(upbeat music) ♪ Bob and Brad ♪ ♪ the two most famous ♪ ♪ physical therapists ♪ ♪ on the internet. ♪ - Hi folks, I'm Bob
Schrupp, physical therapist. - Brad Heineck, physical therapist. - Together we are the most famous physical therapists on the internet. - In our opinion, of course, Bob. - Brad, what they don't tell you about carpal tunnel syndrome. - What, Bob? (laughing) - We're gonna tell you today, these are little known facts about it. And also some treatments
that may not be known. - And, and very effective ones. - Right. - I think there's such a big misconception about carpal tunnel in general. People, - Carpal tunnel syndrome. - Right. People just say
I've got carpal tunnel. And if they really understand what it is, it's not so scary and how you can treat it with some of these simple
techniques that can be effective. - Surgery's not always needed here. - Exactly, right. - There's times it gets too far and surgery is needed but, you know, I don't want people to feel guilty. - Right. - When it gets to that point, but-- - Can show you some things you can do at home that can really turn things around and you don't even need
to see a therapist. - You got a few stats about it first? - Right. - Statistics. - This is interesting. 3% of adults in the United States end up with carpal tunnel syndrome. - That's a lot. - Yeah. Actually, actually it is. When you think about it. Yeah. Women, females are three times more likely to get it, just statistically speaking, I'm not sure why. - I think they, they,
they thought it was due to the shape of the bones and stuff. Again, the carpal tunnel is a tunnel that goes right through your wrist. Basically it's two bones
that form a tunnel. And then there's a ligament
that goes over the-- - We better not just say two bones because it's got all the carpal bones. - Oh, right. Right. - We'll get in trouble 'cause there's some therapists watching. - Yeah, exactly. (laughing) But the median nerve, a nerve that comes out through from your neck and travels all the way down your arm, goes in through that,
that little tunnel and and it supplies the
sensation to your hand. - Right. And along with that
nerve, there's a number of tendons that make your fingers flex. And so it can get kind of packed up and a little bit too tight in there. And if it gets too tight in there, we're not gonna go through
the reasons right now, but that nerve can get pinched. And when that nerve gets pinched, you start getting numbness,
tingling, weakness all these symptoms in your fingers. And it's typically your-- - Thumb, pointer. - Yeah. - Middle and ring. - Right. - Half of the ring. - Right. - Pinky's usually not involved. - So a lot of times
what you're gonna see is is even a little bit of muscle wasting right here in, in the thumb. - Right, if you've had it long enough. - If you've had it long enough. - And if you compare, if you have it on one side, not the other, you'll see that the muscle may have even wasted a little bit there, so. - Sure. Okay. - So anyways, that's the anatomy of it. So don't get too excited
when they do surgery they actually just go in and they open up the carpal tunnel by cutting the ligament that, that goes across and forms the bridge, so to speak. The other thing is the
average age of the person or who gets this the most. 50 to 55. - 55. - Yep, yeah. So it's not so much younger people. Not so much the older, but that-- - That's me. - Yeah. (laughing) - I'm 56. You're 54? - Yes. Exactly. - Okay. All right. All right, there, there's
some tests you can do, - Right. - You could even do yourself. Right, Brad? - Exactly, Yep. The tinels test, just put your hand out like this. - And you're gonna tap. - Tap. You know what? You know what tapping reminds me of, Bob? - What's that? - We got a little button. - Oh, that's right. - You got a button here. You could tap on. - If you're new to our, you know, our, our channel please take the, just a second. - Right. - To go ahead and hit that little subscribe button there because we provide you with lots of videos on how to stay healthy and fit. And we upload a video every evening. - Right. - We're really good at this. We'd really appreciate if you subscribed. - Yeah, okay. - The tinels test, you tap. You're gonna do that for 60 seconds. And if you start to
develop, or the symptoms in your fingers start to
get worse from the tapping. - Yeah, you start getting
