We've been off for a week, so let's get back to it Brad.
Hi folks, I'm Bob Schrupp physical therapist, Brad Heineck physical therapist.
Together we are the most famous physical therapists on the internet in our opinion of course Bob.
Three reasons your carpal tunnel syndrome is not getting better.
We're gonna show you some self treatments that work. Well they better work.
Well my wife was just using one of them the other night.-Yeah. She's been struggling with this.
Is it just one side or both sides?
Well both I think one's worse than the other but you know, she was-Does she watch our videos?
Well, not yet, some of them, but anyway, that's another story Bob.
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All right so today we're talking about carpal tunnel syndrome,
which is basically you got compression on the median nerve.
The median nerve comes out of C5 through T1, somewhere in that area,
comes down from your neck, goes down the front of the shoulder, down and into the hand,
and generally, which fingers does it innervate Brad?-The median nerves?
Well, we're talking about these two.-The thumb that'd be the pointer?
The middle finger and ring finger, half of the ring finger.
Right right. So if we're counting--you count the thumb number 1, 1 2 3 and half of 4.
So if you're getting pressure generally with carpal tunnel syndrome,
you can get pressure anywhere along the median nerve.
Now the typical place you're gonna get it is right where the carpal tunnel is.
That's in the wrist, made up by a couple bones and there's a ligament that goes over the top of it.
But you could also-well now people are gonna get technical. They're gonna say well, I think there's seven bones in the carpal.
Whatever. It's a bunch of bones.-Oh I meant, a bunch of bones,
but the other thing is you can actually get compression up here too with the double crush syndrome
And so we're going to talk about that today where you may want to do some treatment up here also,
in addition to treating it down here.
Right, cuz it's not very difficult or take long to do and there's a good chance that you need some stretching up there anyway.
It's gonna help. Yeah. It's certainly not gonna hurt.
So we're gonna start off with the exercises that you should try first if you have carpal tunnel.
We've had--I've had some success with this.
I've had some people that literally you know didn't have to go in for surgery
because of this-sure and it's great that's the goal.
So we're gonna start off with nerve flossing.
So, I don't know Brad if you want to do this along with me or not,
but you basically take your arm out straight across like this. It's not down. It's not up.
It's straight across and you're just gonna start working on bringing the wrist and the hand down like this.
So when you're doing that you can keep going Bob, but you know, Bob had mentioned,
this nerve comes out from the neck area,
that's what he when talking about the C7 the C6 or whatever level which we're coming out and it's literally like a spaghetti,
that comes-the strand that comes down,
yep, under your clavicle by the first rib,
and it goes all the way and then it wraps around through that carpal tunnel and down into the hands and fingers,
so when the hand goes down like this, it's literally pulling that nerve from there up
and so you're moving that nerve back and forth like a string-like you're flossing.
Yeah-and that's why we call it flossing.-Yeah. Watch this Bob.
So here's that nerve and we're going back and forth.
I'll get coordination with your hand movement. And so that nerve is actually being flossed within the sheath.
And what I've found Brad and maybe you found this too,
but generally if like a person has it on one side and not the other, this one is tight.
This one doesn't want to move. That nerve is not flossing like the other side is.
Right yep so compare right to left or vice versa.
So you're gonna try this and if you're getting a lot of symptoms, you know
if it's making it worse, you got to back off and not do it as far.
The idea about this is not to flare up your your carpal tunnel.
But in the first day, I'd only probably do a set of ten-so ten times,
and the next day I'd maybe do two sets of ten.-Right.
And then if you're getting to the point where those are really going quite well, you're getting the risk quite--
You know far down, now we can add in some neck movement along with it.
Okay.
So we're gonna go ahead and
we're gonna do this and we're gonna go ahead and
put your head off to the side like this and you can actually do both at the same time if you want.
So the palm goes down,
the head goes off to the side which actually pulls and puts a little more stress on that nerve.
Right, right, or you can just if you want to make it simple, you can just bend the head away and go like this.
It might be a lot easier to coordinate.
There's that complicated thing where you kind of coordinate the movements, but-that's what I'm thinking.
This is gonna be a lot easier just to pull your head over and go like this and that's giving a little more stretch.
In fact if you want to stretch it a little more you can bring the arm back a little bit more like that, Brad's gonna show you
This way.-Yep that'll put a little more stretch on it.
So here is here and then if we go back that way without moving the body, so it's not this it's this.
Perfect. So if that gets to be too easy, you do two sets a day for a while,
and that feels fine now, then we're gonna go ahead and you need a wall and
Brad and I are gonna build a wall right now. Build that wall!-Oh, yeah. There ya go.
No political affiliations folks.
We don't wanna go there- yeah we don't wanna go there.
But what you're gonna do is you're gonna go ahead and you're gonna put the hand against the wall and
you're gonna again stay somewhat level here. I'm gonna be up a little higher like this and now you're just gonna move the head away.
So this stabilizes the wrist in a stretched position.-I actually feel a little bit of the symptoms there.
Is it?-I do!-Well Bob well it's a good thing a little maintenance here.
