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Carpal Tunnel Syndrome Swelling - A Secondary
Effect
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Swelling
of structures within the carpal tunnel is usually
a secondary effect of the nine flexor tendons
and median nerve having to glide through the
carpal tunnel which has decreased in size, causing
friction and resulting in the irritation and
swelling of the soft tissue structures within.
How does the carpal tunnel decrease in size? The thenar eminence, hypothenar
eminence and palmaris longus muscle (Also palmar fascia from the palmaris longus
muscle covering the anterior portion of the hand) which runs over the TOP of
the carpal ligament, plus the flexor muscles of the forearm which tendons run
through the carpal tunnel, become overly short and tight, compressing the carpal
ligament from above and within as well as pulling the carpal bones inward causing
the carpal tunnel to become smaller and impinging the median nerve. The carpal
tunnel cannot expand due to the fact that the carpal ligament does not expand,
therefore keeping the carpal tunnel from actually becoming larger, or the hand
from folding in half lengthwise, as if you were touching the backside of the
little finger and thumb regions together. Leaving the carpal ligament in place
is also important in order to keep the flexor tendons from "bowing" and is used
as a fulcrum point for leverage as it is necessary for a strong grip.
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Because
the finger and wrist flexor and finger adductor
groups are exercised on a daily basis with virtually
every activity we perform, they become stronger,
shorter and tighter, thus causing the carpal
bones to shift inward, collapsing the carpal
tunnel and making it smaller. As daily hand motions
are continually performed with the carpal tunnel
now reduced in size, the result is increased
friction of the nine flexor tendons and median
nerve within the carpal tunnel. And what does
friction cause? Irritation and swelling to the
soft tissues within the carpal tunnel. This is
why surgeons severe the carpal ligament, making
more room for the flexor tendons and median nerve.
If the carpal tunnel is returned back to its
original size by lengthening the short, tight
flexors and strengthening the weak, extensors,
the carpal tunnel is returned to its original
state, the friction and swelling is eliminated
and the symptoms disappear.
Now, if the carpal tunnel is not collapsing on itself, then what would cause
the narrowing of the carpal tunnel and related swelling? The carpal bones could
be growing larger, but they are not. (Unless some form of bone disease is present.)
Maybe the flexor tendons are becoming thicker and are causing the decreased space
within the carpal tunnel, and the carpal tunnel really isn't collapsing? This
would not fit most cases, but is possible. So, to correct tendons and their sheaths
which have become thickened, it would still be suggested to perform active and
passive stretches in order to elongate the hands flexor / adductor tendons, making
the tendons thinner and therefore increasing space within the carpal tunnel,
and again, to strengthen the extensors/abductors in order to shorten them and
pick up the slack created by lengthening the flexor / adductor muscles.
Either way, performing active stretches to the finger and wrist flexors and finger
adductors and performing active exercises to the finger and wrist extensors and
finger abductors will help correct instances relating to the primary cause of
swelling caused by friction within the carpal tunnel, whether the space within
the carpal tunnel has reduced in size because it is collapsing or whether the
tendons and their sheaths have become thicker.
Mr. Anliker
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. |
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