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Health, Wrist

Carpal Tunnel Exercises: Avoid Surgery

April 4, 2017 • By

Carpal tunnel syndrome causes pain, numbness, and weakness in the wrist and hand and with nearly 50% of all work-related injuries are linked to to it, finding carpal tunnel exercises that help avoid surgery is key.

We explained in greater detail in our earlier post about Carpel Tunnel Syndrome, what causes it and the aspects needed to treat it non surgically.

Because of the potential side effects and risks of surgery, not to mention the at times long recovery, many patients are now being advised to do a period of physical therapy first, to help avoid surgery all-together.1

In this post we cover an important aspect of con-surgical carpel tunnel treatment: Carpel Tunnel exercises.

The exercises should look to address:

  • Muscle tension and nerve mobility through the side of your neck
  • Forearm muscle flexibility
  • Nerve and tendon mobility/gliding through the carpel tunnel
  • Grip and thumb strength

If you just pick one or two of these, you risk missing an important component, potentially taking a lot longer to get better or worse yet, leading to unnecessary surgery – So go all-in and do it properly!

1. Starting at the top, we need to keep the neck mobile, where the arm nerves originate: Perform all of the below three stretches twice a day for 30 seconds, each way. Remember that stretches should be gentle.

carpel tunnel exercises

Carpal tunnel stretch2. Stretch out your forearm by pulling your fingers and wrist into extension, as shown and holding for 30 seconds and then in the opposite direction, into flexion for another 30 seconds. If either of these bring on wrist or hand pain and is not giving a gentle stretch in the forearm, don’t do it yet.

 

3. Floss your median nerve:Carpal tunnel median nerve glider This is a great one. It essentially mobilizes and lubricates the median nerve along it’s entire pathway (including the carpal tunnel of course). Repeat 20 times, 2 x daily.

This exercise needs to be gentle, and pain free, so only stay within the comfortable range, which may mean you aren’t straightening your arm right out initially.

 

4. Take your hand to the gym

Through pain inhibition, lack of use and the median nerve being affected, sufferers of Carpal Tunnel Syndrome typically lose strength in their hand and particularly their thumb. If this isn’t sorted, this can mean the injury really hangs around and afterwards, leaves you at risk of future recurrence of the injury.

carpal tunnel syndrome exercsies hand strengtheningSo the best way to sort this, is to work out your hand.

An awesome little tool for this is the Eggzerciser (which you can get Amazon Here), which is an ergonomically shaped hand therapy ball to offer resistance to the muscles of your forearm and hand to build strength back up, safely.

Level 1: Start off by performing the 6 exercises shown here by doing 10 holds of about 5 seconds. I say “about” because everyone is different and you are better off just aiming to be fatigued by the end of the 10 holds of each exercise.

Level 2: When improving, you can then step it up to 3 sets of 10 squeezes (reps) for each exercise, without holds.

Do the strengthening just once daily and if needed you can step this back to every second day.

Reminder: Do not push into of through pain.

 

Persevere with this exercise regime and our previous advice for at least 6 weeks as it can take this long to start seeing significant results and of course if there is any worsening of symptoms, consults your local doctor of physio.

 


Health

Carpal Tunnel syndrome: Avoid Surgery

March 24, 2017 • By

Carpal Tunnel Syndrome is very, very common with nearly 50% of all work-related injuries linked to carpal tunnel syndrome.  Fortunately, there are effective and evidence-based Carpal Tunnel syndrome exercises and conservative treatment that can help fix carpal tunnel pain and avoid surgery! (1)

 

Firstly, what is carpal tunnel syndrome?Carpal tunnel syndrome avoid surgery

The Carpal Tunnel is a channel at the front of your wrist which is covered by a band of strong connective tissue (retinaculum). Through the tunnel that is formed, runs tendons, a blood vessel, and your median nerve. Carpal tunnel syndrome occurs when these structures don’t slide nicely through your tunnel and with repetitive or sustained tasks, can lead to pain, numbness, and weakness.

