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ERS today I'm going to be bringing you the carpal tunnel syndrome video so you've got the median
nerve is the one that travels through the carpal tunnel you always want to make sure and check the
neck first you can watch another video that I just did on the thoracic outlet syndrome which is the
brachial plexus that comes out from C5 through T1 and it breaks into five nerves and the median
nerve is the one that goes through the carpal tunnel but it travels down it could be compressed
at the PEC minor so you want to check the neck and the scalenes and the PEC minor and down also
the pronator teres I'm going to show you that one so it travels down and they usually feel numbness
tingling weakness pain they start look losing grip or they may even feel like a little bit of
electrical shocks and it goes in to the thumb the index finger the middle finger and half of
the ring finger that's how the nerve travels and it innervates these three fingers and half of the
ring finger okay and it goes through the carpal tunnel right here so you also have the transverse
ligament that goes across to keep all the carpels in place and that's the roof of the carpal tunnel
and sometimes that's what presses so the median nerve travels underneath the pronator teres
and it goes through the carpal tunnel you have the transverse carpal ligament that goes right
across here to keep all the carpels in place and sometimes that puts pressure on the median nerve
and there are nine tendons from the flexors that go through here so it's pretty you know sometimes
there's not enough space and you've got to be able to loosen some of these muscles so you always want
to make sure and loosen the 4 forearm muscles and work on the forearm muscles there are two
tests you can do the phalans test and the tinel test so we're going to include those in the you
know in the description so you can kind of look at them and test your client however I'm going
to remind you that we don't diagnose okay we just go ahead and just see if maybe that could be it so
uh again the the me the median nerve innervates the thumb and these two fingers and then half of
the ring finger okay and some of the symptoms are that your arm go your hand goes weak you
can't grasp things that it tingles that it's numb usually wake up people wake up with it
feeling numb in the morning and it happens with uh people that uh truck drivers people that grasp
things of waiters and waitresses that carry a tray like this tennis players people that
you know weight lift hairdressers so it's it's repetitive motion that puts a lot of pressure
on that median nerve so to start off with you really want to relax the forearm muscles so
you can do you know some motions just uh guiding down with your thumb not putting too much pressure
remember you always want to go work towards the heart because the veins have little valves that
prevent the blood from back flowing so you don't want to do damage to those veins but you can warm
up the forearm you know warming up all the the muscles and relaxing you might want to go to the
medial epicondyle where you have so many origins of so many flexors here and also the origin of the
tear the pronator teres so you want to treat that while you're here also known as golfer's elbow
right here on the medial epicondyle and you might want to work the insertion also on the radial bone
and once you've warmed up you can even use your forearm to warm it up or you can use the soft fist
to warm it up you know just make sure you warm up you can even do some skin rolling you know
but you want to go ahead and warm up all the forearm very important for you to warm up all
the forearm muscles now that you've warmed up now you're gonna do one of the techniques that you can
do is you're going to ask your client to flex and extend while you move down you know from distal to
proximal one inch at a time so go ahead and Flex for me and I am just putting pressure and I'm I'm
trying not to put pressure on the median nerve you don't want to put direct pressure on the median
nerve okay because that will just irritate it and flare it up so I'm going like on the sides of it
and just asking her to move your wrist back even further and then I move okay keep going and I'm
just moving one inch at a time one inch at a time and if it's somebody that does have carpal tunnel
you know they'll start feeling maybe a little bit of Sensations so make sure that you go by
what your client needs you to if it hurts don't do it anymore but you can go all the way you know
from distal to medial here all the way and you can do this two or three times and when you're using
oil or lotion it'll Glide a little bit more and it'll Glide a little bit better too okay
so now I'm gonna she's gonna continue doing that and I'm just gonna Glide down
okay and another one that you can do is radial and
ulnar deviation you're going to ask her just to move her wrist you know sideways radian and all
the deviation so go ahead and do that for me while you're putting you know a good amount
of pressure moving down you can do this two or three times two or three times would be perfect
you know so these are techniques that you can use to release the flexors
okay so after you've done that another one that you can do is you're gonna
uh you know like you're going to give them a handshake and you're going to go there's
a trigger point right on the pronator teres and the reason we drew the pronator teres is because
it sometimes had traps sometimes it traps the median nerve you know because it travels beneath
the pronator teres so you're going to get your client in a handshake you're gonna hold like the
belly of the muscle and then you're gonna pronate and supinate at the same time pronate and supinate
their hand remember supinate is when you're holding the soup and then pronate is when you
spill the soup so hold that trigger point right there there's usually a major trigger point right
