♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Yeah, we are the most famous physical therapists
on the internet.
- In our on opinion, of course, Bob.
- I wanna discuss the top two home exercises
and treatment for carpal tunnel syndrome.
These are proven by science and plus,
we're gonna give you two self tests.
By the way, we're gonna do it all today,
aren't we, Brad?
- Well, this is a comprehensive video.
I've spent a lot of time looking over studies
and trying to get to the core of it,
the two best things you can do at home.
I think this is it.
- Well, we appreciate you putting in the time, Brad.
By the way, if you're new to our channel,
please take a second to subscribe to us.
We provide videos, how to stay healthy, fit, pain free,
and we upload every day.
Also, you wanna join us on our Website, BobanBrad.com.
Go to the giveaway section, 'cause we're
always giving something away.
This week, we're giving away the--
Where are they at?
- Right up there, Bob.
- That's right. - We got 'em locked
on the wall where they-- - Yeah can take the
suction cup-- - can work.
This self-massaging, get trigger points and knots out.
You can do it either laying on the floor,
or you can do it on the wall.
Other nice little devices.
- Yeah they can even use it on the bottom of your feet
if you have a little plantar fasciatus.
- Good point. - You can find the contest
also on Facebook, be pinned at the top of the page.
Want a short version of us?
Go to Twitter or Instagram,
"60 Seconds of Bob and Brad"--
- Tic-toc, too? - And tic-toc,
there you go.
All right, Brad, take it away, sir.
- All right, so carpal tunnel syndrome
like I said, I did a fair amount of research on it
just to figure out to boil it down to what we have here,
for results, but let's talk about what is carpal tunnel
if people aren't aware of it.
And the symptoms, I do want to talk about that,
is typically pain in the hand,
numbness or tingling,
and it's specific to location:
The ring finger, typically just half of the ring finger.
- After this finger-- - That's digit number four,
three, two, and one, the thumb.
These four fingers, if you will, will have these symptoms.
- Yeah, if you're having symptoms more over on the pinky
and the small, it's probably not--
- Carpal tunnel. - It's not carpal tunnel.
It might be something else. - And the reason for that is
is that the carpal tunnel, which I've got this brace on,
we'll look over here is
you know, the carpal bones are here
and they form a tunnel in your wrist.
There's only one nerve that goes through the carpal tunnel,
and it happens to be the median nerve.
And that nerve innervates those four fingers.
- Yeah, so you can get burning, also,
and you can also get weakness.
- Right. - One thing that we look
on people who've had it for a while,
this fatty part of the thumb, it gets smaller
'cause it's--
- There's more than fat in there,
there's a big muscle. (chuckling)
- Well, atrophy, it becomes small,
especially when compared to the other side
if the other side doesn't have the carpal tunnel.
- And that is, you know, more longer term.
- Longer term, right. - More severe symptoms.
So the pinky finger's innervated by the ulnar nerve
which does not go through the carpal tunnel,
so that's another scenario.
All right, so how do we test for this?
At home, there are some simple tests you can do.
Do you wanna demonstrate?
- This is actually, probably one of the easier things
that you can test for at home.
So, there's first phalanx test.
Now, this is the way they're saying?
- Right. - 'Cause there's also
you could go like this, so-- - Well, yeah,
so when I looked at both ways, I usually do it this way,
but I will do it the other way, as well.
I'll start out like Bob has, here.
So he's, the back of the hands are touching
and then you maintain 'em.
Touch like you got a C-clamp, there.
And then bring your elbows down
to where they're at, end range.
- That's not as far as I can go.
- You've got a pretty flexible wrist, Bob.
Some people won't be that flexible.
Others may be more, I'm not.
Anyways, you hold it there for 30 to 60 seconds
and if you get the symptoms, the numbness, tingling,
burning in your hands, that's a positive, okay?
Now that doesn't mean you definitely have carpal tunnel--
- Positive doesn't mean good, either.
Positive means you have it.
- Well, yeah, but we're gonna do another test
and if both are positive, you can feel--
- No, what I meant is people think positive
vesus negative. - Oh, (chuckling)
right, I see what you're saying.
- Right. - Yeah, that can be confusing.
Positive means-- - It's actually,
we think you have it.
- It's indicative that you do have it, yes.
- So you could also do it this way,
when you bring your elbows up.
The same thing, hold it that way.
You may wanna do it both ways.
- Yep, and then add the second, or if you look at it
that way, the third test is Tinel's, which is a tap test.
Your palm's up like this and right over the carpal tunnel,
you don't tap real hard, it's not like
you get a little hammer.
You just with your finger, you can use two fingers,
and tap, you know, about like this for 30 seconds.
And if that's enough to irritate that median nerve
which is in there, it's a positive.
In other words, it's indicative that you
do have carpal tunnel.
- Yeah, when the people I see that have it,
they feel it right away, and they feel the tingling
and they can-- - Yeah.
- I actually feel a little bit, myself.
- Oh, Bob, maybe you're developing it.
- I do, I actually have a little bit on one of the thumbs.
It's just, uh, it's just real minor, though.
- This is personal to me.
Not me, personally, but my wife does have carpal tunnel.
And with her, the next thing is you always wanna--
Our potential is there's carryover
or not a carryover, but--
- Some neck involvement. - Right.
And you could have both carpal tunnel
and impingement of that median nerve up in the neck.
We're not gonna get into that.
We do have another video on that.
So if you're these two tests are positives,
it's a pretty good indication--
- It's a pretty good chance that you have--
- Yep, exactly. - carpal tunnel.
