Carpal
Tunnel Syndrome - A Secondary Effect
What
causes carpal tunnel syndrome to develop? Although
there are many professional opinions out
there regarding the subject, most do not
provide an accurate description of how
carpal tunnel syndrome actually occurs.
What is agreed upon is the
fact that the flexor tendons and median nerve
are operating in a much smaller space than
they were prior to the onset of symptoms. Many
professionals state that it is the swelling
of the involved tissues that is diminishing
the space and others say that is caused by
a muscle imbalance between the flexor and extensor
muscles that is causing the carpal bones to
shift into the carpal tunnel, making the carpal
tunnel much smaller.
After much research, my opinion
is that the swelling is a "secondary effect" of
the nine flexor tendons and median nerve having
to glide through the carpal tunnel which has
decreased in size due to a muscle imbalance*.
How does the carpal
tunnel decrease in size? The carpal
tunnel decreases in size because the flexor
muscles that 'close' the hands are exercised
on a daily basis with virtually every activity
we perform, and they become stronger, shorter
and tighter than the extensor muscles that 'open'
the hands, thus causing the carpal bones
to shift inward, collapsing the carpal tunnel
and making it smaller. As the tendons and
median nerve slide back and forth in the
much smaller space, friction between the
tissues occurs.
What does friction
in the carpal tunnel cause? Friction
between flexor tendons and median nerve within
the carpal tunnel causes inflammation and
swelling, which puts pressure on the median
nerve, resulting in carpal tunnel syndrome.
This is the reason that surgeons sever the
carpal ligament, making more room for the
flexor tendons and median nerve to move around
in. If the carpal tunnel is returned back
to its original size, prior to onset of symptoms,
the friction and swelling is eliminated and
the symptoms disappear.
Continually performing repetitive
wrist and finger flexion while symptoms are
already present will ultimately aggravate the
existing condition even more and lead to possible
irreversible damage of the flexor tendons,
blood vessels and median nerve within the carpal
tunnel.
How can carpal tunnel
syndrome be eliminated? By stretching
and lengthening the overly restrictive flexor
muscles that 'close' the hands and strengthening
and shortening the extensor muscles that 'open'
the hands, the carpal tunnel can return to
its normal size, decreasing impingement of
the tendons and median nerve, which also
eliminates friction and causes the carpal
tunnel symptoms to disappear.
Now is the time to take the
steps to prevent carpal tunnel syndrome or
rehabilitate an existing injury by starting
a stretch / exercise
program for your hands. Speak with your
doctor or contact a certified therapist today
to implement a good stretch and exercise program
to keep you strong, healthy and injury-free!
*REFERENCE MATERIALS:
- "If certain muscle
groups are underused, opposing muscle groups
will be overused. Muscles in either a lengthened
or shortened position will be at a mechanical
disadvantage and weak. The overused group
will hypertrophy, and the underused group
will continue to be weak. This combination
produces a self perpetuating condition that
maintains the abnormal posture and muscle
imbalance." Philip E. Higgs, M.D. and
Susan E. Mackinnon, M.D. Department of Surgery,
Washington University School of Medicine,
St. Louis, Missouri. Annu. Rev. Med. 1995.
46:1-16
- "Muscle balance must
be restored with specific exercises. Otherwise,
the already strong and overused muscles get
stronger, and the weak and underused muscles
remain weak. Individuals get good at using
the overused muscles and must be trained
specifically to recruit and strengthen the
weak underused muscles." Philip E. Higgs,
M.D. and Susan E. Mackinnon, M.D. Department
of Surgery, Washington University School
of Medicine, St. Louis, Missouri. Annu. Rev.
Med. 1995. 46:1-16
- "All of the extrinsic
hand muscles become involved in a power grip,
in proportion to the strength of the grip."........ "Strong
agonist-antagonist interactions are needed
between the flexors and extensors of the
hand and fingers to produce forceful hand-grip.
Powerful flexion of the distal phalanges
requires strong activity also of the finger
extensors." Janet G. Travell, M.D. and
David G. Simons, M.D. Myofascial Pain and
Dysfunction-The Trigger Point Manual. Volume1
Upper Extremities, Ch:35, pg. 501. Copyright
1983.
Author: Jeff
Anliker, LMT, is a Therapist and Inventor of
Therapeutic Exercise
Products that are utilized
by Corporations, Consumers and Medical Facilities
around the world for the prevention and rehabilitation
of repetitive strain injuries. hand-therapy.net
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