♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Howdy folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And in particular, we are the most famous
physical therapists on the internet.
- In our opinion, of course, Bob.
- Today we're, I had a patient, Brad, that texted me.
And I'm not treating him right now,
but he's having trouble with carpal tunnel.
So I wanted to make sure it wasn't his neck, his shoulder.
But it can also-
- So you had a patient years ago
and now he's got your number and he's texting you.
- Right.
- Okay, that's a good situation.
- So he did have further testing now,
and it's probably from his neck.
But I want to go over the tests,
what you could even do yourself.
- Wait, he thought he had carpal tunnel
that ended up being in his neck?
- Right, exactly.
And that's quite often the case.
- It can be a, you know, those two symptoms are similar.
- Right.
So when you have carpal tunnel syndrome,
quite often you're gonna have numbness or tingling
or pain in the thumb. - Yep.
- What's that, the...
- The pointer finger. - Pointer finger.
Middle finger, ring finger.
Half the ring finger.
- Sure.
- So, and you'll also maybe have a little bit of atrophy
in the thenar eminence.
- Right, that spot right there.
Yeah, because we're talking about the median nerve.
- Right.
- Because there's three nerves that feed the hand
and those area that you just mentioned are the median nerve.
- When I say atrophy, the muscle has wasted away.
- Because the nerve is not telling it to function
and then it just...
- Your strength is gone.
- Yep, yep, exactly.
- So we're gonna go over some of the common tests here.
And I was surprised Brad,
a lot of these tests are considered poor.
Like they're not good indicators.
- So if it's positive or negative,
it may be 50/50. - Right.
- But we'll go through them, because-
- I think they're still good to do.
- Yeah, and if you're positive on all of them,
there's probably a good indication
that you do have carpal tunnel.
So we've got four of them we're gonna go through.
They're pretty simple, you can do them.
- Let's go Phalen's first.
So Phalen's, you basically are gonna look
like you're praying.
- So hands like this and keep the palms touching, is that-
- Right, right.
And then you're gonna lift the elbows up.
And for, I don't know, they don't always say how long.
- But 30 to 60 seconds I believe.
- And you're looking for your symptoms to get worse.
Say, the numbness, the tingling, the pain recreates.
Now I've seen reverse fail too.
- Yep, right, going this way.
And all we're doing is stressing...
- Trying to compress the tunnel.
- Right, in which will compress the nerve.
What's happening is you've got all these tendons
going through that carpal tunnel and the median nerve.
And it gets too compacted together, and then pinches a nerve
and you get the numbness, et cetera.
- So if you're looking at where the median nerve goes,
it goes right between these two meaty parts of your hand.
So the next test, you're gonna do Tinel's test,
which is just tapping on the nerve.
So you're gonna tap right in between,
right between those two meaty parts.
- Now this one, I do this, I usually go 30 seconds.
I may go longer.
And then, it's irritating, and then, like,
because my wife had this, I've done this on hers.
And then she says, "Stop it."
It's creates the symptoms down into her hand.
It's not fun.
Especially if it's flared up.
- All right.
Next one is actually compression test
where you just take your thumb and push on that same spot.
- Which makes sense, you're just compressing
all those tissues and turn on the symptoms.
- And like I said, look for atrophy.
I think that's a good sign.
This is a new test I saw, Brad.
And it hasn't been studied a lot,
but when it was studied, it was very accurate.
- Okay.
- So basically, you just put your hands above your head,
and for two minutes.
And you're looking for symptoms.
- Well, you're gonna get tired shoulders.
- I know!
(Brad laughing)
That's a long time.
What you're looking for,
did it increase your symptoms again?
The final thing, if you want to do one neck range of motion,
you could do, let's say it's on the right side here.
I turn to the right and go back, extend back.
- So if we do it this way-
- That closes the holes down where the nerves come out.
And so if it is coming from your neck,
that might make your symptoms worse too.
It could be both. - Sure.
- Your neck and your-
- The double crunch syndrome.
- Yep, double crush.
- So when we do this, we're pinching that median nerve
at this location versus this location,
which can give you similar symptoms,
almost the same symptoms. - Right.
That said, give them a shot.
I think like Brad said, if they're all positive,
they all give you symptoms, the likelihood
of you having CTS or carpal tunnel syndrome are higher.
- And if you want to treat it,
you can go to Bob and Brad YouTube
and just type in carpal tunnel syndrome treatment.
We have a number of videos on options on how to treat it.
And it's something, a lot of things you can do.
- How's your wife doing with hers, Brad?
- Good, she had surgery.
- Oh.
- Actually, she self-treated
for like at least six or seven years successfully
by using the night brace and she did some other things
that we talk about in the videos.
But eventually she had to have surgery,
and it's completely taken care of.
So it was a great success. - One side.
It was just one side. - One hand, yes.
- All right, remember Brad and I can fix
just about anything.
- Except for...
- A broken heart.
- Broken heart.
And yeah, these carpal hunnel, tunnel things are just,
they're not gonna...
- The carpal honey might help you.
- We're gonna do a video on honey next, actually.
- Yeah, very interesting.
- So very good.
- Take care. - Take care.