Monday, April 23, 2012

Carpal Tunnel Syndrome - A Secondary follow

What causes carpal tunnel syndrome to develop? Although there are many professional opinions out there about the subject, most do not provide an strict article of how carpal tunnel syndrome of course occurs.

Trigger Finger Surgery

What is agreed upon is the fact that the flexor tendons and average nerve are operating in a much smaller space than they were prior to the onset of symptoms. Many professionals state that it is the swelling of the involved tissues that is diminishing the space and others say that is caused by a muscle imbalance in the middle of the flexor and extensor muscles that is causing the carpal bones to shift into the carpal tunnel, development the carpal tunnel much smaller.

After much research, my opinion is that the swelling is a "secondary effect" of the nine flexor tendons and average nerve having to glide straight through the carpal tunnel which has decreased in size due to a muscle imbalance*.

How does the carpal tunnel decrease in size? The carpal tunnel decreases in size because the flexor muscles that 'close' the hands are exercised on a daily basis with virtually every action we perform, and they come to be stronger, shorter and tighter than the extensor muscles that 'open' the hands, thus causing the carpal bones to shift inward, collapsing the carpal tunnel and development it smaller. As the tendons and average nerve slide back and forth in the much smaller space, conflict in the middle of the tissues occurs.

What does conflict in the carpal tunnel cause? conflict in the middle of flexor tendons and average nerve within the carpal tunnel causes inflammation and swelling, which puts pressure on the average nerve, resulting in carpal tunnel syndrome. This is the fancy that surgeons sever the carpal ligament, development more room for the flexor tendons and average nerve to move nearby in. If the carpal tunnel is returned back to its former size, prior to onset of symptoms, the conflict and swelling is eliminated and the symptoms disappear.

Continually performing repetitive wrist and finger flexion while symptoms are already gift will finally aggravate the existing condition even more and lead to inherent irreversible damage of the flexor tendons, blood vessels and average nerve within the carpal tunnel.

How can carpal tunnel syndrome be eliminated? By stretching and lengthening the overly restrictive flexor muscles that 'close' the hands and strengthening and shortening the extensor muscles that 'open' the hands, the carpal tunnel can return to its normal size, decreasing impingement of the tendons and average nerve, which also eliminates conflict and causes the carpal tunnel symptoms to disappear.

Now is the time to take the steps to preclude carpal tunnel syndrome or rehabilitate an existing injury by starting a stretch / exercise program for your hands. Speak with your physician or sense a certified therapist today to implement a good stretch and exercise program to keep you strong, salutary and injury-free!

*Reference Materials:

"If definite 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 blend produces a self perpetuating condition that maintains the abnormal posture and muscle imbalance." Philip E. Higgs, M.D. And Susan E. Mackinnon, M.D. Group of Surgery, Washington University School of Medicine, St. Louis, Missouri. Annu. Rev. Med. 1995. 46:1-16

"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 develop the weak underused muscles." Philip E. Higgs, M.D. And Susan E. Mackinnon, M.D. Group of Surgery, Washington University School of Medicine, St. Louis, Missouri. Annu. Rev. Med. 1995. 46:1-16

"All of the extrinsic hand muscles come to be involved in a power grip, in proportion to the compel of the grip."........ "Strong agonist-antagonist interactions are needed in the middle of the flexors and extensors of the hand and fingers to produce forceful hand-grip. Considerable flexion of the distal phalanges requires strong action 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.

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