♪ Bob and Brad, the two most famous ♪
♪ physical therapists on the internet. ♪
- Come on in.
Hi there folks. I'm Bob Schrupp physical therapist.
- Brad Heineck, physical therapist.
- And together we are the most famous physical therapists
on the Internet.
- In our opinion, of course, Bob.
- What are you trying to, I don't mean.
- I'm stretching Bob.
I'm trying to get some myofascial release.
- All right.
We're gonna talk about carpal tunnel syndrome today.
- Yes. Yep. Bob, we are gonna show you how to test for it.
Some common symptoms, all the way from some statistics.
I just took a course on it.
So this is updated information.
- Glad to hear.
- It's very complete.
- By the way, we are giving away
always giving away something, go to the Giveaways
section on bobandbrad.com
and sign up for a back and neck massager.
People love it.
- This is really a nice, you know, when I first saw it.
Eh, you know?
Then you put it on it's like, whoa, whoa.
And it goes all the way down
to the back actually even works on your hamstrings
and calf muscle.
- Actually works on your daughter.
- Yeah. Yeah.
My daughter uses for her neck
and she was extremely grateful.
She has one at home right now.
Anyways, let's go on carpal tunnel syndrome.
So in the wrist, everyone has a carpal tunnel, but
carpal tunnel syndrome is when the carpal tunnel is here.
The median nerve actually gets pinched in there.
- By a ligament that goes across.
- And the common symptoms are numbness, tingling.
And you can get it in the thumb,
the first finger here,
the middle finger, and half of the ring finger typically.
- Half of the, right.
- It can be very annoying.
And it can disturb your sleep, is a real common symptom.
- One thing you could see if you had it
for a while is actually this meaty part of thumb.
- Yep.
- It starts to wear away, atrophy.
- Yeah, atrophy. Wear away would technically be right.
- I don't know how they say it. The lingo's first.
- Right, but it gets like a hollow spot there.
- Right. If you look at one compared to the other.
- And if yours is that bad
you really should be seeing a doctor already.
- Right. Right.
- So we're thinking about when you have it
and you have that numbness
and tingling and it oftentimes
- Irritating pain.
- Yep. Can come with your work.
Now, some statistics on common people that have it:
majority of people are over 45 that get it,
you know, more females have it than males.
- As it should be.
(laughs)
- You are really asking.
- I'm not implying anything.
- Yeah. We just lost a lot of subscribers on that comment.
- Goodbye.
- Anyways, no, statistically it's 1.5 to 4 times
more females have it than than males.
- Well, really they're tougher that we are.
- Well, there's no doubt about that.
- So they can handle it better.
- Well, yeah.
If you're diabetic
or you have a BMI over 30, if you're overweight
those people are typically, will have it more.
If you're an industrial worker
and you use your hands aggressively,
particularly if you work with equipment that vibrates
- Right.
- onto the hand, that really irritates it a little quicker.
- I always think of carpet layers, cutting that carpet or
- Yeah.
- Like hedge trimmers,
of course they have like electric ones now.
- Sure. Well, which is worse yet 'cuz it's vibrating.
- Oh right. Still vibrating.
- Sanding equipment.
- Yep.
- I think about the people using the jack hammer.
(imitates jackhammer)
- Yep.
- Wow.
Anyways tests.
Now we're gonna talk about some tests that you can do
and they, they're not real difficult.
- Yeah, they're really easy to do.
- That you should do.
- Right. So you wanna show them Tinel's?
- Sure.
- I don't know if people pronounce it differently.
- The nerve runs right between the two meaty parts here.
- Yes.
- And all you do is tap on there.
- Yep.
- And, actually, Brad, I've seen it
where people tap all the way up to the hand even.
- Okay.
- But you definitely wanna tap right here.
- Yep.
- And if that kind of gives you pain or tingling,
- The symptoms that you get.
That's a positive test.
- Yeah. You may have.
- And you would do that for 60 seconds.
- Right.
