♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet. ♪
- Hi folks, I'm Bob Scrupp, physical therapist.
- Brad Heineck, physical therapist.
- We are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- This is the single best stretch
in our opinion for carpal tunnel syndrome.
And plus we're gonna give you five other helpful tips
beyond the stretch.
- A lot of 'em are preventative too,
things that can prevent you from getting it
as well as help manage it,
if you are in an episode of that syndrome.
- Brad and I were just saying,
we don't see a ton of people with carpal tunnel syndrome,
but I've seen enough.
And these steps have helped.
I wouldn't say it has helped any, all of 'em by any means.
I mean, it's a percentage, but,
- Right.
And there's a number of 'em - It's certainly worth a try.
- Right, they don't cost anything.
Well, some of them don't,
the stretch in particular,
you just need a wall.
- That's right.
- Right and your arm, you gotta have your arm, Bob.
- Yeah, yeah, okay.
If you are new to our channel by the way,
please take a second to subscribe to us.
We provide videos of how to stay healthy, fit, pain free.
We upload every day.
Also go over to the Facebooks and like us because
Brad and I all this week, once again
we are providing you with positive vibes.
If you give us the likes.
- Vibes, yes.
- Bob and Brad.
- Strong like bull.
- All right, carpal tunnel syndrome, Brad.
Generally what you're talking about here
is an impingement of the
the median nerve
and the median nerve comes off of T
well, let's see, let me get that right. C5 to T1, so.
- We're talking the low neck, upper back there.
- This is by the way, Sam
The Super Skeleton, he's from 3B.
They were kind enough to send us one of these.
So, we really appreciate it, right, Sam?
- Yes.
- He's working out pretty good.
We have had to discipline him a little bit
but so far we're, he's getting A plus.
- Yeah.
- Well maybe an A minus.
- He's doing well.
So, anyway, we're talking about, you know, the
the first seven bones make up the neck
and then T1 and T2,
that's the kind of getting into the mid-back.
- Right, you're just below that, that bump
that big bump on the bottom of your neck there.
That's the C7 there.
- So, we're all right in the area.
- So, all these little yellow nerve roots come together
and they form the median nerve.
- Yeah, let's get, let's get Gumby outta there.
He's kind of getting in the way.
- So Brad's done a nice job of kind of representing
the median nerve here,
comes down underneath the collarbone,
goes up into the armpit a little bit,
then it goes in between the bicep
and the brachialis and then it comes down
and it goes into the hand.
- And look at this fits right into that carpal tunnel,
which is the carpi bundles
And there's a tunnel.
There's a, basically, it's not really a tunnel.
It's an open tunnel.
And you can see as you flex the wrist or extend the wrist
how it fits right in there.
And that can be the primary cause of carpal tunnel syndrome.
- 'Cause there's a ligament that goes across too.
So that it really is.
It makes the closed tunnel
- Yeah. Yeah, because we want have a tunnel that's not open.
- Right.
- And we bring all this other information
up because there are times when carpal tunnel
syndrome can be actually caused
from a problem up here and it's misdiagnosed.
Yeah. They call it Double Crush Syndrome.
So a lot of times the theory is that the
the nerve's getting impinged upon up here
or pinched up here.
- Right.
And so it's hypersensitive.
So by the time it gets down here, it
the another crush here.
So you got a crush here
and a crush here and that's starts causing the symptoms.
Right.
So we as therapists tend to treat
up here and down here, and this also kind of shows how you
this first exercise that we're gonna do with the
the main exercise, how it kind of glides the nerve.
- Right.
- You know, as it
as it moves along up, you know, on its trail here
- Right.
The, this nerve has to slide
up and down and have a, a movement in there.
And if it gets pinched
or trapped or crushed, as the term says
that can cause that pain, numbness, tingling
all those symptoms that are - And usually what is it, Brad?
Brad is the, the thumb,
first finger, second finger.
And usually half of the third finger.
- Yeah.
- You're gonna have numbness
and tingling into these areas here.
Quite often this thenar eminence,
- That pad right there, your thumb
- That pad right there.
If you compare it to the other side
if you only have it on one hand
it actually might be a little what we call atrophied
or smaller because it's gotten weaker
because the muscle's been, you know, it's not
getting the nerve conduction, like it should.
