Carpal
Tunnel Relief - Exercise Is The Best Solution
Carpal tunnel Syndrome (CTS) is one of many musculoskeletal
injuries listed under the broader terms of Repetitive
Strain Injury (RSI) or Cumulative Trauma Disorder
(CTD). A number of other injuries listed under
these terms, but that are not exclusively caused
by a repetitive strain injury or cumulative trauma
disorder, include Guyon's Syndrome, Tendonitis,
Cubital Tunnel Syndrome, Epicondylitis and Trigger
Finger.
Carpal tunnel syndrome and other types of repetitive
strain injuries are most often caused by excessive
overuse of a muscle or group of muscles in a unidirectional
(One way) movement pattern. Examples would include
typing, wringing a washcloth and using a computer
mouse. All of the movement patterns involve motion
against resistance in one direction - flexion.
This one-way motion does not actually have to involve "repetitive" movements
as the term "repetitive strain injury" implies,
as it is just as common for an individual to become
afflicted with a repetitive strain injury while
performing activities that involve no movement
of the hands at all. Examples of this would include
holding onto a steering wheel, gripping a pen or
a tool such as a hammer all day. With these types
of activities, no repetitive type motion is involved
at all, but instead, "static flexion" is utilized,
which involves the overuse of these muscles, but
in a manner that is stationary.
Since Repetitive strain injuries are most often
caused by unidirectional movement patterns, the
best way to counteract each specific overused motion
is the implementation of an exercise program that
involves resistance exercises for the opposing
muscle or group of muscles that is being overused.
An example training program for carpal tunnel syndrome
would include resistance exercises for the muscles
that open (extension) the hands in order to counteract
the overuse of the muscles that close the hands
(flexion). This principal of "balancing" muscles
groups so that there is a more natural equality
of strength between muscles that surround a specific
joint, whether it is the wrist, elbow, shoulder
or neck, is basic common sense and integrated into
training programs by the top practitioners and
therapists in the industry today.
Here are a few examples of practitioner responses
regarding the implementation of restoring balance
between muscle groups in order to prevent and rehabilitate
repetitive strain injuries including Carpal tunnel
syndrome.
"Muscle balance must be restored with
specific exercises. Otherwise, the already strong
and overused muscles get stronger, and the weak
and underused muscles remain weak. Individuals
get good at using the overused muscles and must
be trained specifically to recruit and strengthen
the weak underused muscles." Philip
E. Higgs, M.D. and Susan E. Mackinnon, M.D. Department
of Surgery, Washington University School of Medicine,
St. Louis, Missouri. Annu. Rev. Med. 1995. 46:1-16
"If certain muscle groups are underused,
opposing muscle groups will be overused. Muscles
in either a lengthened or shortened position
will be at a mechanical
disadvantage and weak. The overused group will
hypertrophy, and the underused group will continue
to be weak. This combination produces a self
perpetuating condition that maintains the abnormal
posture and muscle imbalance." Philip
E. Higgs, M.D. and Susan E. Mackinnon, M.D. Department
of Surgery, Washington University School of Medicine,
St. Louis, Missouri. Annu. Rev. Med. 1995. 46:1-16
A strong example of how important it is to properly
balance muscle groups is seen in the following
statement regarding the balancing of the in the
hands and forearms.
"All of the extrinsic hand muscles become
involved in a power grip, in proportion to the
strength of the grip."........ "Strong
agonist-antagonist interactions are needed between
the flexors and extensors of the hand and fingers
to produce forceful hand-grip. Powerful flexion
of the distal phalanges requires strong activity
also of the finger extensors." Janet
G. Travell, M.D. and David G. Simons, M.D. Myofascial
Pain and Dysfunction-The Trigger Point Manual.
Volume1 Upper Extremities, Ch:35, pg. 501. Copyright
1983.
Performing corrective exercises in order to prevent
and rehabilitate carpal tunnel syndrome and repetitive
strain injuries is of the utmost importance. In
95% of most cases, there is no need for invasive
techniques like cortisone injections or surgery
in order to eliminate carpal tunnel or other repetitive
strain injuries. It is one thing if you have an
actual structural anomaly that needs to be corrected,
but since most cases of carpal tunnel and repetitive
strain occur in later years, it is quite obvious
that a physical anomaly does not exist as this
would be experienced by the individual in their
younger years. Instead a structural or joint imbalance
exists that has developed due to long-term overuse
or sudden trauma due to overuse, and is a result
of overly strong muscles pulling one direction
while the opposing weak muscles try unsuccessfully
to counteract and pull the other direction.
Muscle imbalances can be corrected with simple
exercises. Below is a chart showing the activity
that can cause the muscle imbalance and which muscles
need to be stretched and which ones need to be
strengthened in order to eliminate the symptoms
associated with carpal tunnel syndrome. By performing
an active exercise program that focuses on keeping
muscles balanced, individuals can stay healthy
and pain-free!
NOTE: Be sure to be aware of any pain that is experienced
'while' performing exercises. If pain is experienced
while performing exercises, stop immediately. Post
exercise soreness is normal. Always be sure to consult
a physician before beginning an exercise program. |