How To Fix Carpal Tunnel

Hi, I’m Dr. Molly with Your Goals Physical Therapy. Are you looking for a way to fix your carpal tunnel? This video is perfect for you. I have treated and worked with numerous active adults who have come in suffering from numbness in their hands to the point that they can now no longer hold a glass without fear of it falling.

They don’t pick up their cell phones without two hands because they’re afraid that it’s just going to hit the floor. It has encroached on their ability to do their job because they can’t type for very long. Forget about using a mouse. It just makes their entire hand go completely numb.

Then, there are other people who have to turn things all day and they’ve lost their ability to grip anything at all. So as you can imagine, it becomes very, very debilitating. For many people, the reason that they have delayed seeing somebody is they assumed that the only solution was to have surgery.

They didn’t know if they could take themselves out of their life for six to eight weeks as they healed from the surgery. They didn’t want to even go talk to a doctor about how to deal with their carpal tunnel. So it just progressively gets very, very bad.

In this video, I am going to talk about how you can fix carpal tunnel without surgery. I’m going to start with defining what carpal tunnel is, and how you diagnose it. We’re going to talk about what the root causes of carpal tunnel are, and then we’ll get right into a few things that you can do to treat it. All right, so let’s get started.

First, what is carpal tunnel?

Well, very simply, carpal tunnel is the impingement of, or the pinching of the median nerve in your arm.

All of your nerves start in your neck. They come out of the spine and they go across the front of your shoulder and then they go down your arm and they go through what’s called a retinaculum into your hand.

Though the retinaculum is a little disconcerting because it’s not a small thing. It’s actually a little band on the top of your wrist and it helps to support the front part of your wrist because you have nerves, you have bones in there, you have tendons, ligaments – a bunch of different muscles. It just helps keep it all nice and tight. I would think of it as kind of like a wristband, but it’s just permanently in there.

A lot of times the surgery for carpal tunnel is to just cut that right retinaculum and allow more space for the nerve so that it’s no longer being pinched. That’s a little bit about the surgery I got ahead of myself. That is simply put what carpal tunnel is, it is just the pinching of that median nerve.

What that typically gets for people is some form of numbness in their hand. If it’s just the median nerve, then it should be your thumb, your pointer finger and your middle finger. You’ll get some symptoms on the back of your hand as well. It makes gripping very difficult if you can’t feel where those fingers are.

Now, how do you diagnose it there?

There are several ways, one way that physical therapists, and I mean other practitioners can do it as well, is by simply having you do little movements to see if it pinches on the nerve.

Really a lot of the tests or all of the tests that we would do would be something that would make the symptoms come on. That just tells you that it really is the median nerve that is being annoyed.

One of the tests is simply having your wrists folded down and just having that pressure there for a sustained amount of time, about a minute

If the symptoms come up that would be positive and would indicate that you possibly have carpal tunnel and you would proceed with other tests. 

So that’s one way you can also tap the nerve to see if that makes it annoyed. Some of these take a little bit to do it correctly and take a little bit of practice. I wouldn’t just go tapping nerves because you can annoy a lot of things, and please don’t sit here for five hours trying to get symptoms to start up. It really isn’t supposed to take that long.

Now here is what I think the crux of this video is ....

What is the root cause of the carpal tunnel?

As I pointed out, the surgery implies that the root cause would be something that somewhere in here is where the nerve is being pinched.

That’s not the only place that nerve can be pinched. That the median nerve can be pinched anywhere from coming out of the spine across the front of your shoulder and down your arm. In some cases you can have something going on in your neck. You could have something going on with posture that’s causing that pinched nerve or something in your wrist.

Some people you could have something happening in more than one place that’s actually causing it. So it’s getting pinched in your neck, it’s getting pinched in the front of your shoulder and is getting pinched in your wrist.

Just cutting the retinaculum isn’t necessarily going to resolve all of your issues. This is where I root for non-invasive things or at the very least, a full assessment of the whole area that could be affected by that median nerve. Now I’ve actually treated some people and I came up with two examples that I wanted to talk to you about that kind of highlight these things.

Tim is a machinist. All day he did the same thing repetitively just in it was always twisting like he described everything he did and it was all this twisting motion. Based on the size of his forearms, his grip would’ve been very, very strong. They were very, very large forearms. That was from years of working because he’s in his fifties at this point. When he showed up it was sort of as a last minute he just sort of showed up, didn’t have an appointment, he just wanted to find out what the rehab after having carpal tunnel surgery would look like.

I asked him a whole bunch of questions. I could tell he is a little bit annoyed, but he did end up coming in to have a pre-surgery evaluation and because he just could not imagine getting any of the feeling back in his hands without having surgery. He just assumed that that was the right route for him. When he came in he had absolutely no grip strength. He could not hold a pen. He had numbness and tingling. He said it felt like he had socks on his hands all the time, but it would get worse where he just absolutely couldn’t feel his hands at all.

We did an assessment.

We looked at neck, we looked at shoulder and we looked at his wrist.

Without question, like most people, everybody’s posture could be better, but that didn’t really affect him.

His wrist had absolutely no mobility, nothing. There was nothing there, that he could not move his wrist this way to save anything. I spent 15, 20 minutes working on his forearms to try to help loosen it up and do some other manual techniques to help get some more mobility in his wrist.

