♪ Bob and Brad, the two most famous ♪ ♪ physical therapists on the internet. ♪ - Come on in. Hi there folks. I'm Bob
Schrupp physical therapist. - Brad Heineck, physical therapist. - And together we are the most
famous physical therapists on the Internet. - In our opinion, of course, Bob. - What are you trying to, I don't mean. - I'm stretching Bob. I'm trying to get some myofascial release. - All right. We're gonna talk about
carpal tunnel syndrome today. - Yes. Yep. Bob, we are gonna
show you how to test for it. Some common symptoms, all
the way from some statistics. I just took a course on it. So this is updated information. - Glad to hear. - It's very complete. - By the way, we are giving away always giving away something,
go to the Giveaways section on bobandbrad.com and sign up for a back and neck massager. People love it. - This is really a nice, you
know, when I first saw it. Eh, you know? Then you put it on it's like, whoa, whoa. And it goes all the way down to the back actually even
works on your hamstrings and calf muscle. - Actually works on your daughter. - Yeah. Yeah. My daughter uses for her neck and she was extremely grateful. She has one at home right now. Anyways, let's go on
carpal tunnel syndrome. So in the wrist, everyone
has a carpal tunnel, but carpal tunnel syndrome is when
the carpal tunnel is here. The median nerve actually
gets pinched in there. - By a ligament that goes across. - And the common symptoms
are numbness, tingling. And you can get it in the thumb, the first finger here, the middle finger, and half
of the ring finger typically. - Half of the, right. - It can be very annoying. And it can disturb your sleep,
is a real common symptom. - One thing you could see if you had it for a while is actually
this meaty part of thumb. - Yep. - It starts to wear away, atrophy. - Yeah, atrophy. Wear away
would technically be right. - I don't know how they
say it. The lingo's first. - Right, but it gets
like a hollow spot there. - Right. If you look at
one compared to the other. - And if yours is that bad you really should be
seeing a doctor already. - Right. Right. - So we're thinking about when you have it and you have that numbness and tingling and it oftentimes - Irritating pain. - Yep. Can come with your work. Now, some statistics on
common people that have it: majority of people are
over 45 that get it, you know, more females have it than males. - As it should be. (laughs) - You are really asking. - I'm not implying anything. - Yeah. We just lost a lot of
subscribers on that comment. - Goodbye. - Anyways, no, statistically
it's 1.5 to 4 times more females have it than than males. - Well, really they're
tougher that we are. - Well, there's no doubt about that. - So they can handle it better. - Well, yeah. If you're diabetic or you have a BMI over
30, if you're overweight those people are typically,
will have it more. If you're an industrial worker and you use your hands aggressively, particularly if you work
with equipment that vibrates - Right. - onto the hand, that really
irritates it a little quicker. - I always think of carpet
layers, cutting that carpet or - Yeah. - Like hedge trimmers, of course they have
like electric ones now. - Sure. Well, which is worse
yet 'cuz it's vibrating. - Oh right. Still vibrating. - Sanding equipment. - Yep. - I think about the people
using the jack hammer. (imitates jackhammer) - Yep. - Wow. Anyways tests. Now we're gonna talk about
some tests that you can do and they, they're not real difficult. - Yeah, they're really easy to do. - That you should do. - Right. So you wanna show them Tinel's? - Sure. - I don't know if people
pronounce it differently. - The nerve runs right between
the two meaty parts here. - Yes. - And all you do is tap on there. - Yep. - And, actually, Brad, I've seen it where people tap all the
way up to the hand even. - Okay. - But you definitely wanna tap right here. - Yep. - And if that kind of
gives you pain or tingling, - The symptoms that you get. That's a positive test. - Yeah. You may have. - And you would do that for 60 seconds. - Right. - Okay. The next one's Phalen's. - Right. - It's one of those "ph" instead of "f". - So you're going to basically pray. - Yeah. - I've seen it go both ways. - Right. And actually this course, they recommended this. - They did. - But you can do it both ways. You can do a test each direction. - Please have my pain go away. - Yes. - So, or you can go like this. - And you hold it there. Touch and then bring the
elbows down 60 seconds. - Right. - And see if that
reproduces, that numbness, tingling, those painful symptoms. Now this other one is interesting. And I think this one gets missed a lot and I always test this. - Yes. - You can get symptoms in the hand that will be identical
to carpal tunnel syndrome from the nerve getting
pinched in the neck. - Right. - So I'll show you. This
is how I typically do it. I'll have the person in a
nice firm chair have 'em sit up nice and tall. Ask 'em if they have any symptoms in the hand and where
they're at if they have some, and then I'll say, just lean back tuck the chin in gently and
then look back like this. And if they go back like this
and their neck starts to hurt and it doesn't, the range is limited. And if they have symptoms, that increases the symptoms
in the hand or down the arm, we gotta get after that neck
'cuz they could either have just a neck problem or
it could be neck problem along with carpal tunnel. - If you wanna take it a little further you could go back and go to the side, too. - There you go. - As you had trouble and you
could go the other way too. - Yep. - That's Spurling's test and
it does often indicate, too, whether or not you have a neck problem. - Right. You know, if you do
this in this all feels fine. - Yeah. - It pretty much clears the neck. - Yeah, it does. - It's a good strong indication. So make sure that is checked. - So, how do we treat this Brad? - Excellent question. Now I have talked to a
surgeon who does this. (imitates drill) - Right. - And he does the surgery and he does all kinds of surgeries
on the hand and wrist. And he says his number one treatment. - Go to treatment. - Go to treatment. - Is a simple wrist splint or wrist brace. - While you're sleeping. - Right. - He said, that is a wonderful way. - It's a good way to start. - Yeah. So if you wake up