Note that symptoms are variable due to the different structures that pass through the tunnel – Sometimes there is more median nerve involvement that tendons and vice versa.

What causes it:

Anything that causes compressed, irritates or effects mobility of the median nerve in the carpal tunnel can cause this which can be from a huge number of causes, with many cases not having a clear cause.

Carpel Tunnel syndrome can be caused by wrist or hand sprain and fractures, inflammation involved with rheumatoid arthritis and commonly certain activities or jobs that require a lot of bending of the wrist, gripping or vibration, among other things.

Some known risk factors are

  • diabetes – a chronic (long-term) condition caused by having too much sugar (glucose) in the blood
  • any kind of arthritis – a condition where the joints become painful and inflamed
  • hypothyroidism – an underactive thyroid gland
  • obesity in young people
  • some drugs used to treat breast cancer – such as exemestane (Aromasin)
  • pregnancy

 

Treatment

Carpel tunnel syndrome can be treated with Physiotherapy or surgery, with surgery often only for the more severe or unresponsive cases as one-third of patients don’t return to work within 8 weeks after an operation as it has a significant recovery period and is not always straight forward and the quick fix that people want as surgery can lead to scarring.

The main aspects of non-surgical treatment that need to be covered for best results are:

    • Brace: Wearing a splint during aggravating activities and at night time can be very beneficial and help speed up recovery by decreasing load on the wrist and holding it in the optimal position for maximal space in the carpal tunnel. The best braces have a metal bar in the palmar aspect specific to carpal tunnel syndrome, so ideally don’t just get any old wrist brace. A good example of one is theMueller Carpal Tunnel Brace
    • Reduce load: Even though there is often 1-2 risk factors such as swelling in pregnancy, inflammation from a fracture close by or a congenitally narrower tunnel – That does not often cause carpal tunnel syndrome by itself. In the majority of cases, you still need repetitive or sustained movement of the wrist or hand, more that it is used to. So, to give the wrist a chance to settle down, you need to figure out what it was that over-loaded the wrist, whether it be using a hammer a lot, writing or typing all day or obsessively cleaning your house and then decrease how much you do that where possible. You don’t need to completely stop the task often, just change how you’re doing it, decrease it and maybe even become a little ambidextrous for a while.
    • Exercises to improve: The third and final thing is home exercises to address any excessive neural tension, muscle tension or lack of joint mobility. The exercises should look to address:
      • Muscle tension and nerve mobility through the side of your neck
      • Forearm muscle flexibility
      • Nerve and tendon mobility/gliding through the carpel tunnel
      • Grip and thumb strength

So there you have it, a rough blueprint on helping lessen the pain from carpal tunnel and start on the road to recovery. We will be putting up another post in in two weeks detailing effective home exercises for Carpal tunnel pain so stay tuned!


Health

Are there any benefits of Compression Socks??

January 17, 2017 • By

meb, compression socks, recovery performanceCompression garments provide a means of providing external pressure to your muscles and so potentially stabilizing and supporting the underlying tissues. But are the claims backed up by results? Do compression socks help with circulation and blood flow? Or performance and recovery?

It doesn’t take much for a new trend to start – particularly when elite athletes are seeing using them and performing well!(1)

So, even though anecdotally, they have some benefit, it is prudent to check the research and see what the studies show.

So what do the manufacturers claim compressions socks help with?

  • Aids return to de-oxygenated blood to the heart through the veins
  • Increases the flow of oxygen-rich blood through the arteries to your muscles

This is proposed to help reduce muscle fatigue, enhance performance and speed up recovery… but do they?