- Okay. The next one's Phalen's.
- Right.
- It's one of those "ph" instead of "f".
- So you're going to basically pray.
- Yeah.
- I've seen it go both ways.
- Right. And actually this course,
they recommended this.
- They did.
- But you can do it both ways.
You can do a test each direction.
- Please have my pain go away.
- Yes.
- So, or you can go like this.
- And you hold it there.
Touch and then bring the elbows down 60 seconds.
- Right.
- And see if that reproduces, that numbness,
tingling, those painful symptoms.
Now this other one is interesting.
And I think this one gets missed a lot
and I always test this.
- Yes.
- You can get symptoms in the hand
that will be identical to carpal tunnel syndrome
from the nerve getting pinched in the neck.
- Right.
- So I'll show you. This is how I typically do it.
I'll have the person in a nice firm chair have 'em sit
up nice and tall.
Ask 'em if they have any symptoms
in the hand and where they're at if they have some,
and then I'll say, just lean back
tuck the chin in gently and then look back like this.
And if they go back like this and their neck starts to hurt
and it doesn't, the range is limited.
And if they have symptoms,
that increases the symptoms in the hand or down the arm,
we gotta get after that neck 'cuz they could either have
just a neck problem or it could be neck problem
along with carpal tunnel.
- If you wanna take it a little further
you could go back and go to the side, too.
- There you go.
- As you had trouble and you could go the other way too.
- Yep.
- That's Spurling's test and it does often indicate, too,
whether or not you have a neck problem.
- Right. You know, if you do this in this all feels fine.
- Yeah.
- It pretty much clears the neck.
- Yeah, it does.
- It's a good strong indication.
So make sure that is checked.
- So, how do we treat this Brad?
- Excellent question.
Now I have talked to a surgeon who does this.
(imitates drill)
- Right.
- And he does the surgery and he does
all kinds of surgeries on the hand and wrist.
And he says his number one treatment.
- Go to treatment.
- Is a simple wrist splint or wrist brace.
- While you're sleeping.
- Right.
- He said, that is a wonderful way.
- It's a good way to start.
- Yeah. So if you wake up in the middle of the night
because your hand and the symptoms are bad,
which my wife by the way had for years
and she would do this.
- Quite often you could, you'll sleep in your wrist bent
and you don't even realize it.
- Exactly. So you don't have to have
any special wrist splint.
- Right.
- What's important is that it's comfortable
and it's not too tight.
- You go to a big box store and they'll have there.
- Online and you just look for something.
- Drugstore.
- Yep. Now this one's real comfortable.
It's got a stay which means there's
a metal or a plastic support.
You don't necessarily have to have that.
- And you could shape those.
- Yeah.
- Bend them a little bit and shape them.
- Yeah. This one's pretty tough.
I'd have to take it out.
But anyways,
you want it comfortable and you sleep like that.
It keeps your wrist in a neutral position.
You can also wear this,
if you get it with you're using the mouse or
at a keyboard or whatever job you have,
if you can wear it and still do your job,
that's gonna be helpful.
- Right. Isn't there anti-vibration gloves?
- Yep. They're cushioned a little bit.
- Right.
- It's a good.
- I have one for cutting lawn.
- Oh really?
- When I push the lawn mower.
- You have one in each hand?
- Yeah, I do. I do.
- I know. I believe it. I'm not kidding.
Okay. The next thing is, if you don't have this,
just think about neutral position with your wrist.
If you're gonna do something like this,
that does, you know, put your hand back,
like you're pushing on something
like a, you know, possibly a wheelchair or a cart.
Think about neutral position.
And that's why you wear the braces. To micromanage them.
- And that's also why you don't have the keyboard real high
because you're kind of in a weird position.
- Exactly right.
- You wanna have the keyboards so you can keep the wrists
in a neutral position while you're typing.
- Right. And oftentimes these are more important
than the stretches we're gonna show you.
- Right.
- But, one of the common stretches to stretch
or floss that median nerve.
