(upbeat music)
♪ Bob and Brad ♪
♪ the two most famous ♪
♪ physical therapists ♪
♪ on the internet. ♪
- 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.
- Brad, what they don't tell you
about carpal tunnel syndrome.
- What, Bob?
(laughing)
- We're gonna tell you today, these
are little known facts about it.
And also some treatments that may not be known.
- And, and very effective ones.
- Right.
- I think there's such a big misconception
about carpal tunnel in general. People,
- Carpal tunnel syndrome.
- Right. People just say I've got carpal tunnel.
And if they really understand what it is,
it's not so scary and how you can treat it
with some of these simple techniques that can be
effective.
- Surgery's not always needed here.
- Exactly, right.
- There's times it gets too far and
surgery is needed but, you know,
I don't want people to feel guilty.
- Right.
- When it gets to that point, but--
- Can show you some things you can do
at home that can really turn things around
and you don't even need to see a therapist.
- You got a few stats about it first?
- Right.
- Statistics.
- This is interesting.
3% of adults in the United States
end up with carpal tunnel syndrome.
- That's a lot.
- Yeah. Actually, actually it is.
When you think about it.
Yeah. Women, females are three
times more likely to get it, just
statistically speaking, I'm not sure why.
- I think they, they, they thought it was due
to the shape of the bones and stuff.
Again, the carpal tunnel is a tunnel
that goes right through your wrist.
Basically it's two bones that form a tunnel.
And then there's a ligament that goes over the--
- We better not just say two bones
because it's got all the carpal bones.
- Oh, right. Right.
- We'll get in trouble 'cause
there's some therapists watching.
- Yeah, exactly.
(laughing)
But the median nerve, a nerve that comes
out through from your neck and
travels all the way down your arm,
goes in through that, that little tunnel and
and it supplies the sensation to your hand.
- Right.
And along with that nerve, there's a number
of tendons that make your fingers flex.
And so it can get kind of packed up
and a little bit too tight in there.
And if it gets too tight in there,
we're not gonna go through the reasons right now,
but that nerve can get pinched.
And when that nerve gets pinched,
you start getting numbness, tingling, weakness
all these symptoms in your fingers.
And it's typically your--
- Thumb,
pointer.
- Yeah.
- Middle
and ring.
- Right.
- Half of the ring.
- Right.
- Pinky's usually not involved.
- So a lot of times what you're gonna see is
is even a little bit of muscle
wasting right here in, in the thumb.
- Right, if you've had it long enough.
- If you've had it long enough.
- And if you compare, if you have it
on one side, not the other, you'll see
that the muscle may have even
wasted a little bit there, so.
- Sure. Okay.
- So anyways, that's the anatomy of it.
So don't get too excited when they do surgery
they actually just go in and they
open up the carpal tunnel by cutting
the ligament that, that goes across
and forms the bridge, so to speak.
The other thing is the average age of the person
or who gets this the most.
50 to 55.
- 55.
- Yep, yeah.
So it's not so much younger people.
Not so much the older, but that--
- That's me.
- Yeah.
(laughing)
- I'm 56. You're 54?
- Yes. Exactly.
- Okay. All right.
All right, there, there's some tests you can do,
- Right.
- You could even do yourself.
Right, Brad?
- Exactly, Yep.
The tinels test, just put your
hand out like this.
- And you're gonna tap.
- Tap. You know what?
You know what tapping reminds me of, Bob?
- What's that?
- We got a little button.
- Oh, that's right.
- You got a button here.
You could tap on.
- If you're new to our, you know,
our, our channel please take the,
just a second.
- Right.
- To go ahead and hit that little
subscribe button there because
we provide you with lots of videos
on how to stay healthy and fit.
And we upload a video every evening.
- Right.
- We're really good at this.
We'd really appreciate if you subscribed.
- Yeah, okay.
- The tinels test, you tap.
You're gonna do that for 60 seconds.
And if you start to develop, or the symptoms
in your fingers start to get worse from the tapping.
- Yeah, you start getting the tingling or the pain.
- Yep. That's a positive.
- That's a positive sign.
- Doesn't mean you necessarily have it.
