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The Carpal Tunnel is a passageway in which the nine
flexor tendons, median nerve, radial artery, blood
and lymphatic vessels pass through in order to supply
function and movement to the thumb, index, middle
and one-half of the ring finger.
The Carpal Tunnel is lined by the carpal bones on
the posterior surface (backside) of the wrist, and
the transverse carpal ligament, positioned on the
anterior (front side) of the wrist. The size of the
carpal tunnel is about the size of a dime in diameter,
and the flexor tendons, arteries and nerves are expected
to glide past each other with ease within the carpal
tunnel. But in such a small, confined space, there
is little room for error. If the tendon size increases
from inflammation, carpal tunnel syndrome will result.
Many therapists and doctors still blame Carpal Tunnel
Syndrome on the increased size or swelling of the
tendons that run through the carpal tunnel however,
in the past few years, many other specialists began
to ask, "What caused the tendons to swell in the
first place?" After years of study and testing, it
was found that the most prevalent reason for the
development of carpal tunnel syndrome was the narrowing
or collapse of the carpal tunnel. Once the carpal
tunnel begins to collapse in on itself, any form
of repetitive or static flexion such as typing, writing,
grasping, etc., will cause friction of the flexor
tendons against the carpal bones, median nerve and
blood vessels, causing irritation, inflammation and
increased swelling of the structures within the carpal
tunnel. Thus the swelling of the tendons is a secondary
reaction. This is why so many Carpal Tunnel procedures
or treatments have such a high rate of failure - they
do not treat what caused the swelling of the tendons.
The most common reason for the carpal tunnel collapsing
in on itself is caused by a muscle imbalance that
results from weak extensor muscles not able to hold
the carpal bones in position due to the tremendous
pull from the overly strong flexor muscles. The key
to eliminating muscle imbalance is one of the easiest
and least expensive treatments available today. It
also has the highest rate of success. And when the
proper stretching and strengthening program is used,
improvement of symptoms is often noticed by the end
of the second week, making it one of the fastest
ways of treating symptoms. Most cases of repetitive
strain injuries are a result of muscle imbalance
and therefore the very first treatment approach for
patients should be a proper exercise program focusing
on the extensor muscles within the entire lower arm.
The therapist must properly stretch and lengthen
the flexor muscles that close the hand, while strengthening
the extensor muscles that open the hand, only then
is there a result of a more stable equality of muscle
length and strength within and around the carpal
tunnel. This in turn will stabilize the carpal bones
into their natural / proper position, keeping them
from collapsing into the carpal tunnel and pinching
the tendons. It is important for the doctor or therapist
to focus on exercise that will strengthen the entire
lower arm, including fingers, hand, wrist, forearm
and elbow. A treatment program that includes all
of the above body parts will be the most beneficial,
longest lasting and help prevent most all of the
common injuries associated with repetitive strain,
including but not limited to; Golfers Elbow, Tennis
Elbow, Carpal Tunnel Syndrome, Guyon's Syndrome,
Cubital Tunnel, De Quervain's Syndrome and even Trigger
Finger.
(Consult your physician before beginning any type
of exercise program.)
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