the tingling or the pain. - Yep. That's a positive. - That's a positive sign. - Doesn't mean you necessarily have it. - Positive doesn't mean good. Positive means that it's possible that you have. - Right, right. - Carpal tunnel. - Then the other one, you take the back of your
hands, put it together, go like this and then
squeeze up like this. - Phalen's test. - Yep. - Hold that for 60 seconds. - That's reverse Phalen's test, I believe 'cause this is Phalen's test, this way, right? You're gonna do it both ways. - Right? I, I like to do it both. I, I, and this way for 60 seconds see if the symptoms are irritating. - You're recreating the symptoms. - Right. Or this way
and bring, go this way. You're just, this way puts a crush. Well maybe we don't need to get into the, the details of the mechanics of it, but those are the tests you can do it. And if they're all
positive, well, you know you've got a pretty good chance you may have carpal tunnel syndrome. - Right. - But not a hundred percent! - Obviously you're
gonna go see your doctor about it. - Right. Alright, you wanna go to some of the causes of, of what, you know, causes your carpal tunnel syndrome to appear? - Well, that's the interesting thing. Oftentimes you can have these symptoms in your hand and they're not from the carpal tunnel but they
can be from your neck. - Right. - The, the nerves that, the median nerve starts way up here in your low neck. So the neck, the nerve
could be compressed here and irritated, causing the numbness and tingling down here
and we can get fooled, you know, and therapists and doctors can get fooled by that. - They can get compressed a, a number of places on the way down. - Exactly, right. - That's where we're gonna talk about how important it's to
have good posture and, and do some stretches even. - Exactly. Right. So if you're working
at a computer station, it's just not so much as you're working your hands but your posture of your body. - Right. Are you rounded forward? - Exactly. - Shoulders forward. - This is putting stress on the nerve before it even gets down to the hand. - Right. It becomes what we call
a double crush syndrome where you get pressure up here, it gets sensitive, the nerve is sensitive. So now it gets a little pressure down here and it's even more sensitive and it starts giving you the symptoms. - Right. - So we need to get this
posture in good position and you need to maybe
even do some stretches. - Right. So if, if we're treating a patient for carpal tunnel, we'll
not only treat the hand and do stretches for the hand, but we'll talk about posture. We'll talk about stretching,
the scaling muscles which are in here, which you can stretch out here because that nerve bundle does go through the scaling muscles. - Yeah. And then we're gonna work on the first rib, as a matter of fact, Should I show that first long stretch? - Sure, yeah. This is something you can do at home. You take a belt, if it's on your left side, sit on the belt with your left butt cheek. Take that belt, go over
the top of your shoulder. Okay, and then you just, you pull down here with both hands and you're compressing here and
then you take your head. - Usually we start with
just deep breathing, Brad. - Okay. - We take a couple deep breaths while you're giving pressure on it. - Different therapists
do things differently. - Right. (laughing) - But I like Bob's is more complete. - So, just as, as a starting point. - Yeah, let things relax. - And then you go ahead
and do the stretch. - Good point, thanks Bob. And we go like this. And you can get a lot of, I, I really get a lot, a good stretch on here. - Looking at a rib that
may be a little bit tight and we're trying to
mobilize that first rib because it can put pressure on the, the nerve as it goes
up over the top of it. So it, it, this, this gives a little bit of relief to that. - Feels good, too. - Yeah, it does. That one always feels good. Even if it doesn't help. It's it's a good one to do. - Sure. All right. - So we talked about posture. - The other thing, I think, you know, a good stretch to do, Brad, is if you're in a doorway and you know here's the doorway, you put your arms on both sides of the doorway, and then you're gonna just stretch forward. Like this, you're gonna put this, it's gonna support you. You can do it down here, here, up here. And you're gonna get the different parts of the pectorals major
and minor, which can also put some stress on the
nerves that's going through. - Sure, yep. - So, good stretch to do. - And I'm sure people are thinking, well, what about the wrist stretches? And, and the things you