I can feel a little bit in the thumb kind of weird, and I'm not having troubles with this.
So it's just proof of the validity of this stretch-Yeah-There ya go.
We were validated. All right, so that's flossing.
The next thing I want you to try is just do some neck extensions.
A lot of people, you know, if this gets all crunched up you can get some pressure on that nerve.
So Brad why don't you show us some neck extensions here,
and you'll find quite often that you do have poor motion in that direction.
Right so get in a good chair, that's a firm chair with an upright back,
scoot your bottom back in, good posture shoulders back.
You need to have a good base.
You can start with a little chin tuck and then roll back and just see how this goes. So look at this.
He's stretching all this all out here-And I may even do this.
Especially if you're having symptoms up in here along with symptoms down here, this is really a great one to do.
Yep he's helping you open up that whole area there.
So there's plenty of room for the nerves to go through and be happy.
All right. Let's go to the final one Brad.
I just want to mention Bob on this if you bring your head back and you're starting to get some pain
that's kind of sharp, you're gonna just back off on that and hold off.
Yeah you just go to the point where you feel the pain and then come back again.
Right so be cautious with that if needed.
Quite often what can be happening also is that the first rib could be pushing up against that median nerve.
So this is a first rib stretch you do and this is real simple to do, it actually feels really good.
I don't if you've done this one, Brad but I've done this. So you just take a roll towel or a roll sheet.
We got a little bit of tape around it just to keep it in place and you're gonna go ahead and throw it over your shoulder like this and
you're gonna go ahead and pull down on both sides.
Sometimes if it's real long
you can sit on it like Brad's doing right there and you're gonna pull down
and then you're just gonna bend your head to the opposite direction.
So I'm having symptoms on this side on the left side and I'm gonna pull down and
turn, you know pull away from the pain here and that's pushing a little bit down on that first rib.
Give a little motion to it. This is the one like I said, this feels good doing it.
Oh yeah it does, I like it right now. I like when you sit on it you get a firm chair, your bed might be too soft.
To be honest, that is the better way to do it because otherwise you're using the arm that's giving you trouble.
I can completely relax this. So this is a lot better way to do it and of course Brad ends up showing me up again.
Well Bob, it's not hard.
Alright, the next thing you want to do is you want to make sure
that the reasons you're getting carpal tunnel are going to be eliminated.
So one of the reasons why people get carpal tunnel is
if they got their screen too low and are down like this and everything's getting pinched.
You want to raise this up and you know on someone like me, you know
you want to have my eyes hit about the middle of the screen,
so look how high that screen has to be, and believe it or out at home that's how I have it.
Yeah well that's how it should be.
And the keyboard itself you want to make sure that's not up, you want to make sure you're not on a sharp edge like this.
I've seen this quite often. People are typing off a sharp edge like that and
you want to make sure the keyboard is down to the point where your arm is actually vertical here, the upper arm,
and this one can actually be horizontal or slightly lower than horizontal-but you definitely don't want it up.
0Yeah, and some people go ahead and just put the keyboard on their lap or they get one of those lap boards,
Sure-to hold it or they just have their desk set up at this height.
So this makes a big difference, especially if you do a lot of typing on the computer or some other device.
I guess the iPads, what else do they all use nowadays?
I don't know Bob, I can't keep up with it and I'm just lucky I can use a keyboard.
All right, the final thing we're gonna have you do is you want to make sure at night that,
if you don't mind Brad, I'm gonna lay down here.-Well take a nap. Why not?
You want to make sure at night that you're not curling up your arm. You're not laying on your arm.
Let's say this isn't my involved side and let's say, you know if you can avoid laying on the involved side,
please do. Where's my mic?-Right there.
So you want to you know lay on your back or lay on your other side.
But if I go like this and I got my wrist curled up all night long,
I got pressure on that median nerve all night long.
So one of the things that helps sometimes if you're bent on laying on that side,
we do use an additional pillow here and we create our canal here,
and this takes off some of the pressure off that arm and you can lay it out flat like this,
especially if you have a large bed and your spouse or partner is not gonna you know give you the room,
you can lay it out like this and keep it flat all night long.
Could be the dog. Some people would sleep with their dog.-Yeah, that's true too.
But you don't want to have your spouse or your dog or your partner lay on--
Oh yeah then you got the triple crunch.-Yeah.
Are we gonna talk about the wrist brace yet?
Oh, yeah, and then that's another thing to go ahead and try is to go ahead and use a wrist brace.
Right and that keeps it comfortable. This is really comfortable. I've had it on for about 30 minutes now, I've forgotten about it.
Yeah, and your wife's using one right now too right? Well at night not right now, she's at work. Yeah.
Let's get literal about it.
Here's another one, this actually holds the fingers up too. I think we have some of these in our--
not on our Amazon recommended I think on our website we have some of these recommended.-Oh, okay.
Yeah I'm not sure but they are handy. They just keep that wrist in a neutral position.
All right. We're about to ready to block out here. So, thanks everybody for watching.-Be careful.