Why do Tendons Swell Within the Carpal Tunnel? By Staff Writer





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.)