 

What they do help with:

They DO seem to help with improving recovery. Recent studies have proved that compression socks have a moderate effect in reducing DOMS (delayed onset muscle soreness), which will help you bounce back faster between training sessions. (2) Although this may be partly due to perceived ratings of recovery and not all studies agree (5,6)

 

What they don’t help with:

The don’t reduce the size or hematoma or shorten the time to recovery after acute muscle injury (muscle contusion or strain)3

The definitely don’t improve performance. The hard work you put into training is going to do this – there is no quick-fix! 4

that the use of compression garments had a moderate effect in reducing the severity of DOMS (Hedges’ g=0.403, 95% CI 0.236 to 0.569, p<0.001), muscle strength (Hedges’ g=0.462, 95% CI 0.221 to 0.703, p<0.001), muscle power (Hedges’ g=0.487, 95% CI 0.267 to 0.707, p<0.001) and CK (Hedges’ g=0.439, 95% CI 0.171 to 0.706, p<0.001). These results indicate that compression garments are effective in enhancing recovery from muscle damage.

 

So all in all, there is no harm done wearing compression socks or any compression clothing for that matter but they aren’t going to improve your performance except for some possible placebo effect. They may, in fact, help with recovery though so, throw them on for recovery afterward or have an ice bath but the only real reason to wear compression socks during an event would be to look the part and psyche out the opposition. (7)

 


Health

Injuries: How to Heal Faster

December 12, 2016 • By

I am often asked about how to heal faster, so here is the answer. It isn’t a magic bullet but through mechanotherapy, you can heal faster, and stronger.

In the clinic, it is sometimes blindingly obvious whether someone has been doing the exercises I asked of them or not. If they have, they are getting a whole lot better. A large part of why Physcial Therapy (or physiotherapy) works is through challenging your body to adapt and make changes for the better. It encourages your body to heal and improve itself. There is often a hands-on treatment component such as manual therapy and soft tissue releases, as well as effective education on diagnosis and prognosis but these are nothing without you, the patient, taking charge of your rehab.

You can sit back and rely on a clinician to work on you and get you better, or you can take an active approach by following advice and diligently doing the homework given to you. Do them regularly, you are going to get better faster – So why not?

passive vs active rehab physioThe two approahces are often called active and passive therapy, or active and passive rehab and the main point is that active therapy gets you lasting changes and a more bullet-proof body so that you have less chance of future pain or injury and don’t end up with a “bad shoulder” or “bad ankle” because it wasn’t rehabbed properly

 

So how does active rehab work so well?

Results and effected through what is called mechanotherapy, which simply can be described as:

active rehabMechanotransduction is the physiological process where cells sense and respond to mechanical loads

This means that your tissues respond to the load put through them. Here is a brief description from the above study: Mechanotransduction refers to the process by which the body converts mechanical loading into cellular responses. These cellular responses, in turn, promote structural change. A classic example of mechanotransduction in action is bone adapting to load. A small, relatively weak bone can become larger and stronger in response to the appropriate load through the process of mechanotransduction

This is the same process by which you’re muscles get stronger from training in the gym  or on the sports field. So you want to know how to heal faster? Load them and they will adapt, as long as they have adequate time to do so between work-outs.(1,2,3)

 


Health

Self myofascial release

November 22, 2016 • By

Self myofascial releaseFor years, myofascial release has been used by massage therapists, physiotherapists, osteopaths to improve mobility and function and more recently self myofascial release have been utilized to improve recovery and boost healing times through self-treatment at home.

Self myofascial release is becoming a common prescription for patients and something that is now all over the internet and readily available. This isn’t just a fad either, there are a lot of benefits to it and it can be far more effective, time efficient and easier than stretching.

So what is a myofascial release?

Myofascial release works in a few ways:

  • As an inhibitory technique that decreases overactive tissue via stretching of the Golgi tendon organ. this leads to improved flexibility and mobility
  • Increasing  blood flow to the area (and all the goodies that it bringswith it)

Here are just some of the proven benefits of self myofascial release

  • Improves joint range of motion (1), particularly when combined with either postural alignment exercises or stretching
  • Reduction in arterial stiffness and increase in vascular endothelial action = more blood flow(2)
  • Immediately improved flexibility (3)

 

So how can you now give it a go? Get a Massage Ball, lacrosse ball or Foam Roller and get to work on your muscles

For guidance, check out our recent Ebook release and search through our past posts.