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Carpel Tunnel Syndrome: What is it?

Jan 25, 2021

The carpel tunnel is a narrow, rigid passageway of ligament and bone that is found at the base of the hand. It houses the median nerve, which is a mixed sensory and motor nerve that runs from the end of the brachial plexus (located at the root of your neck) through the forearm to provide sensation and feedback to the thumb and first three fingers. Carpel tunnel syndrome is one of the most common peripheral nerve entrapment disorders in the upper limb and occurs when the median nerve becomes compressed or squeezed at the wrist. This kind of injury is most commonly caused by sudden trauma to the wrist, such as a sprain or fracture, that causes swelling. Other common causes include an overactive pituitary glad, an underactive thyroid gland or rheumatoid arthritis. This compression on the median nerve leads to symptoms including feelings of pain, numbness and tingling in the hand and arm.

When treating carpal tunnel syndrome, it is important to begin as early as possible once symptoms start. Non-surgical treatments can assist in making the problem go away if you’ve only experienced mild to moderate symptoms that come and go for less than 10 months.

Exercise Rehabilitation:

Range of motion and nerve gliding exercises have been shown to be the most effective in improving pain, pressure pain threshold, and overall function in patients with carpel tunnel syndrome.  Nerve gliding (also referred to as nerve flossing or neural gliding) is a stretching technique that takes areas of the body through specific ranges to help target and free up injured nerves and improve mobility.

Evidence shows that symptoms should begin to improve within two weeks of consistent daily nerve gliding exercises. After six to eight weeks, it is expected to feel no tightness or pain within your affected wrist.

 

Other Non-Surgical Therapy:

  • Splinting: Most common initial treatment is to wear a splint at night. A splint will stabilize the wrist and minimise pressure on the median nerve allowing a period of relative rest from movements that may increase symptoms.
  • Prescription medication: Corticosteroids or the drug Lidocaine can be prescribed and injected directly into the wrist or taken orally to relieve pressure on the median nerve.
  • Alternative therapies: Yoga has been shown to reduce pain and improve grip strength in people with carpel tunnel syndrome. Better joint posture may decrease intermittent compression, and blood flow may be improved to decrease ischemic effects on the median nerve.

 

James McNally (BSc – GradDipClin Exercise Physiology)

Workers’ Compensation Specialist

References:

Ruth Ballestero-Perez, Gustavo Plana-Manzano, Alicia Urraca-Gesto, Flor Romo-Romo, Maria de Los Angeles Atin-Arratibel, Daniel Pecos-Martin, Tomas Gallego-Izquierdo, Natalia Romero-Franco. (2016). Effectiveness of Nerve Gliding Exercises on Carpel Tunnel Syndrome: A Systematic Review. Journal of Manipulative and Physiological Therapeutics , 40 (1), 50-59.

NK Visweswaraiah. (2013). Yoga for Occupational Health and Rehabilitation. Indian Journal of Physiology and Pharmacology , 57 (5), 20-21.

National Institute of Neurological Disorders and Stroke. (2020). Carpel Tunnel Syndrome Fact Sheet. Retrieved from: https://www.ninds.nih.gov/disorders/patient-caregiver-education/fact-sheets/carpal-tunnel-syndrome-fact-sheet

 

We live in a 3D world, it's time to start training that way!