By the time he left, the sock sensation had gone and his eyeballs were the size of dollar bills. 

He just could not imagine that any of his symptoms could be made better without having to have surgery.

We were able to work together for the next several weeks because ultimately we wanted him to get strong enough to do his job. At the end, he had no numbness and tingling. He had near normal range of motion in his wrists and he knew exactly what he needed to do to keep doing his job as long as he wanted to do it because he was obviously going to have to make some changes to what he was doing so that it didn’t come back. So he was very, very excited.

Now, Sarah was early forties. She had young children and this onset was much quicker and a lot more scary for her because it was like she was fine one day and she felt like she was not good the next day, but she had that numbness and tingling in her hands.

She also felt a lot of strain everywhere else, but she couldn’t decide if that was because of her small children that she was still carrying, all the typing she did at work and she also played tennis. All of those things all used the same side she was having a problem with.

When she was gripping the racket with her right hand, she felt like she didn’t have the strength. She was like, it was very embarrassing the first time the ball hit her racket and the racket flew out of her hand and almost hit the person behind her.

That was what she was going through. That’s where she decided she would actually come and see somebody. She was telling me that she was having more problems if she had to hold her kids on her right side versus on her left.

She was waking up with a lot of aches and pains and her hand would be numb in the morning, which was very, very scary. When she came in, really she just wanted to be able to get back to playing tennis. She needed to be able to hold the racket and to be able to hold her kids. Well, when we looked at it, it was her neck. She found out, we found out that she had something going on in how her neck alignment was working. When we addressed those, then she stopped waking up with numbness.

She was able to get back to playing tennis and not being afraid that she was going to have to have a surgery on top of holding kids because you can’t stop holding onto your kids. 

You can stop playing tennis for a little bit.  You can’t stop picking up your kids. It’s very, very difficult. It was a huge weight off of her when she came in and she found out exactly what the root cause was and she had a clear plan on how to get rid of it.

When she left the evaluation, we already knew ways that she could adjust her sleeping position and her workspace to help her resolve her issues. So that was Sarah. That kind of brings me down to what the non-invasive treatments are.

Once find out what the root cause is … Is it coming from your neck? Is it coming from your wrist? Once you find that out, then it’s all about you, you create a plan with stretches in it. Because most of us get stiff and tight and that is causing undue stress and strain on our tissues. In this case, if you’re getting numbness and tingling, it’s because that tightness is causing stress on your nerves.

Wrist stretches,

I’ll just give you a couple quick ones. If you put your hands flat together and then bring your hands down. You don’t want your shoulders up here, you just wanna bring that hand down to where – as far down as you can. I mean, if you don’t have this much ranch, you don’t come this slow. The idea is to get it to where everything, the heel of your hand still stays together.

Your fingertips are flat on each other and you just bring those down to where your elbows are pointed out. You can hold that for 30 seconds or a minute, whatever you can tolerate. 

What that does is that helps stretch all of these muscles out.

Next you can do strengthening exercises.

If it’s your wrist that we’re trying to strengthen, then working on anything that helps move your wrist in through these full range of motions. How far up can you go? How far down can you go? Nice and easy, just work in those.

Now posture

is a little bit harder to give you an example because it depends on what you’re doing with your posture. If you can stand up as straight as you can imagine and pull on your shoulder blades back, getting your head back and trying to maintain that for as long throughout the day as you can. If you just allow yourself to fall forward, then you’re going to be adding a lot of pressure to all the nerves inside the front of your shoulder because everything just collapses in.

Alright, now your desk space,

that can be a huge culprit, especially if we work on laptops like many of us do. You’re going to have to give up working on your couch in that nice slumped position. This does not help anything. Your workspace should be set up as ergonomically as possible. That is just a fancy way of saying that when you sit at your desk, you should be in the most upright position possible.

You shouldn’t have to reach really far to use your mouse. Your monitor should be about eye level so that you’re not having to crane one way or the other. You’re not having to look up really far. You’re not having to look down really far because that just helps you stay in a much better alignment and put less stress on things.

There’s lots of people that are using standup desks and depending on how that’s set up, it would be the same. Ultimately it’d be the same concept, whether you’re standing or sitting. The nice thing about the standup desk is you get to change your position. You can stand up for a little bit, you can sit down for a little bit and changing positions is always better. You’re not designed to spend eight hours a day sitting in the same position.

Really you can get ergonomic assessments. A lot of companies actually offer those. So you might ask your boss if there’s a team that can come in and look at your workspace.

Now the fifth one, and the fastest way to figure this out is to work with a movement specialist like myself. Find somebody in your local area or call me and find the way they can help you go through all these things that I’ve talked about.

Carpal tunnel initially seems like it’s such a simple thing, it’s just your wrist has got a problem, but really the pinching of that nerve can come from a lot of places and you could do all the wrist stretches in the world and you do all the strengthening, but if it’s coming from a different spot on that nerve from your neck down to your wrist, if it’s not just coming from your wrist, then all I mean, not that those exercises are for nothing, but they’re not necessarily going to help you and it doesn’t mean that nothing would help you.

The fastest way

to do that is to have somebody do a physical exam with you and come up with a specialized program just for you to help you get back to the activities that you really want to get back to

If this is the type of service that you’re looking for, I’m going to leave a button that says ask about cost and availability. That will take you to a form. You’ll fill out the form and my office will get back to you if you have questions.

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