Is it Carpal Tunnel Syndrome?

     With all the work we do on our smart phones, tablets, and computers, it's not surprising that many of us suffer from pain in our arms, hands, and fingers.  It's easy to write off the swelling, numbness, tingling, and general discomfort as carpal tunnel syndrome.  However, I've worked with several clients who had surgery for such a diagnosis with little to no relief.  So if it's not CTS, what's the problem?

First, let's clarify what Carpal Tunnel Syndrome is:
     The carpal tunnel is an opening in the wrist made up of the carpal bones, ligaments, and other fibrous tissues.  With Carpal Tunnel Syndrome, the median nerve and tendons traveling through this passageway become compressed when the carpal tunnel is swollen or restricted.  This compression causes numbness and tingling of the wrists, hands, and fingers.

     More commonly though, the impingement of the thoracic outlet (the opening between your collarbone and upper ribs where the nerves and blood vessels pass through to supply the arms and hands) is actually the root of all these symptoms.  When the muscles (i.e. the scalenes) around this opening become tight and shortened, they pull the first rib up against the collarbone, restricting blood, lymph, and nerve supply to the arms, which ultimately causes all the same symptoms as carpal tunnel syndrome.  (The pectoralis minor, triceps, brachialis, and some of the forearm muscles can also become tight and impinge nerves of the arms and hands.)

If it is truly CTS, where most of the restriction is at the wrist, maintaining proper body mechanics, stretching your hands and forearms throughout the day, and avoiding poor sleep habits (like bending your wrists or tucking them under your pillow all night) should alleviate many of the symptoms.

I also use contrast bathes frequently for my forearms and hands.  Ice water submersion for 1-2 minutes, then hot water for the same - just go back and forth about 3 to 5 times, always ending with the ice water!  This basically creates a forced circulation, pushing blood out with the ice water then opening up the blood vessels and tissue to new oxygenated blood with the hot.  It works wonders.

If your symptoms seem to be stemming from further up the arm - maybe even into the shoulder and neck - your scalenes (anterior, medial, and posterior) and pectoralis minor are most likely the main culprits. 

Check out my previous post - Shoulder Pain - for stretches and exercises to alleviate tightness and pain in the shoulders and neck.

On a semi-side note, POSTURE is everything!  Check in with your posture throughout the day; you'll probably be amazed by how curved forward and curled up you can get while engrossing yourself in work (or a Netflix binge).  Sit up straight, lift the crown of your head to the ceiling, and let those shoulders fall back.  This might seem easier said than done, but with massage, self care, and stretching, you can absolutely work your way to less pain with better posture.

And I'll leave you with this.  :)

IT Band Syndrome

     I got this awesome (and incredibly relevant) topic choice from one of my FB followers!  With this amazing cool(er) weather, I've starting to run again, which means  - you guessed it! -  lots of foam rolling and stretching!  Unfortunately, that doesn't always cut it.  I have several of cyclist and runner clients who have chronically tight legs and hips, but more specifically, TIGHT I.T. BANDS!

The Iliotibial Tract (IT Band) is a fibrous strip of thick connective tissue (a reinforcement of the fascia latte: the deep connective tissue of the thigh).  It originates at the iliac crest (the curve of your hip bone) and runs aloing the lateral side of the thigh, insterting at the top of the tibia (the shin).  It encases the Tensor Fascia Latte (TFL) and also recieves most of the gluteus maximus tendon.

Actions: stabilizes the knee in extension and in partial flexion (i.e. walking/running, squatting, cycling, etc.)

Iliotibial band syndrome (ITBS or ITBFS, for iliotibial band friction syndrome, Runner's Knee) is the chronic inflammation of the IT Band; it is one of the most common causes of lateral knee pain.

   

There are several different things that can cause ITBS, such as overuse, leg length discrepancies, and improper form when exercising/running. 

So what can we do for ITBS?

As far as massage goes, trigger point and myofascial techniques would be the way to go to alleviate some tightness throughout the entire thigh, with a focus on the knee attachment points of the IT Band and hamstring tendons (just behind the IT Band insertion point).  The TFL and the Gluteus Maximus would be the next section to address because of their direct relation to the IT Band.

Your Homework:

For prevention and management, stretching and proper strengthening exercises for the lateral thigh will take strain off the IT Band.

4 Exercises to Prevent Runner's Knee

For more exercises/stretches for the legs, follow me on Pinterest.

And if you have a flair up, always R.I.C.E. (Rest, Ice, Compress, Elevate).  

Really.  Do NOT power through it.  

Take care of yourself.  :)

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