happen when you flex the elbow deeply (tricep extensions) or compress the neck (back squats).
  • Traction: Happens during heavy carries or deadlifts without straps.

This plan is built to:

  1. Unload the Neck: No axial loading (barbells on back).
  2. Spare the Elbow: Limit end-range flexion where the nerve stretches most.
  3. Fix the Posture: Massive focus on thoracic extension to open the nerve pathway.

Safety Gates 🛑

Do not progress to the next phase unless:

  1. No Numbness: You have zero ring/pinky numbness for 24h after a session.
  2. No "Zingers": No electric shock sensations during any rep.
  3. Grip Strength: You can hold a 20kg dumbbell for 30s without pain.

Phase 1: Quiet the Nerve (Weeks 1-3)

Goal: Reintroduce movement, blood flow, and stability. Zero nerve irritation. Frequency: 3x / Week (Mon/Wed/Fri)

Daily Maintenance (5 Mins)

  1. Thoracic Extensions (Foam Roller): 2 mins.
  2. Ulnar Nerve Glides ("The Mask"): 10 reps per side. Gentle tension only. [Demo Video]
  3. Neck Isometrics: Press head into hand (Front/Back/Side) for 10s holds.

The Workout (A)

RPE 6-7 (Leave 3-4 reps in the tank)

ExerciseSetsRepsCues for Nerve Safety
Goblet Squat (Heels Elevated)310-12Keep chest up. Torso vertical = less neck strain.
Chest-Supported Row (Neutral)310-12CRITICAL: Use neutral grip (palms facing). Squeeze shoulder blades back.
Dumbbell Floor Press (Neutral)310-12Floor stops elbows from going too deep. Neutral grip saves the elbow.
Romanian Deadlift (WITH STRAPS)38-10MUST USE STRAPS. Do not tax the grip. Hinge only.
Lateral Raises (Machine/DB)312-15Keep elbows slightly bent. Stop at shoulder height.
Pallof Press310/sideAnti-rotation core work. Keep lower back glued to floor.

Phase 2: Reintroduce Tension (Weeks 4-6)

Goal: Increase load and volume. Introduce controlled eccentrics. Frequency: 3-4x / Week (Upper/Lower Split optional)

The Workout (B)

RPE 7-8 (Leave 2 reps in the tank)

ExerciseSetsRepsCues for Nerve Safety
Leg Press / Hack Squat38-10Safe way to load legs heavy without spinal compression.
Lat Pulldown (Neutral/Mag Grip)310-12Torso upright. Chest lifted via T-spine, not lower back. Stop at chin level.
Incline DB Press (Neutral)38-1015-30 degree incline. Control the bottom. Keep wrists stacked.
Seated Hamstring Curl312-15Focus on the squeeze.
Wall Slides with Lift-Off310-12Replaces triceps. Fires serratus/lower trap to fix scapular mechanics.
Pallof Press310/sideAnti-rotation core work. Keep lower back glued to floor.

Phase 3: Return to Performance (Weeks 7-8)

Goal: Progressive overload. Testing near-maximal strength safely. Frequency: 4x / Week

Introduce one "Riskier" movement per week to test tolerance (e.g., standard bench press, unstrapped deadlift).

Key Modifications Going Forward

  • Neck Cue: "Chin gently tucked (axial elongation) during all lifts." Never look up.
  • Shoulder Cue: "Retract lightly." Do NOT aggressively shrug down and back (pinches plexus).
  • Life Cue: Extend elbows fully between sets. Do not sit scrolling on phone with bent elbows.
  • Straps: Use when loads exceed grip capacity. Gradually rebuild grip tolerance later.
  • Forever: Warm up the T-Spine before pressing.

Note: If symptoms return (numbness > 30 mins), regress to Phase 1 immediately for 1 week.