in the middle of the night because your hand and
the symptoms are bad, which my wife by the way had for years and she would do this. - Quite often you could,
you'll sleep in your wrist bent and you don't even realize it. - Exactly. So you don't have to have any special wrist splint. - Right. - What's important is
that it's comfortable and it's not too tight. - You go to a big box store
and they'll have there. - Online and you just look for something. - Drugstore. - Yep. Now this one's real comfortable. It's got a stay which means there's a metal or a plastic support. You don't necessarily have to have that. - And you could shape those. - Yeah. - Bend them a little bit and shape them. - Yeah. This one's pretty tough. I'd have to take it out. But anyways, you want it comfortable
and you sleep like that. It keeps your wrist in a neutral position. You can also wear this, if you get it with
you're using the mouse or at a keyboard or whatever job you have, if you can wear it and still do your job, that's gonna be helpful. - Right. Isn't there
anti-vibration gloves? - Yep. They're cushioned a little bit. - Right. - It's a good. - I have one for cutting lawn. - Oh really? - When I push the lawn mower. - You have one in each hand? - Yeah, I do. I do. - I know. I believe it. I'm not kidding. Okay. The next thing is,
if you don't have this, just think about neutral
position with your wrist. If you're gonna do something like this, that does, you know, put your hand back, like you're pushing on something like a, you know, possibly
a wheelchair or a cart. Think about neutral position. And that's why you wear the
braces. To micromanage them. - And that's also why you don't
have the keyboard real high because you're kind of
in a weird position. - Exactly right. - You wanna have the keyboards
so you can keep the wrists in a neutral position while you're typing. - Right. And oftentimes
these are more important than the stretches we're gonna show you. - Right. - But, one of the common
stretches to stretch or floss that median nerve. - Nerve. - Because that nerve comes
through here all the way up - Right. - under the armpit to the neck. - So you're gonna go out
like this and palm up. - Keep it level. Keep the arm level. - Yep. - And you can to even go
back a little bit, Brad. - Yeah. So we're - a little bit. Right. - And even on a healthy
median nerve, you know, I do this, you know, I can
feel the stretch, you know. - Yep. - I can bring my palm
down and all of a sudden I feel it up here. - Right. - You know you got a tight nerve. - Now, if you want really wanna floss it you could actually first
just start the wrist. - Yep. - And then, eventually, you could even put the head down while
you put the wrist down. - Yep. - And you're kind of flossing it. - Yeah. Yeah. We've got another video on
flossing the median nerve that if you go to Bob and Brad we get more into detail with that. - Yeah. You can also use a wall
to help stretch that. - Right. - And if you, like, I
stretch here like this and then I go over like this. - That really stretches you. - Yeah. So don't get too aggressive. If you feel that all the
way up into here, be gentle. Give it a few days. - Yeah. Cause you could get it fired to up and make it worse. - So you're gonna do that maybe about 10 times gently and
then see how it responds. This next one is one
that gets missed a lot. - Yes it does. - That nerve can also often
get caught in the first rib - Right. - which is underneath your clavicle. It's a really small rib
and the way you treat that it's a very simple thing to do. And regardless if it
is pinched there or not this is a good stretch. - Yeah. I like it. That
feels really good to me. - It does. So you, you take a belt. And I like the buckle on the belt because I'm gonna sit on the
buckle and it kind of grabs. So on a firm chair, I'm gonna
sit there and I wanna stretch, this is the side with the carpal tunnel. I'm gonna take this belt
and put it right over. So it goes over your clavicle not over the end of the shoulder,
but in closer to the neck. You're gonna hold it here, let this relax, and then we're just going to,
when I lean this direction the belt tightens and it pulls down and my head goes this
way, it pulls down on that clavicle and over the first rib. There we go. And you could feel that
pressure going in there. And this is just a nice stretch. And again, you can't really do anything. No harm with this or anything but good. - Right. It should feel good. - Yeah, it should. I mean
this does feel really nice right now. - Yeah. - You might just wanna do it regardless. So just a nice stretch. But that can alone, it's
the double crush syndrome. - Right. So the idea is that
you're getting the nerves getting pressure on it up here. - Yep. - Then it gets pressure down here. - Right. - So it double and it intensifies. - Right. Exactly. So that's a lot of
information for one video. So also we, we do have
more videos on this. Do we have a Programs on this one? - No. - Yeah. I don't think not yet. So, but if you Google Bob and
Brad Carpel Tunnel Syndrome we definitely have some more
videos to give you more. - And we do have videos on neck pain. I mean, if you, if you go to programs, we have one on neck pain so if you think that it's mostly from your
neck, we do address that. - When you do that,
initially it hurts here. Our Programs is like a
library of specific videos for the neck, go to bobandbrad.com, go to the
Programs tab, click on that, go to the Neck, and open
up about 20 or 30 videos. And they all have PDF print outs showing the video and
the exercises on paper so you don't have to go
back and look at our faces. - I gotta tell you, we're
really being generous with these because a lot of people charge for these. - Exactly right. - We have absolutely no charge, no email. - I wanted the charge for them and Bob says, "No, we're not going to." - No! - Yeah. So I said, okay, let's
do it. Let's be generous. So very good. - Bye. Thanks. - Good luck with all your neck problems. And if you got a broken heart we can fix anything except for - a broken heart. - Right. That's what I just said. - Yeah. That's what you just said. - But we're working on
that in our spare time. - Thanks. (short music outro)