By Alison Absolute Balance • 24 Apr, 2024
The human body is designed to move in a three-dimensional plane divided into the following segments: Sagittal Plane: Cuts the body into left and right halves. Forward and backward movements. Frontal Plane: Cuts the body into front and back halves. Side to side movements. Transverse Plane: Cuts the body into top and bottom halves. Twisting/rotational movements. Too often we get caught training mostly in a sagittal plane, think running, squats, bicep curls etc. While these are all good exercises, in day-to-day life we don’t only move along a sagittal plane. What happens when you need to quickly get out of the way of the e-scooter flying towards you on the foot path or make a quick sidestep to avoid a pothole – these movements are along the frontal plane. While movements such as turning to check your blind spot while driving or turning to talk to the person next to us are in the transverse plane. When it comes to injury prevention and movement efficiency it is important to incorporate exercises from all planes of movement into training programs. Sagittal If a line ran down the middle of the body splitting it from left to right, movements parallel to this line are within the sagittal plane of movement. The sagittal plane is the most common plane of movement and is trained overwhelming more than the frontal and transverse planes of movement. Movements/exercises considered to be in the sagittal plane include running, squats, deadlifts and bicep curls. Now while all these exercises are good, with the way our lives having evolved into many desk sitting roles, driving from place to place etc, to then go to the gym and focus heavily on movements that are predominantly up – down, and forwards – backwards we can end up reinforcing these pathways and becoming somewhat robotic, heavily limiting our natural movements. Frontal If a line ran down the middle of the body splitting it into front and back, movements parallel to this line would be within the frontal plane of movement – essentially any movement that involves moving away from or towards the midline. Often neglected in strength programs, frontal plane exercises include Cossack squats, lateral lunges, and side raises. Transverse If a line split the body in half separating it into top and bottom with the pelvis being the point of division, any movement parallel to this line would be considered to be in the transverse plane of movement. Movement along/through a transverse plane is generally more rotational such as a Russian twist or trunk twist. By focussing largely on sagittal plane movements, we are risking developing muscle imbalances, limited mobility and uncoordinated movements in the neglected planes. Our body is designed to move on a 3-dimensional plane so make sure to train in a way that will allow it to move the way it’s supposed to. Katie McGrath Injury Prevention Specialist Injury Prevention Services

Stretching and mobility benefits

18 Apr, 2024
Stretching and mobility exercises are indispensable components of both injury prevention and recovery strategies. Incorporating dynamic stretches before physical activity can help prepare the body for movement by increasing blood flow to muscles and enhancing joint flexibility. This dynamic warm-up routine primes the muscles and connective tissues, reducing the risk of injury during subsequent activity. Furthermore, static stretches, performed after physical activity, helps alleviate muscle tension and improve flexibility, thereby minimizing the likelihood of strains and tears. In the realm of injury recovery, stretching and mobility exercises play a crucial role in rehabilitation protocols for individuals recuperating from various musculoskeletal injuries. Following an injury, muscles can become tight and weakened due to disuse or trauma. Gentle stretching exercises aid in maintaining or restoring flexibility, preventing muscle atrophy and contractures. Additionally, targeted mobility exercises assist in restoring range of motion and functional movement patterns, allowing individuals to gradually regain strength and flexibility while reducing the risk of re-injury. Moreover, stretching and mobility exercises promote tissue healing by improving circulation to the injured area. Increased blood flow delivers essential nutrients and oxygen to damaged tissues, facilitating the repair process and reducing inflammation. By incorporating a comprehensive stretching and mobility routine into their regimen, individuals not only safeguard themselves against future injuries but also expedite their recovery journey, enabling them to return to their activities with greater resilience and confidence. Mariah Adolphus Workers Compensation Specialist (AEP, ESSAM) Exercise Rehabilitation Services ‑ WA

Meet a Team Leader at AB

05 Apr, 2024
Hey, my name is Blake, and I am an Exercise Physiologist, Workers Compensation Specialist and Clinical Team Leader at Absolute Balance. I graduated from Edith Cowan University in 2015 after completed my Bachelor of Science (Exercise Science and Rehabilitation). I grew up on a farm Northeast of Perth past Gingin with my parents and two brothers, both of which are back working on the farm, which has been in our family for generations. My love for sport and interest in the human body initially prompted me to complete my Bachelors in Exercise and Sports Science, and my initial thoughts on a career were either Physiotherapy or Phys Ed Teacher. However, this quickly changed when I commenced my first Exercise Physiology unit in my Sports Science degree as it opened my eyes to exercise rehabilitation, and how important it was to individuals with injuries. Having experienced multiple injuries personally playing football (AFL), basketball and tennis, I can fully empathise with how much injuries can impact your life. Being an EP and being in a role where I can make a positive and meaningful impact on individual’s lives who have sustained an injury is extremely important to me. This doesn’t only extend to the patients I see, but also the team members I lead within Absolute Balance. I guide a team of five in the Northeast region at Absolute Balance, assisting them with their own patients and leading them to grow as Exercise Physiologists and individuals. Although it has its challenges, leadership is extremely rewarding and has helped me grow both personally and professionally. Whilst I am not at work, I am spending my time at the gym, at football training and games during February-September (or in the car travelling to and from comes with the gig of country football), spending time with my wife and our dog Otis. I spend the other half of my weekend manicuring my lawn and watching good shows and sports. Blake Cocking Workers Compensation Specialist ‑ Team Leader North East (AEP, ESSAM) Exercise Rehabilitation Services ‑ WA
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