I’m Dr. Eric Cobb of Z-Health Performance.
Today, we’re going to begin talking about carpal tunnel syndrome and different approaches that might help you if you’re struggling with this particular issue.
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So carpal tunnel, let’s discuss what it is very quickly. Most people have heard the term.
This condition affects somewhere between eight percent and ten percent of the population. so we’re looking at, you know, probably one in ten people will have this. Most people complain about wrist pain, they will complain about loss of sensation, numbness, tingling, weakness in the thumb, the index finger, and the middle finger.
Those are all very common. It is also very common to have people get very irritated from specific activities, like typing on a keyboard, using a mouse, and often people will complain about pain at night. So there’s been a tremendous amount of research done on carpal tunnel. And the question is, what works? What doesn’t work? And right now, there’s no huge consensus. because every case is a little bit different.
But there are some things that we do know that in general are very important. I’m gonna go through those first. then over the next few videos, I’m gonna show you some progressions of movements and exercise approaches that we have found to be very effective.
So number one, as you always hear, avoid irritating activities. And that sounds a little bit goofy because most people will have this occur because of things that they’re doing at work or recreationally, But for instance, if I am right-handed and I use a mouse on my computer all day with my right hand, one simple idea is to try switching over to the left hand, at least periodically throughout the day. Most people will go crazy trying to do that because it’s very frustrating and you’re not as coordinated. but we do have to start to avoid irritating activities.
That’s number one. Number two, we have to be very aware of the things that cause the issue.
So anything that requires us to do a heavy gripping motion or movement that is loaded with speed can also be problematic.
So if you play tennis, use a hammer for a living, any tight gripping exercises or anything that requires full flexion and extension movements of the wrist can be irritating.
So kind of think through your day and go, okay, what can I begin to limit just a little bit as I’m in the healing phase? Another thing that’s very useful in at least in the research literature is a use of night splints.
These are little wrist splints that hold your wrist in a comfortable position to prevent you from curling up like a baby at night and getting into a deeply flexed position which will irritate carpal tunnel syndrome.
So night splints. They don’t work for everybody and they can be a little weird to get used to, but a lot of people have reported good results and there’s some good research to back that up.
Now more importantly, as we move forward, I think it’s very important for you to take ownership of your own issues.
So the thing that I like to start most carpal tunnel clients with is getting them to keep an irritation journal. An irritation journal basically means when you wake up in the morning, scale of one to ten, how much discomfort am I feeling?
And then throughout the day. If you are doing any specific activity, you write that down. This takes you about thirty seconds of work throughout the day.
But then you can start looking day by day and think, okay, today, I’m a five. What did I do yesterday? Oh, yesterday, I was, you know, I was six hours in the computer at work. Well, now we’re starting to identify find maybe some causative issues.
So keeping that journal is really important and is even more important when you begin including the exercises that I’m going to show you.
Because some of the exercises are going to work super well for many people, others may be irritating. The only way to know that is for you to track your own response.
So get that journal going. Kinda last but not least in the support idea is making sure that you don’t give up activity.
But whenever you begin doing things, we need to grade it. In other words, we need to make sure that it stays in a pain-free or relatively comfortable safe range for you.
So everything that I’m gonna show you, that’s going to be the goal.
We’re gonna do it, but we’re gonna do it very gently.
We wanna make sure that the next day, you don’t wake up with more discomfort.
So I like to always give people something active to do. So whenever we look at the literature and then we go through our experience of what works well for people, The first place to start is looking at the neck, the cervical spine.
This is where the nerves that are going to eventually form the median nerve, which is what’s involved in carpal tunnel syndrome, originate. Two basic movements are very important.
Lateral gliding of the neck and anterior posterior gliding of the neck.
There’s multiple studies that have shown if a therapist comes in and does some gentle lateral mobilizations and general anterior, posterior mobilizations of the neck, that can reduce issues with carpal tunnel. Not all of us have that kind of time. So I like to always have tools available for people to do this their own.
So what I’m gonna recommend that you do is grab a towel, a band, a loop, something that has a little bit of resistance, but is very comfortable. So we’re going to imagine first that I have issues in my right hand.
So I’m gonna start off with a little bit of anterior posterior gliding.
So I’m gonna go through some movements See how my hand feels. Do I get a little numb? Do I get a little tenderness? And we’re gonna start off with anterior posterior glides.
This is just a basic “chicken” exercise. But what we wanna do is we want to take the band and we’re going to loop it around the base of our neck.
So I’m now going to be holding the band gently and if gripping is problematic for you, you just simply loop it around the edge of your hand so that you can relax your fingers.
You don’t have to create any tension So what I’m gonna do is I’m going to start that little chicken exercise, and as my head comes forward, I’m pushing forward with my hands a little bit, so the band is helping pull me anteriorly, and then I’m going to move backwards into the resistance of the band.
So again, from here, I’m going to push my hands forward as I go into that anterior glide again very gently. I’ll drive back posteriorly and then I’ll release the tension and see if I can go a little further Super simple, subtle movements.
You’re gonna do five to ten repetitions of that. You’re gonna relax and recheck and see how your hand feels. From there, we then want to go to the lateral glide movement.
Now, most people, if I ask them to do this lateral glide, they can’t. They just kind of rotate their head but it is the intention to make the movement happen right now that’s most important.
So for this, again, we’re gonna use the band. We’re gonna take the band and we’re now wrapping it so that it is around the side of our neck. Alright? So just like this, don’t cross it over.
We’re just around the side of our neck. So now I’m going to be pulling I mean, in this particular case, I’m pulling away from my body.
And as I pull away from my body, I’m going to try to move my neck into that resistance.
Pull away from my body, move my neck into that resistance. And depending on where you feel tension, you can move the band up excuse me up or down.
And you can also change the angle of your hands to help you begin to identify where do I have that tension.
Now, as you do that, what’s very important is to understand this. If I have tension in my right median nerve, if I glide away, that’s going to typically increase tension in that nerve in my neck.
So you may need to begin if you have right carpal tunnel issues by gliding toward that side first and then away from that side second. those are things that you’re going to need to test on your own and note down in your journal. Alright?
So this is our kind of initial entry into talking about carpal tunnel syndrome. I
hope you found this really useful and educational. Let us know. Hope it works well for you.