What is carpal tunnel syndrome?
Carpal tunnel syndrome is a condition marked by discomfort and functional limitations in the wrist and hand due to excessive pressure on the median nerve, which runs down the inner arm through the center of the wrist to the hand.
“The pressure can happen anywhere along the route of the median nerve, but is commonly seen in the neck as a result of a herniated disc,” explains physical therapist and founder of Fit Club NY, Kellen Scantlebury, DPT.
That compression leads to numbness, tingling, and potentially weakness into the hands, wrist, and even elbow, which are all hallmark signs of carpal tunnel syndrome.
The median nerve innervates the thumb, index, and middle finger, along with the inner surface of the ring finger, so any or all of these fingers can be affected. “Typically someone with carpal tunnel syndrome will notice that these fingers get numb often during sleep, computer work, or other activities involving the hands,” shares Dr. Scantlebury.
How can strengthening exercises prevent and alleviate carpal tunnel syndrome?
According to Dr. Scantlebury, strengthening exercises can help reduce the risk of developing carpal tunnel syndrome, and alleviate symptoms. "Exercises that strengthen the finger flexors and extensors as well as the wrist flexors and extensors are most effective," he says.
However, there’s an important caveat: Carpal tunnel strengthening exercises (as well as general strength training exercises) must be done properly and with good form. “Many need to be performed with a neutral wrist to reduce pressure on the median nerve,” says Dr. Scantlebury.
Dr. Scantlebury notes that one of the primary symptoms—weakness—can make general strength training difficult (“push-ups need to be avoided,” he says), but doing targeted strengthening exercises for carpal tunnel syndrome can help counteract this issue.
“Training your postural muscles is also important. Many times, posture habits are the main contributing factor leading to carpal tunnel syndrome,” he says.
Five easy exercises for carpal tunnel syndrome
Although seeing a physical therapist is usually the best approach for getting a rehab program tailored exactly to your needs, Dr. Scantlebury walked us through some basic carpal tunnel exercises you can try at home.
1. Towel or ball grips with wrist extension
Dr. Scantlebury says this is one of the best exercises for carpal tunnel syndrome because it improves your grip strength and the strength of your wrist extensors simultaneously.
“Both of these areas can be impacted with carpal tunnel syndrome,” he says. “These are especially important as we spend more time typing on a computer.”
To perform this exercise, grip a soft ball (like a stress ball) or a hand towel, squeezing your fist as tight as possible, while simultaneously extending your wrist, as though you're putting your hand up to signal someone to stop—the back of your hand should come towards the hairy side of your arm.
2. Towel or ball grips with wrist flexion
This one addresses grip strength and wrist flexion, so it helps to prevent and alleviate carpal tunnel syndrome by strengthening and minimizing the muscles surrounding the median nerve.
For this one, perform the exact same tight-fisted ball or towel squeeze, but this time, flex your wrist by bringing your palm towards the inner arm.
3. Prone Ts
This exercise strengthens the trapezius muscles in the upper back, which support shoulder and neck postural muscles.
“Oftentimes, weakness of these muscles leads to bad posture that can cause carpal tunnel syndrome over time,” says Dr. Scantlebury. “This is a great exercise to increase their endurance.”
Here's how to do it:
- Lie on your stomach with a small towel rolled up under your forehead for comfort.
- Bring your arms out to the side so that your body is in a giant letter “T.”
- Squeeze your shoulder blades together to lift your arms up off the ground, as if trying to fly. Keep your elbows straight.
- Complete three sets of 20 to 30 reps, building up the number of reps you do.
Add small hand weights or hold water bottles to increase the difficulty.
4. Tendon glides
Dr. Scantlebury says that the muscles and tendons that control our fingers need to slide and glide easily on one another to produce efficient, painless movement.
“In our hands, we have a bunch of tendons that connect to the bones to help us move our fingers. If these tendons get stuck, we have difficulty accomplishing movement and fine motor tasks,” he explains. “Tendon glides help us improve this movement and can increase finger strength.”
There are four basic tendon glide exercises you can do to get started:
- Make a fist, squeeze, and relax.
- Bend just the fingers so that the fingers curl over and the pads touch the lower third of your fingers (claw hand position), and then straighten them again.
- Keep your fingers completely straight and bend your hand into an L, so that your fingers are at a 90-degree angle with your palm. Relax back.
- Fold your fingers all the way down to touch your palm and then open them back up.
Complete each exercise 20 to 30 times, as tolerated.
5. Finger taps
Dr. Scantlebury says this exercise increases the strength and endurance of the muscles in the hand, which can alleviate symptoms and prevent functional deficits.
To do it, tap the thumb to each finger in the hand (thumb to index finger, thumb to middle finger, thumb to ring finger, etc.). Complete 10 rounds per hand. You can increase the intensity by adding putty to your fingers; this forces you to pull away against resistance.
Remember the bigger picture
While strengthening can help prevent and alleviate symptoms, Dr. Scantlebury says that exercises should not be the only component of your prehab/rehab program.
“A balanced program consisting of strength training, mobility training for the wrist joint, and nerve lengthening are your best options,” he says. “If you suspect you are suffering from carpal tunnel syndrome, get an evaluation performed by a doctor of physical therapy. If your treatment does not progress well, a recommendation can be made to an orthopedic surgeon.”
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