Carpal Tunnel Exercises - Why? Part I of III

It is quite difficult to find information where scientists so much as postulate the causes of carpal tunnel syndrome, yet people in certain categories of activity continue to commonly experience the condition. The common outcome of research is that increased pressure in the carpal tunnel causes the condition. What we must now ask what is the cause of the increased pressure in the carpal tunnel? And can carpal tunnel exercises prevent or rehabilitate CTS? There are 3 situations that are regularly postulated wherein people commonly developing CTS. They are: 1) A functional problem AT the CT (carpal tunnel) - This first category refers to people whose daily habits consist of repetitively gripping and grasping - especially with small objects. 2) A functional problem THROUGH the CT - (poor circulation via pregnancy, RSI, metabolic issue (diabetes), smoking, etc.) 3) A physical problem AT the CT - (CT is small, fracture, dislocation, etc.). This first article will explore the different theories whereby there is a functional problem AT the CT. It is interesting to note that most of our grasping and gripping activities that are done daily appear do be dominated by finger flexor muscle activity, and it is true that yes the small intrinsic finger flexor muscles of the hand are doing a lot of the work. It is also true that the extrinsic finger flexor muscles are doing work. Both can contribute to a higher risk of carpal tunnel syndrome. Let me explain. The small intrinsic finger and thumb flexor muscles originate from the flexor retinaculum (transverse carpal ligament) and thus finer motor movements in flexion (i.e. grasping small items) can cause pressure and stress on the roof the carpal tunnel (transverse carpal ligament). In small gripping and grasping habits become repetitive, these muscles may even have a tendency to shortened and thicken. Carpal tunnel syndrome seems more likely when this scenario advances without being offset by balanced finger exercises. When the opposing muscles (finger extensor and abductor muscles) are strengthened through proper exercise, this offsets and re-balances the shortening of intrinsic finger and thumb flexor muscles. It is then less likely that he carpal tunnel spacing or pressure problem will occur, and thus carpal tunnel is highly unlikely. The larger extrinsic finger flexor muscles may also cause problems at the carpal tunnel. Eight finger flexor tendons in one thumb flexor tendon pass through the carpal tunnel. If these tendons are thickened, adhesed or inflamed, there is a higher risk for CTS to develop. Once any structure that is inside of the carpal tunnel is enlarged, the pressure inside the tunnel increases and the median nerve is at risk of compression/compromise. Larger extrinsic finger flexor muscles are less likely to inflame or thicken if they are well supported by strong, well-toned finger extensor muscles. This may seem like a strange comment, but the finger extensor muscles support the action of finger flexion. It is a cooperative contraction. If the finger extensor muscles are strong, healthy and well toned, the finger flexor muscles can work efficiently and are much less likely to be overworked or overpowered. In other words, inflammation of these tendons is much less likely if the tendons themselves are strong and healthy and the finger extensor muscles that support the finger flexor muscles are also strong and healthy. If the supporting extensor muscles are weak, the flexor muscles have to work harder and less efficiently and are at higher risk of being overused and inflamed, resulting in higher risk for CTS. Often I hear or read that orthopedic specialists believe that CTS cannot be prevented by balanced exercises and surgery is almost always the solution. I do not believe this is true considering all of the repetitive grip type activities that seem to be fertile ground for CTS. People that hear this type of comment have a tendency to develop a victim-oriented mindset and do not pursue CT exercises - and are inherently at higher risk to develop CTS. To specifically strengthen the hand opening muscles (extensor & abductor muscles) is to not only support the action of finger flexion, but to stabilize the structure of the CT itself. In the next article about CT exercises, I will explain the theories of why CT exercises maximize circulation and why maximized circulation reduces the likelihood of CTS. Dr. Terry Zachary is a chiropractor, entrepreneur, inventor and writer from Vancouver, Canada. He is passionate about bringing healthy daily habits to light and influencing people to take control of their own personal health. It is his specific passion to teach about proper balanced hand and wrist exercises for carpal tunnel syndrome and other RSI's. He is the developer of Handmaster Plus hand exercise system.