Carpal tunnel syndrome is tingling, numbness or weakness in the hand and wrist caused by pressure on the median nerve — the nerve that passes through the carpal tunnel of the wrist and provides sensation to the thumb, index and middle fingers of the hand. This nerve should normally glide smoothly over the tendons and bones of the wrist. However, repetitive movements of the arm, wrist or hand may promote inflammation and compression of the carpal tunnel space, trapping or pinching the median nerve. The purpose of nerve and tendon gliding exercises is to reduce the risk of nerve entrapment and inflammation.
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In a study led by Dr. Leo Martin Rozmaryn, published in the1998 issue of “Journal of Hand Therapy,” participants who were treated with nerve and tendon gliding exercises reduced the need for surgery by 28.2 percent, and 70.2 percent of participants surveyed reported good or excellent results. Nerve and tendon gliding exercises are designed to stretch and promote the flexibility of nerves and tendons that pass through the carpal tunnel. Further research led by Lamia Pinar and published in “Advances in Therapy” in 2005 confirms that nerve and tendon gliding exercises promote more rapid pain reduction and greater functional improvement as opposed to participants who did not use these exercises.
Median Nerve Glide Exercise 1
It is important with all nerve glide exercises to avoid overstretching the nerve, which may create symptoms. Instead, stretch until you feel tension, stopping if you feel pain or tingling. The median nerve glide exercise is performed by placing your arm to your side and slightly behind you with the elbow gently straight. With your palm facing forward, pull your wrist back until mild tension is felt somewhere in the arm, then relax the wrist forward until the tension is relieved. Repeat 10 times. Next, ease the tension on your wrist to about half and slowly raise your arm until you feel tension — never above shoulder height. After that, lower your arm until tension is relieved, repeating this process 10 times. Finally, ease the tension on your arm to about half and tilt your head away from your raised arm with your ear moving toward your shoulder until tension is felt. Straighten your neck until tension is relieved. Repeat 10 times.
Median Nerve Glide Exercise 2
Begin this second median nerve glide exercise with your hand nearly level with your face in front of you, wrist straight, or neutral, and your palm facing away from you. Clench your fingers together to form a full fist. Keep your wrist neutral and straighten your fingers with your thumb close to your index finger. Bend your wrist backward and hold this position. Next, bring your thumb forward and away from your fingers. Rotate your palm to face you and with your other hand stretch your extended thumb out for two seconds. Perform five repetitions of this cycle three to four times daily.
Forearm Extensor Stretch
This exercise is excellent for pain that radiates down the arm and to the elbow. Place your hand in front of you about shoulder height, with the elbow straight and palm down. If shoulder height is uncomfortable reduce the angle of your arm downward until comfortable. Allow your wrist to hang limply forward and, with your other hand, gently push the wrist down and toward the bottom of your forearm until you feel a gentle stretch. Hold this stretch for 30 to 40 seconds while gently closing your fingers to increase the stretch. You should perform this stretch every one to two hours, and two to three times before strenuous activity.
The wrist curl can be done in both extension and flexion positions of the wrist. Performing the exercise both ways helps maintain balance in the wrist. For extension position, place the back of your forearm on the arm of a chair with your palm up. Make sure your shoulders are relaxed and that your elbow aligns with your shoulder and ear. With a comfortable weight in your hand, usually 1 to 5 lbs., bend your wrist forward for a count of 4. Pause briefly and then return to the original position, again counting to 4. Ensure you are controlling the release of your wrist and that it is not snapping forward. The reverse wrist curl, flexion position, places the front of your forearm against the arm of the chair with your palm down. Using the same amount of weight as with extension position, pull your wrist back for a count of 4, holding briefly, then return to the starting position, again counting to 4.
Rubber Band Finger Stretches
Our hands and fingers are constantly gripping and squeezing but rarely get to extend outward. This exercise is meant to strengthen the muscles that open the hand and create balance with the muscles responsible for closing the hand. It is performed by placing a thick rubber band — bands used to bind produce are excellent choices — around all the fingers and thumb. Spread your fingers widely against the resistance of the band, holding for two to three seconds, and then bring them back together. Repeat this motion 10 times. If one band becomes too easy, add another for extra resistance.