Watch Out For Carpal Tunnel Syndrome

by Jason VonGerichten

 

Carpal Tunnel Syndrome (CTS) is the scourge of anyone who works with their hands.  It is most commonly a repetitive stress injury, meaning it’s caused by doing the same actions over and over.  It can also be caused by trauma or edema in the wrists, but most often it’s attributed to flexing and extending your wrists too often without administering any self-care techniques, like ice if it’s inflamed, heat if it’s achy, or self massage and stretching.

carpal tunnel syndromeThe carpal tunnel is the small space at the base of your hand, just a smidge beyond the wrist crease and right in between the two pads (the thenar eminence and hypothenar eminence) of your palm.  The base of this tunnel is, of course, made up of your carpal bones, and the roof is the flexor retinaculum, aka the transverse carpal ligament (in pictures it looks like a strip of masking tape going across your wrist).

 

In this tiny amount of space travels ten structures.  Nine of those structures are tendons for muscles that move your fingers, thumb and wrist.  The other structure, and the most superficial of the bunch, is your median nerve, which is what gets compressed with CTS, and what causes pain into your lateral three and a half digits (your thumb, index finger, middle finger, and lateral half of your ring finger).

The pain from CTS is a nerve pain, which means it can range from numbness and tingling to a shooting electrical pain.  It is often described as a “painful numbness” that wakes you up at night, and in fact one of the main complaints of CTS sufferers is lack of sleep.

 

People who work at a computer all day are susceptible, especially if their workspace is not ergonomically correct.  Musicians, barbers, waiters, butchers, and even (eek!) massage therapists are all prone to CTS.

 

ctsAnd incidentally, the “Syndrome” part of that is very important.  If someone ever tells you, “Aw man, I got carpal tunnel,” just nod at them, and tell them you have two also.  Everyone has carpal tunnels.  It’s when there’s compression of the nerve that you have Carpal Tunnel Syndrome.  If you had a broken leg you wouldn’t go around telling people, “Aw man, I got a shin bone.”  You’d have to mention the broken part for that to be special.

 

So how do we prevent this?  If you can, keep your wrist in a neutral position, not flexed or extended, while working.  If CTS-like pain starts to develop, stop doing what you’re doing and start stretching out your wrist.  The easiest stretch is to grab your fingers and pull your hand back into extension.  This will stretch all the problem flexor muscles in the carpal tunnel and hopefully alleviate some of your discomfort.

 

You can also grab all the tissue just below the wrist and stretch it down towards your elbow to take the slack out of it, and then start rotating your wrist in circles.  This will help to loosen any fascial adhesions around your wrist and over your carpal tunnel.

 

Or get a massage!  A good massage therapist (aka, a Soma grad) will know what muscles to target to relieve your pain and how to reduce fascial adhesions around your wrist.

 

Surgery is also an option in severe cases, but the success of the surgery will depend upon many factors, such as how your scar tissue forms and if you stop doing the actions that caused CTS in the first place.  Oftentimes people get the surgery and are back at the doctor’s office a few months later with the same pains.  So it’s best to just prevent CTS and avoid the surgeon altogether.

Super Stress

By Jason VonGerichten.

 

There was once a man from Lithuania who owned a haberdashery in Cleveland.  On June 2, 1932, during the Great Depression, a man attempted to rob the haberdashery, pointing a gun at the owner.  The owner, profoundly afraid of guns, had a heart attack and died on the spot.  The robber was never caught.

 

One third of all deaths are caused by heart disease, and more heart attacks occur on Monday than on any other day.  This would lead one to assume that these heart attacks are work-related.

 

Studies show that when your stress levels rise, many things can go wrong with your circulatory system, the worst, of course, being death.

 

Your white blood cell count increases to cope with whatever danger you may be facing.  This would be great if you were facing off with an actual pathogen, but when facing off with emotional stress, these extra blood cells can cause blockages in your coronary arteries.

 

Adrenaline (epinephrine and norepinephrine) also coats blood vessel walls to help increase blood flow during times of distress.  Remember you are going into “fight or flight” mode now.  If a bear is attacking you in the woods you need extra blood to your leg muscles to run away from danger, or more blood to your arm muscles to fight danger.  Unfortunately, in times of emotional stress, and with unfit bodies, this can cause plaque deposits to break loose, which can then block your coronary arteries, which can then lead to a heart attack.

 

And let’s not forget stress cardiomyopathy, or “Broken Heart Syndrome,” brought about by acute onsets of grief, fear, anger, or pain.  Basically a sudden rush of adrenaline is released into your system and stuns your heart muscles (the exact mechanism that causes this to occur is still up for debate), causing your heart to become distended, often tripling in size.  The good news is that if you survive this it is usually completely reversible.  Once stress levels drop, the heart muscle returns to normal in a few days or a few weeks.  If the shock was too intense, though, and blood supply to the heart and body were interrupted dramatically, the results can be similar to our friend the haberdasher.

