Carpal Tunnel

[Pablo]

Hey, All!

As noted in a previous post in which Coach Bentz and I were exchanging info, I have wrist "issues." Turns out, after seeing a neurologist yesterday, I may have carpal tunnel syndrome, bilaterally, but mostly in my right wrist. I know that a "well-known" fitness guru on the internet has a program that allegedly CURES carpal tunnel. I don't own any of this guru's products, but overall don't have a good feel for his "example" of what fitness and health are. In any case, all that to ask the question: does anyone out there, especially my MD or Chiro/PT/Bodyworker Tribe friends have any straight skinny on ways to contradict and even heal CTS other than going under the knife? I understand, of course, that you are neither giving, nor am I accepting legally binding medical advice.

Thanks so much, ahead of time!

Agape,

Paul

[Coach Bentz]

Paul,

I recently made some commentary here (http://www.rmaxinternational.com/forum/showthread.php?t=18159&highlight=wrist). If you're abusing your wrist in other ways, like, with a laptop keyboard and staying in ulnar deviation for long periods of time, you may have extra compensation work to do.

Lets go back to what carpal tunnel syndrome is. You've got this nerve running down your arm into your hand, right, and it's being irritated because the 'tunnel' that it sits in (made up of carpals and tendons) doesn't have as much space as it should. And you experience pain, numbness, grip strength problems, that kind of thing.

The question to ask is, what happened to the space?

If what happened is that muscles and connective tissue of your forearm got tight from the way you (over?)use them, they're going to start pulling on the tendons and fascia down there (remember that snag in the sweater image that Coach Sonnon talks about?) The tendons tighten up, maybe they don't sit quite like they used to. Maybe they even bulk up to compensate. Carpals start shifting around, maybe get stuck in odd positions. Maybe you've got some swelling going on in there too (pregnant women can sometimes experience temporary symptoms)

Whatever it is, that nerve doesn't have the space it once did, and it's getting all kinds of stimulation.

If that's what's going on, then absolutely you have choices. Obviously you need your doc to help you figure out what's causing it. But if it's soft tissue then it's simple. Just not easy.

1) Good habits - Figure out (or get help figuring it out) what it is that you're doing biomechanically that irritates it. Then STOP doing that, or modify the activity so that's it's more biomechanically sound.

And I'm not talking about just everything south of your elbow. My orthopedic massage teacher was fond of saying that carpal tunnel syndrome starts in the core, and he taught us to treat it with that in mind. Chase your tension back towards your core. Can you fully straighten and lock your arms in down dog? If not, biceps could be contributing. Are your shoulders usually forward? Check pec/lat balance. Are you slumped? Work thoracic extension. You get the idea I'm sure. Your wrist is very likely the 'spokesperson' for a lot more going on in your body.

2) Compensation - you've got weeks, months, years... maybe decades of overuse. Expect that it's going to weeks and months of patient practice. Not just working the yoga to release the tension but, as Coach Sonnon says, to strengthen the functional opposites. Extensors, supinators are big ones in carpal tunnel syndrome. It wasn't an accident that I recommended screwing pushups to Ryan, in addition to seal & upward facing dog. If you're a laptop jock, I'd also be recommending that god-awful on-your-fists rocking plank pose that Coach loves to torture us with at ICs, where you rock from thumb to pinkie side of the fist, emphasizing the pinkie side of that.

3) Nutrition - my changes were not permanent until I started delivering nutrient dense food to my mouth. In my practice, I met a woman in her 60s who cured her carpal tunnel syndrome with nothing but nutrition.

4) Soft tissue work - someone who's trained in myofascial release, orthopedic massage, therapies like that, can really speed up your recovery, if you are also doing #1-#3 on your own. If you're not, you'll probably only experience a few days relief from any treatment.

5) Chiropractic - a good DC can not only put your bones back in place, but give you clues on where else your structure is contributing. A great DC will also have soft tissue training and apply it (although its a rare DC who will take the extra time to apply it. If you got one that'll spend more than 4-6 minutes with you, follow them WHEREVER they move their office).

6) If anybody gives you a ball to squeeze because you're losing grip strength, that'd be a good time for a second opinion in my book.

7) Try to catch Coach Ilano on one of his Seattle trips. You will not regret it.

I don't know which guru you're referring to, but here's my absolutely honest opinion. If it's soft tissue related, and you understand how to compensate (through movement or manual therapy), AND you believe that it's possible, then "curing" carpal tunnel syndrome pain is almost a trivial matter. It's a simple matter of unraveling the snags in the fascial sweater. It's just not easy the first time through. :)

I encourage you, whatever choices you make in your treatment, to treat this as a communication from your body, and not as some pain you have to fight.

[Ryan Murdock]

Brian,

Could you submit that in article form, please? Excellent work.

[Pablo]

Brian,

WHOA! I have some work to do here. I'm on it. Thanks, Brother! Miss you out here. Hope to see you soon.

Paul

[Kathryn Woodall]

Brian,

That was awesome! Very well said, indeed!

:)

[stevenhogg]

Maybe you've got some swelling going on in there too (pregnant women can sometimes experience temporary symptoms) Any additional pointers for a pregnant woman (like my wife) experiencing this?

[Coach Bentz]

Is she already doing joint mobilization, Steve? Localized, or full body?

If she wants to include the yoga, I would highly recommend that you both consult with someone who's more familiar with yoga and pregnancy than I am. There are hormones flowing (relaxin) in a pregnant woman's body that loosen things up in the body in preparation for childbirth, and you're gonna wanna be careful.

My experience with Intuflow in non-pregnancy situations is that it can have an impact on swelling. Think of it as the giving the lymphatic system a major boost.

I guess you *could* tell her that having the baby will also help with the swelling. However, I foresee that the first words you hear after that will resemble "THANK YOU, Captain Obvious!" :)

[Coach Gostnell]

I guess you *could* tell her that having the baby will also help with the swelling. Coach Bentz, CST, ISA (Incorrigible smart a**) :D

[Coach Bentz]

Learned from the best, mom! ;)

[stevenhogg]

Coach Bentz, CST, ISA (Incorrigible smart a**) :DIt's a dominant male genetic trait - We can't help it. ;)