Transcription
Here's the secret cause of carpal tunnel syndrome that no one is talking about. Most health care professionals will blame carpal tunnel syndrome on frequent repetitive movements with the hands. Movements like typing on a computer and repetitive jobs like labor jobs that you need to use your hands on a lot but don't necessarily require a lot of strength.
What ends up happening in jobs where you're typing on a computer or similar activities is you actually lose strength in your hand. You get good at handling fine motor things like pressing on keys on a keyboard, but it doesn't take a lot of strength to do that. So, as a result, you'll get weakness in your hand muscles. And then another tricky one that people don't really pay attention to much is you get weakness in your upper trapezius muscles, the shrugging muscles right here. And this is important to factor in if you have carpal tunnel syndrome because the muscles up in your shoulder area, the the upper trap muscle affect the pressure on the nerves all the way up here in your neck and shoulder. And it's the same nerves that go down into your hand and and pass through the carpal tunnel and affect your hand. That's what causes the symptoms, the numbness, the tingling, the weakness in this area of your hand.
I want to draw you a picture of these bones so that you can better understand how the carpal tunnel works and how the weakness affects the the nerve pressure inside the carpal tunnel. So, I'm going to show you a cross-sectional area of the hand. And so, just to show you what I'm looking at, it's as if you're looking at the bones right here. So, I drew four little bones. It's as if you're looking at them right here. This bone, this bone, this bone, and this bone. You have a bunch of bones there. It's okay. We don't have them all just right. There's there's a bunch of them there. It's all you need to know. And I'm going to show you two examples. In the example on the left, this would be a healthy example. Here's your big palm muscles right in there. Now, I have pretty big palm muscles. If you look at my muscles right here, this right here, that's pretty thick. And this one at the base of my thumb looks like a drumstick right there. And that's because I strengthened my hands. You could tell I lift weights, I have calluses, I'm doing things actively to get my hands tired and I do feel my hands are tired. In people that have carpal tunnel syndrome, very often these muscles are withered away. They're atrophied. They don't have much. And so their muscles look more flat like so. They don't have much there. And the carpal tunnel is the space right here between those muscles in this spot right here. And right over it is a ligament. Sits like that. Kind of like a bridge between the two muscles. And you can see if you have thicker muscles, you're going to have a bigger space for that nerve to pass through. And the nerve would be a circular structure like that if we're doing a cross-sectional view, and it would be right here. So, you can just see that there's less space. And the nerve isn't the only thing in there. There's a bunch of tendons that go to your fingers to operate your fingers that pass in there along with the nerve. And so it just gets more crowded when you have smaller palm muscles in your hand. So, as you can see, we're going to have to get those hand muscles stronger. But that's just one part of the whole thing.
Let me erase this and show you the neck stuff that I need to discuss with you. So, let's say this is your headbone, your skull, and then you have neckbones here. And you have seven, but I'm not going to draw them all just for the sake of brevity here and making sure that I get the point across. There's your sternum. It's more V-shaped at the bottom. And then here's your collar bone. You have two, one on each side. And then you have your ball and socket joint out here. Your armbone goes down. And then you have your elbow here. And you have two bones in your forearm, the ones that make up these right here. And then all those little wrist bones that I drew earlier. And then you have some hand bones and fingers. And it's okay if you don't have all the fingers right, but that's that's your handbones down there. Sorry, they're not drawn the best. I'm not an artist. So then you have nerves that come off your neck and go down on both sides, of course, and they all kind of converge. Um, this is called the brachial plexus, and they go under your collar bone and then go into your arm. And these nerves, they they connect to all the muscles and skin down your arm, and eventually one goes through that carpal tunnel right here. Well, if you don't have good strength in the upper trap muscle, that shrugging muscle, it connects to the outer edge of that collar bone and to the back side of the neck. And if it gets weak, then what happens is this lengthens and your collar bone starts to go down. It drops and it puts pressure onto those nerves right there. And so you get compression of the nerves right here at the collar bone. This is why some people very often people that have carpal tunnel syndrome also have neck and shoulder pain. Sometimes it's right under the collar bone, right behind it. They can feel it. Oftentimes it's in the neck area because those weak upper traps will get achy and and put pressure on the neck and then it can mess with the function of the shoulder and people have things like rotator cuff tear problems, shoulder impingement, eventually they'll develop shoulder arthritis. But it has to do with this decreased collarbone angle. And so if we get this muscle stronger, the the shrugging muscle, get it nice and strong, then you can lift the collar bone up. It's no longer down. Now it goes up and it takes pressure off the nerves here. So if you combine taking pressure off here and then getting those hand muscles stronger in the palm and getting that ligament off the nerve here, that's how you can set up reduced nerve irritation in the carpal tunnel area.
And if you look at the anatomy of the hand, you can see the if I if you look at this angle right here, the bones, they kind of form an arc right here because that's where the tunnel is, right where my finger's lying down. And then you have those big palm muscles that are taking up this space right here on the side. And then under the pinky. So if you look at my hand right here, it would be right there. These big thumb muscles right here. And then the muscles on the on the pinky side of the hand. And you have that bridge area right in here. That's where the the carpal tunnel area would be. And the stronger these muscles are, the more it's going to lift off and even create a a curved area because it's pulling those muscles are start are going to start to pull this area here to make a better tunnel, a more open tunnel.
