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Carpal Tunnel Relief - Is Exercise the 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!
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.
About the author:
Jeff P. Anliker, LMT, is a Therapist and Inventor of Therapeutic
Exercise Products that are utilized by Corporations, Consumers
and Medical Facilities around the world for the prevention and
rehabilitation of repetitive strain injuries. repetitive-strain.com
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