What is agreed upon is the fact that the flexor tendons and median 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 between the flexor and extensor muscles that is causing the carpal bones to shift into the carpal tunnel, making the carpal tunnel much smaller.
After much research, my opinion is that the swelling is a “secondary effect” of the nine flexor tendons and median nerve having to glide 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 activity we perform, and they become 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 making it smaller. As the tendons and median nerve slide back and forth in the much smaller space, friction between the tissues occurs.
What does friction in the carpal tunnel cause? Friction between flexor tendons and median nerve within the carpal tunnel causes inflammation and swelling, which puts pressure on the median nerve, resulting in carpal tunnel syndrome. This is the reason that surgeons sever the carpal ligament, making more room for the flexor tendons and median nerve to move around in. If the carpal tunnel is returned back to its original size, prior to the onset of symptoms, the friction and swelling is eliminated and the symptoms disappear.
Continually performing repetitive wrist and finger flexion while symptoms are already present will ultimately aggravate the existing condition even more and lead to possible irreversible damage of the flexor tendons, blood vessels and median nerve within the carpal tunnel.
How can the 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 median nerve, which also eliminates friction and causes the carpal tunnel symptoms to disappear.
Now is the time to take the steps to prevent and/or eliminate carpal tunnel syndrome by starting a stretch / exercise program for your hands. Speak with your doctor or contact a certified therapist today to implement a good stretch and exercise program to keep you strong, healthy and injury-free!
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