Hi. I’m Dr. Eric Cobb with Z-Health Performance. Today, we are continuing our discussion of carpal tunnel syndrome. If you are new to Z-Health, we are a brain-based education company working with doctors, therapists and coaches all over the world. Ninety plus countries at this point. If you’re interested in what we do here, what you hear, Subscribe to the channel, check out our free resources, and look at our education on our website. Alright.
So we’ve done a couple of videos, pretty long ones on introducing ideas of how we work with carpal tunnel. Today, we’re gonna shift our focus away from the neck, shoulder, and we’re gonna now start to look at what’s going on in the wrist hand and elbow. I like to have people begin by doing some basic mobility exercises. So you’re gonna start off with both hands and I just want you to drive your wrist up and down up and down. We’re not keeping our forearms still right now in doing this. We are actually driving them up and down. So it is a more coordinated movement.
So we’re gonna go up and down first, and then we’re gonna go side to side. And I want you to compare mentally the side with the carpal tunnel presentation and the other side. And just notice which one feels more mobile and more importantly most controlled. Now after you have an idea of your basic range of motion in these mobility exercises, you’re then gonna do a little bit of stretching. Now, this is not going to be us holding here. You’re just simply going to go up into as much extension as you can, pulling the fingers up to the ceiling. and then down. Notice I’m doing this with a bent elbow. You’re then going to extend the elbow and repeat that. I just want you to get an idea of how far you can comfortably move without creating any discomfort, both with an arm bent and an arm extended position. I then want you to do that out to the side. It’s not enough for us to always work here. Right? We’re always reaching. So now you’re gonna go externally rotate your shoulder. In other words, turn it out to the side and repeat those same kinds of test. both with the elbow bent and the elbow straight, getting an idea of how far you can comfortably move.
Now what we wanna do from here is we want to do a little bit of skin mobilization So you’ve done this. I now want you to imagine, well, you don’t have to imagine you’re gonna do it, but grab your arm, but imagine there’s something sticky here, and you’re going to be able to rotate the skin in.
We’re not trying to twist the whole arm. We’re not trying to move the muscle. You’re just gonna simply stay at the surface of the skin and rotate it toward the midline of the body. and you’re going to repeat your movements. You’re then gonna go up to the mid forearm and then to the elbow doing that same thing. Nothing muscular, just rotating the skin, and you’re trying to identify if that improves your ability to go into flexion extension comfortably. You’re then gonna repeat that by rotating the skin to the outside of the body. Because what I want you to recognize is that wrist flexibility, elbow flexibility is not just muscular. There’s a lot of other tissues here. And with carpal tunnel, we have entrapments. It’s possible those entrapments are deep. It’s also possible that some of those entrapments have moved toward the surface. So often what we’ll find is that people with no contact on the arm feel relatively restricted and then we test a little bit of dermal motion or skin twisting and all of a sudden they’re like, oh, wow, that’s much more free. If you find that one of those directions gives you more range of motion, that’s what I want you to use. You’re going to actually do your mobility exercises, etcetera, while maintaining motion or skin movement along with the stretch or the mobility exercise. Alright? It’s actually easier to do than it is to explain. Words are hard, the feeling is easy. Alright? It’s just very important that you start to recognize that you may be able to assist yourself just with a little bit of skin mobilization. So that’s my first set of exercises for you. Basic mobility and then some active stretches in flexion and extension or extension and flexion with some skin mobilization. The last thing I want you to do now is move away from the elbow and wrist, and we’re gonna work on the hand. And there’s a specific set of muscles that are often seen to be involved in carpal tunnel syndrome, and they’re very weird. They are actually hard to mobilize. They are hard to stretch. So I’m gonna show you how to do this. These muscles are called lumbricals. What you’re gonna do is you’re gonna take your hand and point the fingers up to the ceiling you’re then going to bend the first two joints. Alright? So I’m gonna curl my fingertips down, keeping the rest of my hands straight. What I’m gonna do now is I’m gonna take my other hand and I’m gonna cover those fingertips and then I’m gonna reach and I’m gonna try to get to my knuckles. Alright?
Now, I’m not going to be crushing this like a walnut. That’s not the goal here. The goal is to gently help compress the fingers, maintain that flexion, but now watch these fingertips. They’re gonna drive drive those knuckles forward. as I do that, I’m also going to be trying to open my palm and extend my hand a little bit or extend my wrist a little bit. When you do this exercise correctly, you’re gonna feel this kind of very odd stretching sensation in the palm of your hand. It will not feel like a hamstring stretch or anything super intense. In fact, most people in the beginning overgrip their fingers. All that they say is it feels like I’m crushing my fingers. So you need to be relatively relaxed here, again, pushing the knuckles forward, intentionally opening your palm, trying to extend those fingers more and then add a little bit of wrist extension to it. And you can see I’m driving my my the lower part of my palm forward as I do this.
It actually feels really quite cool and quite fantastic when you can find those muscles. And particularly for some people with carpal tunnel, this is a game changer. So give these different wrist hand and elbow exercises a try. Let us know how they work for you in the comments. We hope that they’re very, very useful for you. And remember that lumbar stretch is a little difficult to learn, so take the time to master it because it really matters.