 

Incidentally, that haberdasher had a son named Jerry, who was a junior in high school at the time.  Jerry saw his fathers death as the result of fear of guns, and a few years later, Jerry went on to invent a bulletproof man.  Jerry Siegel is better known for creating Superman.

 

Coincidentally, the day after the robbery, a letter was published in the Cleveland Plain Dealer regarding the robbery and the need for vigilantes during the dark days of the recession.  The letter was signed by A.L. Luther.

Plank You Very Much For The Pain Relief

Most of us will suffer some sort of back pain at some point.  Is yours a deep achiness in your low back that no amount of stretching seems to cure?  This pain might be caused by a postural deviation known as hyperlordosis.

 

All of our spines are curved.  If they weren’t the simple impact from walking would rapidly destroy our vertebrae.  It’s when your low back has an excessive curve, going from a normal lordotic curve, to an abnormal hyperlordotic curve, problems may arise. (Sorry, Kim Kardashian; that’s not healthy).

 

anterior-pelvic-tilt2

 

The main causes of hyperlordosis include, but are not limited to:

 

  1. Gravity.  This simple Newtonian force of nature does a lot of good for us, like keeping us on the ground and stopping our cats from puking into the ceiling fan (which you know they would if they could), but it’s also pretty terrible for our posture.
  2. Abdominal weight gain.  Another reason to replace soda with water and pizza with salad. (Has anyone invented a pizza salad yet?  Someone get on that already.)
  3. Pregnancy.  We know, not fair.  Women get all the tough breaks.  Maybe you could get a pregnancy massage to help!
  4. Poor foot wear.  The main culprit here is high heels.  All of your weight gets thrown forward onto the balls of your feet while wearing high heels, and because of this your spine has to compensate by bending back further.
  5. Tightness in your musculature.  Particularly in the low back erectors, quadratus lumborum, iliopsoas, TFL, or rectus femoris.  These are the muscles that extend your back or flex your hip. And when they pull on your pelvis they shift your spine out of alignment.  These muscles typically tighten from being on your feet all day without stretching.  (Luckily, we teach a treatment for hyperlordosis here at Soma! #shamelessplug)
  6. Weak core stabilizers.  Particularly a muscle called transverse abdominus.

 

When most people are told to strengthen their cores they immediately begin a regimen of crunches and sit ups.  We’re not saying those exercises are necessarily bad for you, but if not balanced out with work to your deeper core stabilizers, they might be necessarily bad for you.  Transverse abdominus might be one of the most important muscles in your body (definitely in the top five), and unfortunately not many people know about it.

 

There are a number of stabilization exercises to strengthen transverse abdominus, but the easiest one is plank position.  Nobody particularly likes doing planks.  They’re boring and can be difficult for beginners.  But they are also absolutely necessary for a healthy spine.

 

Simple plank pose:

 

  1. Find a clean place on the floor
  2. Lay down on your belly.
  3. Place elbows directly under the shoulders, arms parallel on the floor. Push your body into pushup position.
  4. Keep a long, straight line from shoulders to hips to heels.
  5. Ground the toes into the floor, push through the heels and squeeze the glutes to stabilize the body. Be careful not to lock or hyperextend your knees. Lift the belly button toward the spine, keeping the hips in line with the shoulders.
  6. Neutralize the neck and spine by looking at a spot on the floor about a foot beyond the hands. Your head should be in line with your back.
  7. Hold for 20 seconds. The more you practice plank, the easier it will get. As you get more comfortable with plank, hold the position as long as you can without compromising form or breath.

 

plank

 

As you gain strength in your transverse abdominus you will notice that pesky low back pain begin to dissipate.  Transverse abdominus is your internal weightlifting belt.  The stronger it becomes the less pressure gets placed on your spine, and the less pain you feel.

 

And if you don’t have low back pain, do this anyway!  Strengthening your core is a great preventative technique to avoid future spinal problems, not to mention it makes all your other activities (running, walking, jumping, sportsball, etc.) much easier, too.

 

 

Massage for an Aging Population

As the population begins to age, more people are becoming aware of the benefits massage can bring to senior citizens. The Touch Research Institute has conducted studies that show massage therapy can provide emotional benefits to Alzheimer’s patients, because it can facilitate relaxation and communication. For seniors with arthritis, massage can greatly help in decreasing pain, increasing range of motion, and improving circulation to increase natural joint lubrication.

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Why one student loves learning at Soma

Wrapping Up 2014 with My Top 14

In July 2014, I decided to abandon a 30+ year career in the corporate world for something I always wanted to do. I want to help people keep moving so they can do the things they love for as many years as they want to do them. For me “moving” means running marathons but for others it may mean performing their jobs well or being able to play sports with their kids. It took serious guts to give up an established career, substantial salary, and benefits to return to school to learn massage therapy.

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