- There you go.
But if, if it's that far, you've had it for quite a while.
- Yeah. You've had it for a while, right.
Now the, the middle thing, and you said half the fingers are
at the top half or the bottom half.
- Right down the middle, Brad.
- It's the longitudinal half.
So it goes this way.
It's really, it's really neat.
How that you'll see.
- Good point.
- Half is numb and half is not numb. Well, it's neat to me.
I don't know what other people think.
Well, let's get this outta the way.
Sam, I'm sorry. You did your job for today.
We really are loaded for bear on this one.
We got Sam, we got a computer
we got a wall, a wrist splint.
So let's get into the single best stretch.
It's kind of a progression.
You, you know, it's, there's steps to it.
So the first step is that you're actually
it's called nerve flossing.
It's a nerve flossing of the median nerve.
You're gonna put your hand straight, your arm
straight across like this.
And with your head straight up and down
you're just gonna start working
on extending the wrist like this,
and gently.
I don't want you going
to the point where you're firing that nerve up
and making it worse.
- You'll feel it.
- Yeah. You wanna bump up against the pain.
And quite often I've seen Brad,
is if you compare both sides,
again, if you have it on one side
this side is tighter without a doubt.
- So in other words,
you won't be able to extend your hand down as far.
- Right.
- Then that's how you know.
So arms straight across 10 times, just twice a day.
That's all we're gonna start with, Brad.
- Okay.
- All right.
The next progression is
that you're actually going to make it a little
more difficult by actually tipping the head this way.
So you can see how I'm putting a little more stretch
on the nerve roots here, Brad.
- Yeah. Remember that that nerve we showed
with Sam starts here.
And if you bring the head that way, it pulls the nerve
this direction puts a little more tension on it.
And then we put some tension on this way.
So we're stretching it from both ends.
So it's like a double whammy.
- So yeah, let's say you've been doing this one
for a couple weeks and you got kind of pretty full range.
You don't feel any pain at all with it.
You're gonna go to the phase two,
where you're gonna put the head over
like this and, and now start doing the same thing.
- Sure.
- And now you might start feeling pain again.
- Sure.
- So that's the next progression.
Next progression after that, Brad,
you actually can put the arm
back a little bit further.
- Oh, so here.
- Yeah. Good, good way to show it, Brad.
- Yeah.
- So he's gonna go back a little further, same thing.
Tip the head and start moving the hand again
two times a day, 10 times.
That's all you're gonna do and get, you know
you're putting a little stress
on that nerve to, you know, to floss it basically.
- Right. Get it broken loose.
This is kind of a patient thing.
You know, this is not gonna get it in one day typically.
- And then the final one,
if those are again, that's going fine.
There's no pain now,
it's really progressed well.
You're gonna find a wall, which just
for filming purposes, Brad's gonna be the wall here.
And you're gonna put the hand up against the wall like this
and get it all the way flat as much as you can.
And now you're gonna just move the head away
from the wall, just like this.
And now you're kind of really getting a maximal stretch
on that nerve and maximal floss on that nerve.
All right, boy, we took a long time to do that, Brad.
We better get into our tips now.
- Yeah.
- We got five tips.
One is the one we've talked about many times.
Is that, do you wanna just sit down, Brad?
- Yes, I do.
For so many people, they're actually
their computer screen is too high or too low.
And so what happens is their head goes down like this.
We wanna raise your screen up, 'cause that again
opens things up here,
allows plenty of room for the nerves to go through.
Where's the, right here?
- There you go. Bring it up, Bob, keep going.
There you go.
- So, but now the problem is, where are your hands?
Yeah. And we want your hands to be like this.
- Yeah.
- We want this to be vertical.
And we want the keyboard to be down
with your wrist straight.
- Right. You don't want to have your wrist bent
like this all day long or like this all day long.
So we use like often is a lap tray here.
Not a lap dance, Brad.
Don't get excited.
- Bob. It's a family show.
I know.
- Okay. So here we go.
This is black on black. So it might be kind of hard to see
but we got this nice tray that goes on your lap.
The, the keyboard fits on top.
It's nice to get a wireless keyboard
- in this situation.