can do with your wrist. And, you know the stretches I'll do is, you know, stretching here, it's gonna be a general stretch. You're not gonna stretch
the geez out of it 'cause you don't wanna make it sore and irritated too. - Well, I, I like the nerve glide, Brad, and, and we've-- - Let's go through that one. - Yeah. We've been doing
this a lot with patients so you're gonna glide the nerve, the median nerve and that, and that's very easy to do. All you have to do is you're gonna put your hand out like this, palm, you know, facing the wall. - Okay. - Basically if there's
a wall there, you're not gonna start with a wall, but all you're gonna start off first is just kind of doing a few like this, Brad, 'cause it, this may be very tight. - Sure. - Especially compared to the other side. If you only have it on one side. But you're just gonna start with these and then eventually you're gonna even go like this and even stretch it even a little bit more. - And you might wonder, well, what's the neck got to do with it? Well, that nerve goes here
all the way through here through the, by the
first rib, through that, the scaling muscles and up the here. And when you move your head that way, it stretches that nerve out. - So eventually what you can do if if that becomes too easy and you let's say you do a set of 10. I probably wouldn't do more than 10 a day. - Right. - Rather a set of 10 a day. You can then go ahead and even put a hand against the wall like this and go ahead and press like this. Now that's, that's the
more advanced version. - My shoulder's the wall, by the way. - Yeah, exactly. (laughing) And so again, again, this
is a great one to do, but I I can't emphasize this enough, Brad, that you have to be very gentle with this one. - Yeah. - This is not one to go
the first time to start because you'll irritate that nerve. And it'll get worse. - Yeah. - So the first time it's just very gentle. You kind of bump up against the pain. Oh, that hurts a little bit. That hurts a little bit. And then eventually, oh, it's feeling a little bit better. It's stretching out a little more. The nerves are very sensitive. They, they don't tolerate
stretching very well. - It's not like a muscle. - Right. - You get to be a little wimpy and you should be wimpy on this one. - Brad, we should really
talk about bracing because the the studies have shown that this really does help, too. - Right. I, I know a surgeon in Lacrosse and he does a lot of wrist stuff and he, and when he gets someone, he does the right thing. He says before I even, you know do much more with you,
I'll want you to go home get a wrist brace for the involved side and sleep with it. A lot of people think,
oh, you should use it while you're working where the problem is being irritated
which is an okay idea. I have no problem with
that, but it's probably more important to sleep
with your wrist in neutral because that allows circulation through the carpal tunnel taking stress off the nerve and the tendons allowing it to heal
while you rest at night. - And the studies have shown
that this really does help. This really does, you know, decrease the amount of people that end up having surgery. - Right. - So. - Well, my wife has these for hers. When hers flares up,
she starts wearing them. And within two nights,
it's feeling better. - Just really quickly too, Brad. I wanna make sure you're all, some of you may be at
your computer right now. Make sure that two things
that are, are important. One, that your screen is up high enough. So you're not like this, which puts pressure on the nerve. - Right. - The second thing is this part of your arm
is gonna be vertical. - Right. - Okay. You don't want it forward like this and the keyboard is gonna be down here, not up like this, so
your wrist can be flat. - Right. - Sometimes people even
put it on their lap and they can have the
wrists down a little bit. - Right. - You know? - Yeah. I, I took a class for
this specific problem and they talked about if the keyboard was on your lap, that's
actually the ideal location. - And I use a lap board and I put my keyboard on top of there and that's how I actually work in it. It works out well for me, so. - I, I think a lot of these things are what
the people are not told about carpal tunnel. - Right. And so you now you know some of the secrets and if you wanna
know a few more secrets, keep watching our channel and we'll convey them to you. - Yeah. (laughing) - They might get bored watching them. No, they're gonna have fun. Just giving you a hard time. - Thanks for watching. (laughing)