And when you talk about treatment for the carpal tunnel syndrome problem, very often it goes to surgery. In the short term, what you'll get told to do first is to wear a brace, a wrist brace that keeps your wrist straight. And they'll tell you to sleep in this because you know you move around at night and you might end up bending your wrist in an awkward position and that awkward position can put extra tension on the nerves. It just makes the wrist uncomfortable and can aggravate the symptoms going into the fingers for carpal tunnel syndrome. But if you have the wrist straight and it's blocked from moving, then you have less chance you're going to put it in an awkward position and not irritated with movements. And you should be wearing that wrist brace throughout the day, too, to just get things to calm down. But it's a short-term solution because it's not strengthening your shrugging muscles or your palm muscles. It's merely just keeping things from getting worse in the short term.
Now, another thing that you'll hear is the surgery. And in the surgery, they're going to cut that tunnel, the the ligament that goes over the tunnel. And the theory is that if they cut the tunnel open, then they automatically increase the space. And it's true, you do increase the space, but it doesn't strengthen the palm muscles. In fact, it sets you up to have even more weakness in the long term because now you have a surgery to recover from. So, you're not going to be using your hand for a while. And if you never get told or instructed to go get those palm muscles stronger, then you probably won't. And people very often baby their hands after having a surgery and after dealing with carpal tunnel syndrome for a while. So it's rare that I see people recover fully from carpal tunnel syndrome surgery and have zero symptoms. They might have no symptoms for a while, you know, maybe a few months at most a few years, but then the symptoms end up coming back. And it's not just the the tunnel being pinched here and the nerve being pinched here. It's the nerve compression up in the shoulder area because those collar bones are getting lower and lower and lower as these upper trap muscles get weaker. And then you also start get you also start getting neck problems where the nerve can get pinched at the spine, not just under the collar bone.
So the long-term fix, what you've got to do is work out your palm muscles. So when you work out your palm muscles, things like putty, like this putty right here, is going to be super helpful if you can close your palm. Notice how I'm not bending my fingertips very much. I'm not gripping and clutching the putty because then you're going to be using the muscles that bend your fingertips which skip using your palm muscles. You need to be able to close your palm so that you use those muscles right here that help to lift the tendon off the carpal tunnel area. So that means you need to get that putty into a ball and close your palm around it and start to wake up the muscles right here and get it tired. And what I tell people to do is is get putty like this. You can get it at the store or Amazon. And I'll we'll have a link on the video for for this specific putty we're using. And you can play with it throughout the day and just get those palm muscles tired. And you probably need to do both sides. After this gets easy, then you need to get to a a stress ball, a foam ball, and think about squeezing that as well. And there's different sizes. This one's a little bit bigger than than most people would need, but the idea is you're squeezing the ball without clutching it with your fingers. Because if you're using your whole fingers, then you're skipping using your palm muscles. Most people are very strong here with this motion, but not so strong in closing their palm. So, you need to not do this, but close your palm around the ball. After you get better at that and you need even more resistance, then you need to use a device like this grip strengthener. And I like the grip strengthener a lot. This one in in specific because it's adjustable. You can turn this knob here and make it harder or easier. And this one goes up to 90 lbs. It reads right there. It gets challenging. But the way you would use this is similar like with the putty and the ball. You need to be able to squeeze it without wrapping your fingers around the handles. You need to keep those fingers loose so that you're closing your palm using the handles. And what I tell people to do on this one is if you can squeeze it and get the handles to touch, it's too easy, right? Your your strength can overcome the spring there. You need to tighten it so that when you squeeze, it's not going to allow you to bring the handles together and you're struggling. And then you need to be holding that for 10 seconds. And you're probably going to be shaking, grimacing, sticking your tongue out, making faces because it takes more effort to do that. And you should feel muscles here. You're going to start engaging all the muscles. But you should definitely feel the palm muscles. And you might even need to play with the position of this to get the right angle because everybody's hands are a little bit different. You might need to reverse it this way and and put your thumb on that side. Play with it. But the idea Oh, another thing I'll do is I'll I'll help it squeeze because if you have a smaller hand, you might need to pre-squeeze the handle so that you can get your palm around it better without using your fingers and hold at that position. That's going to strengthen your palm even better. And then the next steps after that are to use a dumbbell to do different exercises. At that point, you're doing exercises like bicep curls or you're you're walking around with heavier weights. You have to figure out how to get that dumbbell to handle the dumbbell in the palm of your hand. And and think about using your palm muscles, not just your fingers wrapped around the bar, the the dumbbell. And then eventually work your way up to heavier weights that might include barbells as well.
Now, that's just the hand work, the hand strengthening you have to do. There's still upper trap muscles to account for. And what I recommend you do is start with a wall shrug exercise like this one where you hold for 10 seconds. The holds are really important just like with the hands because it helps you to wake up the muscles and use more of the cells, more of the muscle cells to achieve the motion. You have to go up all the way. It needs to be a maximal shrug to get that collar bone off the nerves right under the collar bone. Then after you do shrugs like this, as that get easier, as that gets easier, then you're going to reach your arms all the way up with only your hands touching the wall. Still maximally shrug and make sure to keep your chin tucked in so that you're not hurting your neck. After that gets easier, then you're going to be doing holds off the wall. So you're just reaching straight up overhead and shrugging. And after that gets easier, eventually you're going to put some small weights in your hands. Hold there. And then after that, you need to start doing reps where you're pushing heavier weight up and down repeatedly to get those shrugging muscles involved with every single movement. If you can go through that progression, you're going to save yourself from having an unnecessary carpal tunnel surgery and you're going to feel great at using your hands. You're going to stop dropping stuff, stop getting that tingling feeling, the numbness in your hands. You're going to be healthy, active, and mobile again.
Hey, if you want to know what not to do when it comes to carpal tunnel syndrome, check out this video. It's the top 10 recommended treatments by health care professionals that actually make carpal tunnel syndrome worse.