Medical References: Repetitive Strain Injuries, Carpal Tunnel Syndrome
Imbalance as a Factor in the Development of Carpal Tunnel Syndrome (CTS) and Repetitive Strain Injuries (RSI'S).
- Musculoskeletal disorders of the upper extremities
include carpal tunnel syndrome, tendonitis, epicondylitis.
Both non-occupational and occupational factors contribute
to the development and exacerbation of these disorders.
- FLEXTEND helps address
muscle imbalance disorders by strengthening the
associated intrinsic and extrinsic extensors
and abductors in order to establish equal pull/tension
on both sides of the joint. Creating an environment
where there is muscle balance can help decrease
compression of the anterior wrist and forearm
caused by the stronger, overused flexor muscles.
Increasing extensor strength can promote stability
of the affected joints by decreasing the tensile
stresses imposed by the flexors onto the weaker
extensor muscles, which stabilize the finger
and wrist joints in the functional neutral position.
- Fry has proposed that
muscle overuse leads to direct painful sequelae
and muscle changes. Biopsy of the first dorsal
interosseus muscle has shown non-specific
fiber ratio changes. Dennet
X, Fry HJH. 1988. Overuse syndrome: a muscle
biopsy study. Lancet 1: 905-8
- The flexor muscles of the
forearm have a large effect on carpal tunnel
pressure by acting on and within the carpal
tunnel (Keir et al., 1995).
- "All of the extrinsic
hand muscles become involved in a power grip,
in proportion to the strength of the grip."........ "Strong
agonist-antagonist interactions are needed
between the flexors and extensors of the
hand and fingers to produce forceful hand-grip.
Powerful flexion of the distal phalanges
requires strong activity also of the finger
extensors." ". Janet G. Travell, M.D.
and David G. Simons, M.D. Myofascial Pain
and Dysfunction-The Trigger Point Manual.
Volume1 Upper Extremities, Ch:35, pg.
501. Copyright 1983.
- "Muscle balance must be restored
with specific exercises. Otherwise, the already
strong and overused muscles get stronger, and
the weak and underused muscles remain weak.
Individuals get good at using the overused
muscles and must be trained specifically to
recruit and strengthen the weak underused muscles." Philip
E. Higgs, M.D. and Susan E. Mackinnon, M.D.
Department of Surgery, Washington University
School of Medicine, St. Louis, Missouri. Annu.
Rev. Med. 1995. 46:1-16.
- "Actions of the finger extensors
are primarily extension of the fingers, and
the hand, at the wrist. They (extensors) make
as essential contribution to forceful finger
flexion." Janet G. Travell, M.D. and
David G. Simons, M.D. Myofascial Pain and
Dysfunction-The Trigger Point Manual. Volume1
Upper Extremities, Ch:35, pg. 497. Copyright
- "Activation of the hand extensors
(muscles), is essential to the power grip." Janet
G. Travell, M.D. and David G. Simons, M.D. Myofascial
Pain and Dysfunction-The Trigger Point Manual.
Volume1 Upper Extremities, Ch:34, pg. 485.
- "The theory we propose explains
pain, paresthesia, and muscular tenderness
on the basis of multilevel nerve compression
caused by postural abnormalities and muscle
imbalance." Philip E. Higgs, M.D. and
Susan E. Mackinnon, M.D. Department of Surgery,
Washington University School of Medicine, St.
Louis, Missouri. Annu. Rev. Med. 1995. 46:1-16.
- "If certain muscle groups are underused, opposing
muscle groups will be overused. Muscles in
either a lengthened or shortened position will
be at a mechanical disadvantage and weak. The overused
group will hypertrophy, and the underused group
will continue to be weak. This combination produces
a self perpetuating condition that maintains the
abnormal posture and muscle imbalance." Philip
E. Higgs, M.D. and Susan E. Mackinnon, M.D. Department
of Surgery, Washington University School of Medicine,
St. Louis, Missouri. Annu. Rev. Med. 1995. 46:1-16.
are several factors which have the potential to
increase carpal tunnel pressure. Cadaveric research
has demonstrated that the movement of the lumbricals
can increase pressure by occupying space within the
carpal tunnel (Cobb et al., 1994).
fingertip loading (gripping/flexing finger tips against
an object) has also been shown to increase carpal
tunnel pressure (Rempel et al., 1994).
- Allied Health Associates FLEXTEND® Study
- 1. Dannet X-Fry, a muscle biopsy study. "Overuse
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M.D., Myofacial Pain and Dysfunction,
The Manual Vol. 1 Upper Extremities, Ch:
35, Pg. 501. Copyright 1983.
- 3. Phillip E. Higgs, M.D., Susan E. Mackinnon,
M.D. Department of Surgery, Washington
State School of Medicine, St. Louis, Missouri.
Annv. Rev. Med. 1995. 46: 1-16.
- 4. Corrie Holloway, D.C.O., Q.M.E., Clinical
Director Allied Health & Associates,
Los Angeles, CA. 06/01/2000 to 10/01/2000.
- 5. Mel Braxton, D.C. Sports Injury Rehabilitation
Specialist Allied Health & Associates,
Los Angeles, CA. 06/01/2000 to 10/01/2000.
University FLEXTEND® Study
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