there and remember you keep it between a five six or a seven you don't want to put too much pressure
while you're pronating and supinating the Hand okay you can do that one another one that you can
do is you Flex their hand what I'm going to do is cut my fingers underneath where the carpal cells
are and I'm going to just separate them so you put their hand in flexion and then open up and extend
flexion and open up and extend so with my fingers on the underneath when I extend I open I open up
the carpals so flexion and then extend flexion and then extend the carpels here reflection and
extend this is another really good one here you want to work the top of the hand you know
you can even use your fingers here to try to really separate
some of this tension here release some of the tension from the bones and the transverse
goes all the way around so you want to go ahead and work around the wrist here
and now I am gonna you know try to work and separate and you can actually get
this better when she is from right now in the Supine position I don't work so much
on the on the on the hand but you can also get right here with your
thumb or even with your fingers just really work these uh the end
of the carpels here the carpals are two rows of eight and they're they go all the
way up here into the pad of your hand there you know this is your your radial bone this is your
ulnar bone so your bones end right here and then the carpals are right here at the base of the hand
so there are two rows of eight one more proximal one more distal so you want to kind of separate
them and be careful here with a hook a hook of handmade because it you can really feel it and
try not to put too much pressure because it does hurt the hookah hemate one of the carpal bones is
right here so if you feel a bony part don't don't try to work that out too much okay and so you can
try to separate you can go each in between the web here between the thumb and the index finger
when people have true carpal tunnel syndrome these muscles start weakening and they're not
as strong and they start losing their tone so they might look smaller and feel smaller than normal so
you want to go in between each metacarpal you know want to work out all the metacarpals the
carpels metacarpals phalanges remember carpels are the ones you drive the car with carpels you
drive the car with tarsals are on your feet for your toes so these are the carpels metacarpals
phalanges so you can work the hand extend also opening it up trying to create more space here
and then like I said at the end you want to go ahead and work and relax the whole arm now
we're going to turn her over and show you some work while she is prone so now that she's in
the prompt position it's really easy to access all the flexors and the carpels and the hand so
what you want to do is continue warming it up this is you can form a soft fist just a soft Fist and
put your hand over her hand and to support the fingers actually you can see the fingers curl
up so you want to see her fingers as you press on the flexors it's going to close her fingers
because remember these are the these are the muscles that flex and close the fingers so you
want to do with a soft fist you can go up you can also work the epicondyle here the origin of
the pronator teres you can work it out again you can do some cross fiber friction all the way down
or from distal to proximal you know do some effleurage if you want to it's just warming
up continue warming up and loosening up the flexors now when you get to the transverse
carpal ligament you know again you want to do some friction some cross fiber friction here
and you want to do some specific work where you can flex and extend the wrist
and all I'm doing is supporting with my fingers underneath and just flexing and
extending her wrist and try to do that you know moving moving like a half an inch at a time
you know you're trying to just to create some opening up here opening
up and spreading that carpal tunnel you can go to the opposite side too
and I like to do some a soft hit a fist with my fingers to go down each each phalange all the
phalanges all the way down stretching spreading creating some movement there creating more space
and I also have my tools here the beveled tool is perfect to
go in between the metacarpals in between all the metacarpals here
sometimes these muscles are really tight so you know even just to spread out here some of the
and like I said be careful with the hook of Hami that's right here don't go too deep if
you feel a little bumpy road there that's the hook so don't try to stay there for too long
but you can really spread
the palm this tool is excellent especially for people that have big meaty hands these
tools really do help and this one's more specific like for you know for trigger points
remember that the median nerve innervates the thumb the index finger the middle finger
and half of the ring finger if it's if this finger is going numb that's the
ulnar nerve so that does not that is not carpal tunnel okay
and again you can do cross fiber friction in the
palm of the hand or you can spread it which is really what you're trying to do you try
to open it up and spread it to create more space here for the nine tendons that go through there
so those four or five techniques if you can really you know get some movement and some flexibility
and work those flexors that would really help someone with carpal tunnel don't forget to end
with your nerve ending Strokes that feel really good to the client and it sends a message to the
nervous system that they can relax now after the intense work because this is if they're in pain it
is intense work so don't forget to follow me on Instagram subscribe share the video leave
a comment and I really appreciate you guys so until the next time create a great day
thank you
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