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Pronator quadratus is a square shaped muscle on the distal forearm that acts to pronate (turn so the palm faces downwards) the hand. As it is on the anterior side of the arm, it is innervated by a branch of the median nerve, the anterior interosseous nerve (roots C8 and T1 with T1 being primary).
The anterior elbow pain is aggravated by repetitive hyperextension and is not affected by elbow flexion. Pronator syndrome Patients with pronator syndrome often complain of pain or paresthesias over the median nerve distribution. Most times, the pain is located over the anterior proximal forearm.