UPPER-LIMB NERVE ENTRAPMENTS IN ELITE WHEELCHAIR RACERS

The prevalence of upper limb nerve injuries has been reported to be as high as 73% in individuals who rely on manual wheelchairs for mobilit y. Many authors hypothesize that the repetitive trauma to carpal canal structures caused by propelling a wheelchair is the reason for this h igh prevalence. The purpose of this study was to determine the prevale nce of nerve conduction abnormalities in a group of elite wheelchair r acers whose wrists are exposed to additional propulsion-related trauma during training and competition. We performed bilateral upper limb ne rve conduction studies on each athlete (n = 12). The racers pushed the ir chairs an average of 56 miles a week for training purposes. Fifty p ercent of the athletes (n = 6) had evidence of median mononeuropathy b y nerve conduction. Of these 6 racers, 5 had evidence of mononeuropath y bilaterally, making a total of 11 positive hands of the 23 tested. T wenty-five percent of the athletes had evidence of ulnar mononeuropath y at the wrist, and 25% had evidence of ulnar mononeuropathy at the el bow. Seventeen percent of athletes had evidence of radial nerve injury . Years with a disability accounted for a significant amount of the va riance in the mean median sensory amplitude (R(2) = 0.511; P = 0.020) and the mean ulnar palmar amplitude (R(2) = 0.605; P = 0.008). Variabl es not correlated with nerve conduction studies include age, hours per day in a wheelchair not spent training, years competing, and number o f miles pushed in training. Despite the amount of time spent training, these wheelchair athletes have a similar or lower prevalence of media n mononeuropathy then reported in the general wheelchair-using populat ion.