Carpal Tunnel Syndrome – strengthening exercises to improve recovery results.
Carpal Tunnel Syndrome is caused by pressure being placed upon the median nerve, which runs down the inner arm, through the centre of the wrist and into the hand. This can cause pain, numbness and restricted mobility. CTS is a condition that tends to worsen gradually over time and can be at its most painful at night. Whereas most cases of CTS are caused by repetitive strain, you are more likely to suffer from CTS if you are overweight, pregnant, have arthritis or diabetes, there’s a family history of CTS or if you’ve previously sustained an injury to your wrist.
Common symptoms are:
- Site specific pain in the wrist, fingers, hand and/or arm
- Numbness in fingers and hand
- Tingling/pins and needles sensation in the fingers
- Weakness in arm, hand and fingers
- Inability or reduced ability to grip
- Restriction in our range of movement
- Disrupted sleep
Although CTS can take a while to recover from, with the correct stretches and strengthening exercises, the recovery period can be reduced.
Reduce or stop activities that exacerbate symptoms - rest your fingers, hand, wrist, and arm as much as possible. Avoid activities which require you to bend your wrist, grip relatively hard and/or for a sustained period, or any activity that subjects your wrist to vibration.
Wear a wrist support - this doesn’t help everyone, but a wrist support may be an option to try and keep pressure off the nerve, by keeping your wrist straight. It can also act as a way to physically limit what you can do in terms of activity, thereby reducing the likelihood of any further damage
Painkillers - over the counter medicines like ibuprofen (anti-inflammatory) and paracetamol (compound analgesic/painkiller) can help reduce pain and increase comfort in the short term and as a temporary measure
Strengthening Exercises and Stretches
There are 5 key exercises and stretches which can help improve your recovery results, by gradually increasing the strength and flexibility of the flexor and extensor muscles in the hand/fingers and lower arm/wrist. Flexors decrease the angle between the bones and extensors increase the angle. It's important that these are carried out properly and without putting additional pressure through the wrist.
Please note - run through each of the 5 exercises, completing all stages in the sequence 5 to 10 times initially, increasing slowly over time, building up to 25 repetitions. Do not break each exercise down into its individual components. Perform the entire sequence, before doing another repetition to avoid straining the body unnecessarily:
1. Ball Grip - squeeze a soft physio ball, approximately the size of a tennis ball or slightly smaller, as hard as you can.
To advance this exercise, you can then bend your hand back towards the top of your arm and towards your body. It’s only a small movement and may be challenging to do.
Grip the soft physio ball again, this time bending the wrist forwards, towards your inner arm.
2. Tendon Glides - make a fist, clench, then release.
Bend the tops of your fingers over to touch the top of your palm and then extend open again.
Keep your fingers straight and fold them to a 90-degree angle to your palm. Open your hand.
Fold fingers down to the base of palm/top of the wrist. Open your hand.
3. Finger Taps - tap each of your fingers to your thumb
4. Rotations - rotate your wrist round and round, starting one way and then going the other
5. Finger Stretches - stretch your fingers away from each other, hold for a couple of seconds, then relax
If the above corrective action fails to work, you may need to visit your GP where they will conduct some tests and possibly refer you on for an ultrasound scan and/or steroid injection. In extreme cases, surgery may be required, but this isn’t particularly common.