Training Resources

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Guyon’s Canal Syndrome (Handlebar Palsy)

Guyons' Canal Syndrome

Like Carpal Tunnel Syndrome, this condition is often seen in cyclists when the ulnar nerve is compressed in its canal over the wrist. Resting the palms of the hands on bicycle handlebars is typically the cause.

Treatment is similar to that for Carpal Tunnel Syndrome - activity modification, such as wearing a padded glove during cycling, rest, splinting, hand therapy - including ultrasound/iontophoresis, exercise, and less often, surgery.

Possible Treatments
Possible Treatment Goals
- Decrease Risk of Reoccurrence
- Improve Muscle Strength and Power
- Decrease Nerve Compression
- Increase Oxygen to Tissues
- Improve Range of Motion
- Improve Relaxation
- Self-care of Symptoms
- Improve Tolerance for Prolonged Activities
Additional Resources
- 3d Anatomy of the wrist and hand
- Guyon's Canal Syndrome

List of Articles

Links: Neck : Shoulder : Back : Elbow : Wrist & Hand : Hip : Knee : Leg : Ankle & Foot

Disclaimer

The information in this medical library is intended for informational and educational purposes only and in no way should be taken to be the provision or practice of physical therapy, medical, or professional healthcare advice or services. The information should not be considered complete or exhaustive and should not be used for diagnostic or treatment purposes without first consulting with your physical therapist, occupational therapist, physician or other healthcare provider. The owners of this website accept no responsibility for the misuse of information contained within this website.

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Kristy Krueger is the Senior Vice President of Human Resources for Therapy Partner Solutions^® Holdings (TPSH). With over 20 years of executive level HR experience, Kristy has a proven record as a specialist in the field of Human Resources with additional expertise in the areas of leadership development, training, professional coaching, and personal performance enhancement all of which continues to contribute to the individual success of our associates and the overall success of our organization.

As the executive in charge of Human Resources, Kristy and her team manage all things related to staff recruitment & retention, benefits and compensation management, employee relations, and professional development. Kristy has been influential in the development our company culture, our award winning employee satisfaction and retention rates (Press Gainey – Employer Choice Awards) as well as building an environment that is employee focused and patient centered.

Kristy earned her BS in ED at Jacksonville State University and is a long standing member of the local and national Society of Professional Human Resources organization, having served on the local chapter board in various positions.

Kristy Krueger is the Senior Vice President of Human Resources for Therapy Partner Solutions™ Holdings (TPSH). With over 30 years of Human Resources experience, including more than 20 years with the company, Kristy is a transformative leader in HR, known for driving innovation in talent strategy, organizational development, and workplace culture. She specializes in fostering leadership development, building inclusive environments, and championing employee engagement, professional coaching, and performance enhancement.

As the executive overseeing Human Resources, Kristy and her team lead critical initiatives in talent acquisition and retention, inclusive benefits and compensation strategies, employee relations, and career development. She has been instrumental in guiding the organization through successful acquisitions and mergers, ensuring smooth transitions, integrating diverse teams, and maintaining TPSH’s culture of belonging and inclusion. Under her leadership, TPSH has achieved award-winning employee satisfaction and retention rates (Press Ganey – Employer Choice Awards).

Kristy earned her Bachelor of Science in Education from Jacksonville State University. She is a long-standing member of the Society for Human Resource Management (SHRM) at both the local, state and national levels, and has served on the local chapter board in multiple leadership roles.

Contact

EMAIL | kkrueger@therapypartnersolutions.com

Janet Shelley is the Chief Disruption Officer at Therapy Partner Solutions^® Holdings (TPSH), focusing on marketplace disruption across TPSH business lines.

Prior to joining Therapy Partner Solutions Holdings, Dr. Shelley was a partner in an independent physical therapy practice, then subsequently founded Medical Billing Center^TM (MBC), a therapy-specific billing and collections company. She served as MBC’s CEO from its inception, until she transitioned out of MBC and into the TPSH leadership team in January 2021.

