Several million Americans are affected by this disorder. Lindy Loya MA, a certified occupational therapist and hand specialist, assured me that carpal tunnel can generally be cured. That’s good to hear.
Let’s examine the carpal tunnel first.
The hand is innervated by three nerves that originate in the spinal cord and run down through the arm and into the hand. They are called the median, radial, and ulnar nerves. The median nerve connects or innervates the muscles that bend and spread the thumb away from the hand and bend the first three fingers; thumb, index and middle finger.
The carpal tunnel
The carpal tunnel is made up of the 8 carpal bones including the hamate, trapezius, pisiform pyramidal, trapezoid, capitate, scaphoid, lunate, and a ligament that runs across the front of the wrist called the transverse ligament. of the carpus. Imagine the palm of your hand when it is supinated.
Nine tendons and the median nerve run through this tunnel. So as you can imagine it could be a bit crowded there.
During movement of the wrist and fingers, these tendons and the median nerve must slide past each other.
Signs of carpal tunnel
In carpal tunnel syndrome, the median nerve is compressed within this tunnel. The first signs are the loss of sensation in the areas that innervate the median nerve, after a specific activity or at night. A therapist will use a Phalen test or a Tinel sign to help diagnose CTS.
There are three levels of nerve injury:
– Neurapraxiais when the nerve is a little crushed. Not unlike having a rubber band tied around your wrist.
– Axonotmesisis a volarian (referring to the palm of the hand) degeneration or necrosis of the axon.
– Neurotmesis is when the nerve has actually degenerated and must be surgically repaired.
Depending on the level of nerve injury, the type of treatment will be determined.
CTS occurs in women more than in men. It seems that women generally have smaller wrists but no smaller tendons. This makes them more susceptible to this condition. There is also a higher prevalence during pregnancy when more fluids are retained, which increases pressure on the blood vessels that travel through the carpal tunnel and further affects the median nerve.
Causes of carpal tunnel syndrome
The most common cause of CTS is a cumulative trauma disorder caused by overuse or repetitive activities. However, two other potential causes of CTS have been identified:
– changes in anatomical structures or
– underlying physiological or systemic disorders such as diabetes, rheumatoid arthritis or metabolic disorders.
The increased incidence of CTS in younger people involved in computer work or repetitive manual work may be due to increased awareness of this condition. CTS that normally occurs bilaterally (both sides) could indicate some type of systemic or physiological disorder.
If you suspect someone has CTS, not diagnose and refer them to a doctor or hand specialist.
If you live in Southern California, look for Linda.
Positions to avoid
Lindy told me that extreme wrist flexion can cause twice the pressure against the median nerve, while extreme extension can cause up to three times the amount of pressure.
Generally, avoid extreme flexion and extension. Do not apply force directly to the tunnel. Push-ups or bench with a false grip would be out of the question. Unless, of course, the push-ups were done with your fists.
Forceful grasping or pinching with your fist or first three fingers can sometimes aggravate the nerve and cause pain.
If a doctor has diagnosed you or your client with CTS, be sure to get a second opinion from a certified hand specialist like Lindy. As she warned me,
“Tendonitis can often be misdiagnosed as CTS, and the nerve can be affected in many different areas as it travels up the arm.”
How to exercise.
Having CTS doesn’t mean you can’t train. You just have to understand the condition and get a little creative.
It’s a bit difficult to train your upper body without a strong grip, so why not bypass the entire joint?
Once the condition stabilizes and / or you or
they have been given permission to exercise, here are some suggestions:
Buy padded ankles that close with a ring instead of a belt buckle. Then go to Home Depot and buy two 24-inch pieces of seat belt or lanyard material. Join these two pieces together in the middle with another large ring and place another ring on each of the two remaining loose ends. It will have what looks like a large V, with a large ring in the middle and two smaller rings at each end.
To perform a seated lateral pull without using your wrists, place the two ankle cuffs on the biceps or just above the elbow, then attach the large center ring of the V-strap to the hook on the extraction cable (where used the bar). ser) and the other ends of the straps to the left arm and the right arm. Now you can perform the pulldown without any effort on your wrists! However, don’t go too high or the straps will start to wrap around your arm.
To perform straight arm pulls, just stand up and keep everything where it is. Pull your arms from about shoulder height in front of you, swing your sides down. Again, don’t let your arms get too high or the handcuffs will come off your arms.
To perform flat and incline dumbbell presses or flyes, move an adjustable bench between the cable columns. Keep the ankle cuffs at or slightly above the elbow. Grip the cables from the top or bottom and secure them to the corresponding ankles. Remember, the good thing is that the pectoralis major or latissimus dorsi does not adhere to the wrist.
For lateral raises, you may be able to move your fists slightly towards the forearm instead of towards the biceps. Simply connect the lower cable of the cable column and align the specific fibers of the shoulder you want to work on. For front raises, stand with your back to the cable column and raise your arm in front of you. For the middle delts, stand with the cable stack to one side, bend at the waist, stabilize the spine, and abduct the humerus by letting the cable pass in front of you. For the rear delts, stand with the cable stack at your side and connect the upper cable to the cuff around your elbow or slightly higher and horizontally section the cable as it passes right in front of you.
For the biceps, attach the V-straps to the lower cable and perform preacher curls facing the cable stack. The ankle cuff will have to go around your forearm and you will not be able to fully extend your arm. The ROM will shorten, but at least the force of the weight won’t cross your wrist.
If you can find some Power Block dumbbells to curl, you will be able to extend the force of the dumbbell over the forearm rather than just through the wrist.
For the triceps, lie on a bench parallel to the cable spine, attach the V-strap to the lower cable and the ends to the forearm ankle cuffs, and perform the elbow extension.
By now, I think you will get the idea. I’m sure you can contribute other ideas. Since carpal tunnel syndrome is found in the wrist, the goal is to
do not involve the wrist.
Don’t forget to include some stretching in your program. Here are some of the stretches Lindy suggested:
– Keep both hands in front of you and place your wrist in a neutral position as if you were a director looking through a television screen. Then, bend all 4 fingers from the first knuckle to the center. Remember to keep your fingers straight at all times.
– With your hands in the same position, just bend your fingers.
– After curling the fingers; make a fist.
– With your hands in the TV position, try to stretch your thumb over your palm and touch the base of your little finger.
– Supine and gently bend your thumb back. When typing or working on the computer, the thenar muscle (that big piece of meat under the thumb) shortens. This stretch will help with that.
Remember that if you feel pain, stop the exercise. If they feel pain, continue to refer them to a doctor or hand specialist.
I hope these exercises are helpful to you or your clients with CTS.