- Positive doesn't mean good.
Positive means that it's possible that
you have.
- Right, right.
- Carpal tunnel.
- Then the other one,
you take the back of your hands, put it together,
go like this and then squeeze up like this.
- Phalen's test.
- Yep.
- Hold that for 60 seconds.
- That's reverse Phalen's test, I believe
'cause this is Phalen's test, this way,
right? You're gonna do it both ways.
- Right? I, I like to do it both.
I, I, and this way for 60 seconds
see if the symptoms are irritating.
- You're recreating the symptoms.
- Right. Or this way and bring, go this way.
You're just, this way puts a crush.
Well maybe we don't need to get into the,
the details of the mechanics of it,
but those are the tests you can do it.
And if they're all positive, well, you know
you've got a pretty good chance
you may have carpal tunnel syndrome.
- Right.
- But not a hundred percent!
- Obviously you're gonna go see your doctor
about it.
- Right.
Alright, you wanna go to some of the
causes of, of what, you know, causes
your carpal tunnel syndrome to appear?
- Well, that's the interesting thing.
Oftentimes you can have these symptoms
in your hand and they're not from
the carpal tunnel but they can be from your neck.
- Right.
- The, the nerves that, the median nerve
starts way up here in your low neck.
So the neck, the nerve could be compressed here
and irritated, causing the numbness
and tingling down here and we can get fooled,
you know, and therapists and doctors
can get fooled by that.
- They can get compressed a, a number
of places on the way down.
- Exactly, right.
- That's where we're gonna talk about
how important it's to have good posture and,
and do some stretches even.
- Exactly. Right.
So if you're working at a computer station,
it's just not so much as you're
working your hands but your posture
of your body.
- Right.
Are you rounded forward?
- Exactly.
- Shoulders forward.
- This is putting stress on the nerve
before it even gets down to the hand.
- Right.
It becomes what we call a double crush syndrome
where you get pressure up here,
it gets sensitive, the nerve is sensitive.
So now it gets a little pressure down here
and it's even more sensitive and it
starts giving you the symptoms.
- Right.
- So we need to get this posture in good position
and you need to maybe even do some stretches.
- Right.
So if, if we're treating a patient
for carpal tunnel, we'll not only treat the hand
and do stretches for the hand,
but we'll talk about posture.
We'll talk about stretching, the scaling muscles
which are in here, which you can stretch
out here because that nerve bundle does go
through the scaling muscles.
- Yeah.
And then we're gonna work on the
first rib, as a matter of fact,
Should I show that first long stretch?
- Sure, yeah.
This is something you can do at home.
You take a belt,
if it's on your left side,
sit on the belt with your left butt cheek.
Take that belt, go over the top of your shoulder.
Okay, and then you just, you pull
down here with both hands and you're
compressing here and then you take your head.
- Usually we start with just deep breathing, Brad.
- Okay.
- We take a couple deep breaths
while you're giving pressure on it.
- Different therapists do things differently.
- Right.
(laughing)
- But I like Bob's is more complete.
- So, just as, as a starting point.
- Yeah, let things relax.
- And then you go ahead and do the stretch.
- Good point, thanks Bob.
And we go like this.
And you can get a lot of, I, I really
get a lot, a good stretch on here.
- Looking at a rib that may be a little bit tight
and we're trying to mobilize that first rib
because it can put pressure on the,
the nerve as it goes up over the top of it.
So it, it, this, this gives a little bit
of relief to that.
- Feels good, too.
- Yeah, it does.
That one always feels good.
Even if it doesn't help.
It's it's a good one to do.
- Sure.
All right.
- So we talked about posture.
- The other thing, I think, you know,
a good stretch to do, Brad,
is if you're in a doorway and you know
here's the doorway, you put your arms
on both sides of the doorway, and then
you're gonna just stretch forward.
Like this, you're gonna put this,
it's gonna support you.
You can do it down here, here, up here.
And you're gonna get the different parts
of the pectorals major and minor, which can also
put some stress on the nerves that's going through.
- Sure, yep.
- So, good stretch to do.
- And I'm sure people are thinking, well,
what about the wrist stretches?