- Nerve.
- Because that nerve comes through here all the way up
- Right.
- under the armpit to the neck.
- So you're gonna go out like this and palm up.
- Keep it level. Keep the arm level.
- Yep.
- And you can to even go back a little bit, Brad.
- Yeah. So we're
- a little bit. Right.
- And even on a healthy median nerve, you know,
I do this, you know, I can feel the stretch, you know.
- Yep.
- I can bring my palm down and all of a sudden
I feel it up here.
- Right.
- You know you got a tight nerve.
- Now, if you want really wanna floss it
you could actually first just start the wrist.
- Yep.
- And then, eventually, you could even
put the head down while you put the wrist down.
- Yep.
- And you're kind of flossing it.
- Yeah. Yeah.
We've got another video on flossing the median nerve
that if you go to Bob and Brad
we get more into detail with that.
- Yeah.
You can also use a wall to help stretch that.
- Right.
- And if you, like, I stretch here like this
and then I go over like this.
- That really stretches you.
- Yeah. So don't get too aggressive.
If you feel that all the way up into here, be gentle.
Give it a few days.
- Yeah. Cause you could get it fired to up
and make it worse.
- So you're gonna do that maybe
about 10 times gently and then see how it responds.
This next one is one that gets missed a lot.
- Yes it does.
- That nerve can also often get caught in the first rib
- Right.
- which is underneath your clavicle.
It's a really small rib and the way you treat that
it's a very simple thing to do.
And regardless if it is pinched there or not
this is a good stretch.
- Yeah. I like it. That feels really good to me.
- It does.
So you, you take a belt.
And I like the buckle on the belt
because I'm gonna sit on the buckle and it kind of grabs.
So on a firm chair, I'm gonna sit there and I wanna stretch,
this is the side with the carpal tunnel.
I'm gonna take this belt and put it right over.
So it goes over your clavicle
not over the end of the shoulder, but in closer to the neck.
You're gonna hold it here, let this relax,
and then we're just going to, when I lean this direction
the belt tightens and it pulls
down and my head goes this way, it pulls down on that
clavicle and over the first rib.
There we go.
And you could feel that pressure going in there.
And this is just a nice stretch.
And again, you can't really do anything.
No harm with this or anything but good.
- Right. It should feel good.
- Yeah, it should. I mean this does feel really nice
right now.
- Yeah.
- You might just wanna do it regardless.
So just a nice stretch.
But that can alone, it's the double crush syndrome.
- Right. So the idea is that you're getting the nerves
getting pressure on it up here.
- Yep.
- Then it gets pressure down here.
- Right.
- So it double and it intensifies.
- Right. Exactly.
So that's a lot of information for one video.
So also we, we do have more videos on this.
Do we have a Programs on this one?
- No.
- Yeah. I don't think not yet.
So, but if you Google Bob and Brad Carpel Tunnel Syndrome
we definitely have some more videos to give you more.
- And we do have videos on neck pain.
I mean, if you, if you go to programs,
we have one on neck pain so if you think
that it's mostly from your neck, we do address that.
- When you do that, initially it hurts here.
Our Programs is like a library of specific videos
for the neck,
go to bobandbrad.com, go to the Programs tab, click on that,
go to the Neck, and open up about 20 or 30 videos.
And they all have PDF print outs
showing the video and the exercises on paper
so you don't have to go back and look at our faces.
- I gotta tell you, we're really being generous with these
because a lot of people charge for these.
- Exactly right.
- We have absolutely no charge, no email.
- I wanted the charge for them
and Bob says, "No, we're not going to."
- No!
- Yeah. So I said, okay, let's do it. Let's be generous.
So very good.
- Bye. Thanks.
- Good luck with all your neck problems.
And if you got a broken heart
we can fix anything except for
- a broken heart.
- Right. That's what I just said.
- Yeah. That's what you just said.
- But we're working on that in our spare time.
- Thanks.
(short music outro)