The Carpal Tunnel Conundrum

Carpal Tunnel

Often we have people walk through our doors because they have been suffering with some chronic pain: carpal tunnel, elbow tendinitis, plantar fasciitis, low back discomfort, hip pain, etc.  They learned from a friend who had experienced the same symptoms that we had helped the friend by giving them a series of exercises to make the pain go away.  They ask if we could show them the exercises we gave their friend because they had the same pain.  Our answer, without appearing rude or smug, is either “no”, or “it depends.”  We then have to explain our answer.

Have you ever experienced a headache because you hit your head on the kitchen cabinet?  Or, have you ever experienced a high level of stress and a headache appeared?  Have you ever eaten ice cream too fast and suddenly a headache came on?  Are you going to treat each headache the same way in each event?  No, because the cause of each headache was different.  The same can be said of Carpal Tunnel Syndrome.  It is merely a symptom that something is not quite right.  Your body is moving in a way which creates pain, inflammation, irritation, etc.

The reason why the carpal tunnel symptom appears could come from a myriad of reasons.  Yes, repetitive movements can often cause pain and irritation.  However, if the movement was the problem then wouldn’t everyone who performed the movement get carpal tunnel pain? Perhaps it would be more accurate to say that the body which performs the repetitive motion tried to organize the movement in a way which eventually brought on the symptoms. What if someone had sustained an injury in a completely different region of their body which unconsciously forced them to reorganize the way their whole body moves?  Could that bring on Carpal Tunnel pain?  Sound too far fetched?  Think about this scenario.

An active woman who works in a local grocery store as a cashier took her dog on a walk.  She exercised daily and never experienced any chronic pain or discomfort.  During the walk her dog saw a squirrel and bolted after it.  When it bolted, it accidentally knocked the woman to the ground.  The woman twisted her ankle and bruised her left hip when she fell.  When the dog eventually came back without the squirrel she put him on the leash and limped home.  During the walk home her body had to find the least painful way to move. It began to re-organize how each joint cooperated with one another to get her home.

The next day at work, she stood behind the register, reaching from right to left.  As she scanned each grocery item she could feel the left hip bruise and the slightly swollen ankle.  Her body now had to unconsciously re-organize how she did her job in order to get away from the pain.  She wasn’t able to easily sway her hips side to side or bear as much weight on her injured ankle as she normally would. Instead, she began to subtly shift her weight onto her right leg and reach more with her upper body and arms.  That action caused her body to rotate over her right hip and allowed her left hip to drop just a little.  If left alone the spine would begin to tilt left so the muscles along her back had to pull more to the right while her ribs tried to balance out the hip rotation by turning left.  At the same time she tried to lift her body weight off her left hip and ankle by lifting her shoulders a little higher. She had found a successful way to get the job done!

Unfortunately, over the next week, her new found successful way of getting the job done became the adapted way of working.  Her body normalized this posture and how she moved since the fall.  Even though the pain had gone away her compensatory pattern of movement remained. Six months later the cashier began to notice tingling in her right hand and a loss of strength.  She tried stretching and massaging the wrist and hand but it did not provide lasting relief.  A few more months go by and she began to wear a wrist brace because pain was beginning to appear.  A few months later she went on disability and considered surgery for her recently diagnosed “Carpal Tunnel.”  She talks to a friend who had found relief from his carpal tunnel pain by going to Rocky’s and getting a series of corrective exercises. When she comes in asking for the exercises what do we say?  No, of course.

Her friend experienced carpal tunnel pain because he was mountain biking and broke his collarbone when he fell off his bike.  His desk job and frequent mountain bike excursions forced him to organize the way his body moves in a completely different manner than the cashier.  His re-organized movements brought on the same symptom but the corrective approach was not the same.  Just like the ice cream headache versus the headache caused by hitting your forehead on the kitchen cabinet.

Instead of giving her the same exercises we needed to be detectives and look for clues to the root cause of the symptoms.  The fall she had when her dog went after the squirrel had occurred a year ago.  She didn’t see the significance of the event and she couldn’t make the connection with her carpal tunnel pain.  Sadly, most western doctors are not well trained in biomechanics and their approach is more focused on treating the symptom rather than hunting down the cause or problem.

We began asking questions and eventually found out about her fall.  Then we began asking her body questions.  What if we were able to train the body to change the unconscious pattern of movement? What if we allowed the body to bear weight evenly over both hips and ankles and allow the shoulders to relax and lower in a pain-free environment (remember the reason she did it was because she was experiencing pain)?

Would you believe that her exercise program for her carpal tunnel did not involve wrist exercises or stretches? T he program involved creating better balance in her hip position and improving her ankle motion.  It involved getting her to breathe properly and deeply to allow the body to experience shoulders lifting and lowering. It also re-organized the way she walked and stood.  It addressed the problem and suddenly the symptom diminished.  Not long after performing the program the pain was gone. She went back to work and began enjoying her life again.

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