And, and the things you can do with your wrist.
And, you know the stretches I'll do is,
you know, stretching here, it's gonna be
a general stretch.
You're not gonna stretch the geez out of it
'cause you don't wanna make it
sore and irritated too.
- Well, I, I like the nerve glide, Brad,
and, and we've--
- Let's go through that one.
- Yeah. We've been doing this a lot with patients
so you're gonna glide the nerve,
the median nerve and that, and
that's very easy to do.
All you have to do is you're gonna
put your hand out like this,
palm, you know, facing the wall.
- Okay.
- Basically if there's a wall there, you're not
gonna start with a wall, but all you're
gonna start off first is just kind of
doing a few like this, Brad, 'cause it,
this may be very tight.
- Sure.
- Especially compared to the other side.
If you only have it on one side.
But you're just gonna start with these
and then eventually you're gonna even go
like this and even stretch
it even a little bit more.
- And you might wonder, well,
what's the neck got to do with it?
Well, that nerve goes here all the way through here
through the, by the first rib, through that,
the scaling muscles and up the here.
And when you move your head that way,
it stretches that nerve out.
- So eventually what you can do if
if that becomes too easy
and you let's say you do a set of 10.
I probably wouldn't do more than 10 a day.
- Right.
- Rather a set of 10 a day.
You can then go ahead and even put a hand
against the wall like this and
go ahead and press like this.
Now that's, that's the more advanced version.
- My shoulder's the wall, by the way.
- Yeah, exactly.
(laughing)
And so again, again, this is a great one to do,
but I I can't emphasize this enough,
Brad, that you have to be very
gentle with this one.
- Yeah.
- This is not one to go the first time to start
because you'll irritate that nerve.
And it'll get worse.
- Yeah.
- So the first time it's just very gentle.
You kind of bump up against the pain.
Oh, that hurts a little bit.
That hurts a little bit.
And then eventually, oh, it's feeling
a little bit better.
It's stretching out a little more.
The nerves are very sensitive.
They, they don't tolerate stretching very well.
- It's not like a muscle.
- Right.
- You get to be a little wimpy
and you should be wimpy on this one.
- Brad, we should really talk about bracing
because the the studies have shown
that this really does help, too.
- Right.
I, I know a surgeon in Lacrosse
and he does a lot of wrist stuff
and he, and when he gets someone,
he does the right thing.
He says before I even, you know
do much more with you, I'll want you to go home
get a wrist brace for the involved side
and sleep with it.
A lot of people think, oh, you should use it
while you're working where the
problem is being irritated which is an okay idea.
I have no problem with that, but it's probably
more important to sleep with your wrist in neutral
because that allows circulation
through the carpal tunnel taking
stress off the nerve and the tendons
allowing it to heal while you rest at night.
- And the studies have shown that this really does help.
This really does, you know,
decrease the amount of people that
end up having surgery.
- Right.
- So.
- Well, my wife has these for hers.
When hers flares up, she starts wearing them.
And within two nights, it's feeling better.
- Just really quickly too, Brad.
I wanna make sure you're all,
some of you may be at your computer right now.
Make sure that two things that are, are important.
One, that your screen is up high enough.
So you're not like this,
which puts pressure on the nerve.
- Right.
- The second thing is
this part of your arm is gonna be vertical.
- Right.
- Okay.
You don't want it forward like this
and the keyboard is gonna be down here,
not up like this, so your wrist can be flat.
- Right.
- Sometimes people even put it on their lap
and they can have the wrists down a little bit.
- Right.
- You know?
- Yeah.
I, I took a class for this specific problem
and they talked about if the keyboard was
on your lap, that's actually the ideal location.
- And I use a lap board and I put
my keyboard on top of there and that's
how I actually work in it.
It works out well for me, so.
- I, I think a lot
of these things are what the people are not told
about carpal tunnel.
- Right.
And so you now you know some of the
secrets and if you wanna know a few more secrets,
keep watching our channel
and we'll convey them to you.
- Yeah.
(laughing)
- They might get bored watching them.
No, they're gonna have fun.
Just giving you a hard time.
- Thanks for watching.
(laughing)