And they're very common nowadays.
- And you can have the mouse down there along with that.
Precisely.
So sometimes people just put the keyboard
on the lap without a lap tray.
- Right.
- And just go ahead.
It's better to even have your wrist.
Maybe even slightly down a little bit.
- Sure.
- As opposed to having it extended.
- I wish I could type better.
That'd be my next best thing.
- Okay. Let's move this outta the way.
That's true, Brad.
- Well because I'd be faster,
And you wouldn't spend so much time there.
Well, I type so bad.
I have to look down half the time.
So now I'm kind of -
You wanna make sure you got correct sleeping postures.
Do not be sleeping on your stomach.
You sleep on your stomach,
your head's turned all the way, one way or the other.
A lot of times you got your arms overhead like this.
It's putting pressure on those nerves.
- Yeah.
- If you sleep on your side, you
you really don't want to sleep on the side.
You're having carpal tunnel syndrome on.
It's gonna put a lot of pressure on it.
If you do feel like you just have to.
Ideally a lot of times what we do
is we have two pillows here.
Yeah, you got that other one right there, Brad.
- Incoming.
- So we got a pillow here.
We're gonna create a canal here.
And this takes some stress
off that arm where the nerve is coming through.
Right. - And so it takes a little bit
of stress off the carpal tunnel, even
basically because you're taking stress off the nerve.
- Yep. Allows more circulation.
It just frees up that area, unlocks it.
- And finally, if you sleep on your back, don't be sleeping
with two pillows and bringing your head way forward.
Again, putting pressure on the nerves.
Have a thin pillow
so that your ears are kinda lined up with your shoulder.
Good posture.
Even when you're, when you're sleeping.
All right, next one, Brad, you might try a wrist splint.
And that's what Brad's putting on right now.
There's a whole bunch of them.
We've got some on our website that we listed that
that work out pretty well.
Right.
And you actually wanna sleep with it because a lot
of times when you sleep, you may, your wrist may end up
in an extended or flex position for a long period of time.
And that can really irritate the nerve.
So, the splint is to keep your wrist in
neutral position all night.
- There's a lot of people that do this type
of thing when they sleep at night, Brad.
And so we're trying to keep you in neutral.
And a lot of times this really helps a lot of people.
I mean -
- Right.
- One thing I wanna point out is a lot of them have staves
in it and those staves, you can actually shape them.
So you can make them a little more comfortable
on your wrist.
You can actually just bend them and, and form them.
- Right, so it's custom fits your wrist.
- Right.
- So makes it more comfortable.
- A lot of times people don't know that they, they get these
and they don't realize it's like, it doesn't fit very well.
Well, you can, you can bend it.
- And usually like on this one, you can actually
if you don't like it, just pull the stave out and -
- Sure.
- But I wouldn't throw it away, you know, hang onto it
put it in your, in your drawer.
- Again, because of the double crunch syndrome.
A lot of times you you might be getting some stress
on the nerve up in here.
So we do have people doing neck extensions.
We have them stretch back as far as they can opening
up this area, giving plenty of room for the nerve.
- Sure.
- The nerve, the median nerve to find its way
down that path and not get pressure on it.
So, these are something you can do.
Oh, you can do them every hour if you want.
You can do a good 10 just to stretch it out.
Again, all these things work out better if you're working
at it constantly, rather than trying to do one time a day.
- Sure. Right.
- And the final thing is you may wanna try just
doing a little massage on the forearm.
That nerve is coming through there.
These muscles can be tight.
You might want to use the Pure Wave.
Well yeah, if you've got one
you definitely want to use it
but you're not gonna go up by the wrist.
- No.
- That's gonna irritate it
You want to get back here where the muscle belly is.
- Here, should I give a little demonstration, Bob?
And you know, I'm actually gonna rest it here
so I can relax those muscles on that
and get into those muscles, get things relaxed.
And of course do it with good posture, Bob.
- That's right.
You'd be kind of defeating the purpose there won't you?
- Yeah, this feels good, Bob. You can keep talking.
- All right.
Well, I think we're done, Brad. So -
- We pretty much, that's pretty comprehensive
what we covered everything here today, I think.
- We're really proud of ourselves.
Thanks a lot.