Janet’s success as a business leader is due, in part, to her willingness to dig deep in the healthcare space, and to her innate ability to recognize, and adapt, to new market trends. Following graduation from physical therapy school Janet snagged a job at an orthopedic specialty hospital and immediately experienced healthcare disruption firsthand as a major shift in payment by Medicare when diagnostic-related groups (DRGS’s) became the payment methodology for inpatient hospitalizations. Consequently, her hours were reduced, while her first home mortgage and student loan payments were due. Thus, disruption, and the ability to react accordingly, became fundamental themes of her professional career.

While DRG’s may have been the first disruption in Janet’s professional life, many others followed. Dr. Shelley became the first female partner in the oldest private practice in South Carolina. Her involvement in the therapy marketplace quickly expanded to include free standing physical therapy offices, hospital joint ventures and home health contracting. While in practice, disruptions to market share and healthcare regulatory challenges (i.e. Balanced Budget Act, Therapy Caps, One-on -one inclusion in CPT coding language, Physician Ownership, Resource Based Relative Value Unit Payment) bore opportunities for growth out of seemingly detrimental policies.

The theme of disruption hasn’t been limited to Janet’s professional career. Personal disruption along the way added a physical therapist husband, a certified nurse anesthetist (CRNA) son who likewise married a CRNA, and a physician daughter who married a mechanical engineer, finally lending some non-healthcare interest to her nuclear family!

Janet is actively involved serving her community with her church family, enjoys a legislative appointment to a regional healthcare board and gives abused and neglected children a voice in court as a Guardian ad Litem.

Dr. Shelley will be the first to admit that the new, disruptive ideas are not usually her own. Instead, she finds insight from a network of professional colleagues and through industry trade associations, many of which she serves on at both state and national levels. She dedicates her time to influence, interpret and educate colleagues on regulatory changes that will disrupt healthcare. Thoughtfully, Janet aspires to “Be like a flower. Survive the rain but, use it to grow.” Y Tiwari

Contact

EMAIL | jshelley@therapypartnersolutions.com

Sam Echols is one of the co-founders of Therapy Partner Solutions^® Holdings (TPSH). He currently serves as the Chief Clinical Officer for TPSH in addition to his role as President of Therapy Partner Private Practice Solutions, the outpatient division of TPSH.

With over 25 years of experience in the therapy industry as a clinician, business owner, and team leader, Sam brings a variety of experience to our TPS partner clinics. With a foundation firmly based on clinical excellence, customer service, and best client outcomes, Sam understands the importance and relationship between Best Clinical Practices and Best Business Practices. Sam currently oversees the TPS programs for Clinical Quality & Compliance, Talent Development, Leadership Training, Operational Excellence, and Strategic Partnership Development.

As a graduate from the Medical College of Georgia in 1995 with a degree in physical therapy, Mr. Echols worked extensively in outpatient orthopedics and sports medicine. With advanced training in many approaches to manual therapy and orthopedics, he was over clinical competency for the licensed staff at Advance Rehabilitation, a regional therapy company he helped to found. Sam also has an educational background teaching and facilitating monthly clinical forums and CEU courses.

In the healthcare industry and specific to the area of rehabilitation, Mr. Echols is a Board Certified Orthopedic Clinical Specialist (OCS) with expertise in Orthopedic and Sports Physical Therapy, business development, developing a strong clinical team and reputation, leadership development, clinical program/protocol development, marketing/relationship development, and currently teaching clinical coding and billing classes not only for clinicians but for area PT schools.

Since 2007, Mr. Echols has been a Board Certified Orthopedic Physical Therapist, and for 20+ years has been a member of the American Physical Therapy Association (APTA) presently including the Private Practice, Orthopedic and Sports section of APTA, Private Practice Section of the APTA and the Physical Therapy Association of Georgia (PTAG). He has been a presenter at the inaugural APTA Future of Physical Therapy Summit in 2023 as well as the 2024 APTA Private Practice Section Meeting. He served as the physical therapist for Berry College Sports Medicine Program for 12 years.

Sam is on the Fellowship of Christian Athletes, Open Door Home, and Cumberland Wilderness Boards. He serves as an elder at his church serving and chairs the personnel and policy committee and serves as a mentor for the Berry College Integrity in Leadership class.

Contact

EMAIL | sam@therapypartnersolutions.com