- So what do you do with it?
At home, you know, there's all kinds of treatments
I've looked at, from surgery, last case scenario,
injections, we don't really wanna do that,
you can't do that at home.
Then there's some exercises, massage, blah, blah, blah.
Well, I've found with the studies is that
the two most-- - Helpful?
- Effective and helpful treatments is, number one,
is what I have, here, is get a wrist brace.
And you know I talked to a wrist surgeon
who does a lot of carpal tunnel, and this is his
first go-to thing to avoid surgery.
- Simple to do, not that expensive.
You can get 'em at, you know, your local--
- Pharmacy. - Pharmacy.
- Yep, you can do that, you can get 'em online.
One thing that both Bob and I really like
is if there is a metal--
- Metal staves. - Stave, and they're flexible.
They're made to be bent to match your wrist.
And I wouldn't-- - You wanna make sure
you get a good fit. - Right.
You know, obviously I did this when I put it on.
My wrist is not in a neutral position.
I wanna bend it, so--
- Yeah, you're tryin' to keep it as
what we call flat, you know, or neutral as possible.
You don't want it bent like this,
and you don't want it bent up like that.
- Right. - You want it
right in the middle. - That keep pressure off
the median nerve, and when you do that,
the inflammation is decreased, and when you have
a tight carpal tunnel with inflammation added,
that really causes those symptoms to flare up.
- Yeah, repeated gripping, the things can cause it
and of course, you know, the big one
is working at the computer where everything's bent and--
- Or any other job that keeps your wrist
at a neutral position, or if someone stands at a table
or work spot and they're leaning like this
and not really thinking of pushing that wrist
into that position.
I do wanna mention the part about a wrist splint.
It's very critical if not more important
to wear it at night while you sleep.
In that case, I do have another brace, here.
This one's all cushioned.
It still has a flexible stave to get the proper position.
But this is all cushioned up
and you want something comfortable for at night.
It may not be the same one that's used during the day.
- So with braces, overall, we're not gonna make
a recommendation of a certain type for you.
Go and check out some online, or check out some
at your store.
- And they're not that expensive.
You should be able to get one for around $15 or so.
- Exactly. - So, that's that,
and the second-- - Second treatment.
- Is going to be nerve gliding.
So what is nerve gliding?
- Well, nerve gliding, you're actually, it's almost like
you're flossing your teeth.
You're making the nerves glide back and forth
through that little, small compartment there,
up, in through the neck.
You wanna make sure that there's no scar tissue
binding it down. - Right.
- And this can actually be very effective for people.
I've had good luck with this in many cases.
- Hence, the studies do, too, so it's a double--
- But! - But?
Oh, always the but. - You gotta be very--
You gotta be very careful with this because nerve gliding
can calm it down, but it could also fire it up.
- If you get too aggressive.
- If you get too aggressive, so we're gonna have you
be very cautious.
We're gonna have to do 10 repetitions.
I'll show you in a second what it is.
10 the first day, then see how it is the second day.
- Right. - If it's got worse
after that, then you gotta back off
and maybe try some posture things and the wrist thing,
the wrist splint, and try it maybe again
in three or four days.
- Right. - Try it again.
- So what is the technique, Bob?
Okay. - The first part?
- So, you bring up about as close to level as you can.
And sometimes, people bring it back a little bit, too.
- All right, so from this angle, this wouldn't be it.
We want it inline with your posture.
- So you're gonna bring the wrist back
and what you'll generally find is that the involved side,
if you have one side that's involved,
it will not bend as well as the other side.
- So yeah, you can compare the involved to the
no-symptom side. - Yeah.
So you're lookin' for the wrist to extend like this.
- Yep, so it's going down with the wrist.
- But when you extend the wrist, I also want you
to move your head this way, at the same time.
- So, we were talkin' about this, and this is
some things I tell my patients.
If you put your hand out, imagine there's a string
from your fingertips to your head, there.
And so, when your wrist extends, that string
is gonna pull your head that way.
So that takes that nerve that goes through your neck
to your palm and it slides it this way,
and it slides it back, and that's the gliding part.
We want that nerve to glide
through that carpal tunnel syndrome, freeing it up,
reducing any scar tissues or any other inflammation problems
that are causing it so that we have no more interference.
- Absolutely, and it, you know, it's--
you don't want it to create any pain.
So if it starts doing increased pain right away,
you gotta back off.
You maybe not get as aggressive with it, to start off.
- Not as many reps or don't get quite so much range.
You just do baby. - Right, baby reps.
- Uh, baby flossing? - (chuckling)
- You like that, baby flossing?
- Here we go. - That's technical, yes.
(laughing) - Baby flossing.
There we go. - Uh, so again,
10 repetitions, and like Bob says, it shouldn't hurt.
Don't go with the idea, "No pain, no gain,"
that's gonna be too aggressive.
- If the next day it was better or was the same,
go ahead and do another 10 and you can do 10 every day.
- Sure. - But the big thing is
wear the wrist splint, and you're gonna wanna
watch your posture.
As always, believe it or not, posture plays a big role.
Neck, chest, and arm posture.
- We happen to have a few videos on posture, too.
- Yeah, I'd say.
- 'Cause it's very important.
- All right. - All right,
well very good, thank you for watching.
And once again, Bob and I can fix just about anything
except for-- - Except for
a broken heart. - Broken heart.
And this nerve floss is not gonna help.
- Well, we're workin' on it. - Yeah.
- It's on this side. - It is!
Okay well, okay.