Of the PT Persuasion: For Writers - Carpal Tunnel Syndrome
Have you ever wished for a resource that helped writers cut back on hours and hours of researching how to accurately portray injuries and medical conditions? Look no further. In this blog series, I’ll be discussing just that. What makes me qualified to do so? Well, I’m a Physical Therapist! Or, rather, I’m a writer…Of the PT Persuasion.
On the heels of the last episode in my Of the PT Persuasion series for writers, let’s talk about another writer nemesis. Well, no, we’re not discussing writer’s block. We’re talking about Carpal Tunnel Syndrome. This hand condition involves nerve compression, causing a series of symptoms, including tingling, numbness, and/or pain in the wrist and hand, particularly the thumb, index, and middle fingers. At its worst, Carpal Tunnel Syndrome can even cause weakness and atrophy of the thumb.
Anyone who spends a good amount of time on a computer or working a desk job has probably noticed that, after a long day typing, you feel the need to shake out your wrist and arm. Maybe it feels tight or stiff. Maybe it’s already tingly or has that weird pins-and-needles feeling. What’s that all about?
If the hand symptoms you’re feeling are coming from a condition of your wrist and hand (yes—they can come from other places like your neck and shoulder!), then there’s a possibility you’re dealing with Carpal Tunnel Syndrome.
Let’s break it down.
What is the Carpal Tunnel? The term ‘carpal’ refers to the small bones of the wrist. If you’ve ever spent any time looking at a skeletal hand (no judgment here), you might have an image in your head of a few, marble-sized bones that make up the wrist and palm, on which the phalanges are attached. (Despite years of doctoral education, I can never read ‘phalanges’ without thinking of Phoebe Buffay’s ‘Regina Phalange’ from FRIENDS.) The carpal bones are arranged into two rows, each row containing four. Both rows form a U-shaped cup; you can see how this shape forms your hand if you look at your palm; it’s a bit hollow-shaped. Now, the top of this “cup” is strapped together with a ligament to hold it stable because, otherwise, the cup would lose its shape without support. And, because of this ligament, a tunnel is formed between the U-shaped collection of bones and the ligament on top. This is the carpal tunnel.
The carpal tunnel contains a few key structures for the hand. Nine tendons and the median nerve pass through the carpal tunnel.
The nine tendons are all flexors, which mean they’re apart of muscles that make the fingers ‘flex’ or bend. They make your hand curl into a fist. And, if you think about typing, it’s just a series of making your fingers bend and straighten. Over. And over. And over… I came across an article recently that posed the average typist’s fingers travel about 1.5 miles typing per day. That’s a lot of movement in the carpal tunnel, where the tendons rub together each time they move. If you’re typing in a compromised position—like if your keyboard is in a weird spot or if you’re slouching in weird posture—then it can create more friction through the carpal tunnel. In turn, if that ends up creating irritation or inflammation, then your median nerve, which also passes through the tunnel, can become quite unhappy. This results in tingling, numbness, or pain in the hand and wrist.
Sometimes, just relaxing in poor positioning is enough for the carpal tunnel pinch on the median nerve, like if you sleep with your wrists tucked under your chin (think of how Cindy Lou Who sleeps).
Nerve pain is a special sort of difficult in the world of PT (and Occupational Therapy, who often deal with wrist and hand conditions). You see, once a nerve gets irritated, it stays irritated for a while. If you’ve ever had Carpal Tunnel Syndrome (or any nerve-related condition), you know what I mean. So how do we prevent and treat it?
One of the best things you can do is sit properly. Yes, I know—that’s such a nagging mother answer, but it’s very effective, especially in terms of prevention! For tips on a good workplace setup and ergonomics, check out my last article on Ergonomics and Low Back Pain.
Another thing you can do is wear a wrist brace to prevent your wrist from bending in positions that pinch down on the nerve. So, if you’re a person who sleeps with their hands tucked up and bent, wearing wrist braces to bed is actually something we recommend to our patients a lot; you just have to be consistent with it for a few days to get started. (Note: make sure the brace isn’t worn too tightly! Snug, yes, but not air-tight.) You can find braces in a drug store or online, and you can usually find “Carpal Tunnel Braces,” specifically.
A long-term, long-lasting solution (besides ergonomics) is a PT’s go-to: stretches and exercises. It’s truly amazing how much movement can fix in the human body, so here are a few ideas to keep the Carpal Tunnel away.
Take a movement break every 20-30 minutes. Get up, do some stretches, walk around or shake things out. Get your body out of sustained positions it’s not meant for! Set a timer and do writing sprints with movement as your break!
Perform wrist flexor stretches. This is a stretch for the flexor muscles whose tendons pass through the Carpal Tunnel. Let’s say we’re stretching the right hand. Hold your right arm straight in front of you with your palm facing down. With your left hand, take your right palm and fingers (don’t forget the thumb!) and pull it up into the “talk to the hand” position. Make sure you keep your right elbow straight. You should feel some stretch on the underside of your right forearm.
You can do this same stretch for the top of your forearm by pulling your palm and fingers down instead of up.
Perform tendon glides. These aren’t so much a stretch as they are a mobility exercises for the tendons within the carpal tunnel to keep them moving (gliding) the way they should. Start with your elbow bent, resting on a table with your hand held up in neutral (the high-five position). This is the starting position. First, curl the top part of your fingers into a sign language E. Return to start. Then, curl your fingers into a fist. Return to start. Lastly, keep your fingers straight, but bend at the knuckles like a sassy “bye-bye” wave. Return to start. Retreat ten times through, slowly and intentionally.
Massage your forearm. You can use your other hand or roll your arm on top of a tennis ball or a rolling pin to gently release the tightness in the muscles of your forearm. You can do the whole forearm, if you want—just avoid massaging bony areas! Massaging the top side of your arm can help prevent Tennis Elbow, too.
Disclaimer: these three exercises are ones I do with my patients on a daily basis, but I am there, in person, to demonstrate and supervise exercises. While these are generally simple and harmless, please note that there is always a small, but inherent risk to activity; should you experience pain, stop immediately.
Hopefully some of these tips and tricks can help prevent Carpal Tunnel Syndrome or reduce any symptoms you currently have. However, if you do have symptoms, please consult your Primary Care Physician for a referral to Physical Therapy or Occupational Therapy. Reading PT blog posts is not the same as receiving adequate medical care.
Thanks for reading, and stay tuned for more Of the PT Persuasion just-for-writers content.
Thank you for reading! I hope you enjoyed this installment to Of the PT Persuasion.
Disclaimer:
If you’re seeking medical advice for yourself or someone you know, you should speak to a medical professional. This blog is not intended for diagnosing or treating real-life medical conditions, only fictional ones.
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