Ah, “Carpal Tunnel.” You likely know a fair number of people who say that they have the symptoms (tingling and/or numbness) or even had the surgery.
I often teach modified Pilates to people with injuries and spinal conditions (like Scoliosis, for example), but I’m excited to also be working with a client/friend who recently wrote to me and asked:
“Can Pilates help with my Carpal Tunnel?”
“Can I do anything else besides surgery?”
I gave her the short answer: Well not from a group class in “regular” Pilates –
but yes, it’s possible to improve if your Pilates Teacher also happens to be a Massage Therapist or Physical Therapist. The teacher needs to have an advanced knowledge of Anatomy and Kinesiology. Classical Pilates training tends not to teach any of that and just go over standardized exercises. Some of the modern Pilates methods focus on Anatomy/Kinesiology, and the ones who do tend to attract P.T.s and others in the healing arts. And a growing number of Pilates teachers seek out additional knowledge once certified. But when it comes to something specialized like Carpal Tunnel Syndrome, your best bet is to find someone who is also in a therapeutic field such as Massage Therapy or Physical Therapy.\
That was enough for my friend to book an appointment and see what this was all about.
The Medical viewpoint on Carpal Tunnel Syndrome is fairly straight-forward. Let’s take a look at a well-respected source, the Mayo Clinic: Physicians say that Carpal Tunnel Syndrome involves a compressed nerve in your wrist. Tell-tale symptoms (such as tingling and numbness in the fingers) are often noticed when gripping (for example, holding your phone), and doing repetitive movements of the fingers/hands/wrists such as typing. To diagnose this condition, Doctors test your muscle strength and sense of feeling in the fingers. They might also order some diagnostic tests such as an Electromyogram, to assess your muscles and nerves. https://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/symptoms-causes/syc-20355603; https://www.mayoclinic.org/tests-procedures/emg/basics/definition/prc-20014183
It’s important to note that you should not diagnose yourself – nor should your Pilates teacher or Massage therapist. Only your Physician can do this.
Conventional Medical treatments for Carpal Tunnel Syndrome are somewhat limited. You’ll likely be advised to avoid activities that aggravate your symptoms. And generally, you’d be considering splints, cortisone shots, medications, and surgery – which generally involves severing a ligament in the wrist. https://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/diagnosis-treatment/drc-20355608
Whether you elect surgery, that is between you and your Physician. Before doing so, I recommend that you do your own research on what to expect after surgery, including the time it may take to recover – and it’s a great idea to get feedback from friends and colleagues who have had the procedure. Also, it’s important for you to define what it means to have a successful result.
Now we have reached that proverbial million dollar question: Does Carpal Tunnel Surgery “Work?” It depends on whom you’re asking – the Surgeon? Or the Patient? Results vary, and long-term results speak volumes. So again, the more information you have, the more you can manage your expectations.
I don’t mean to scare you, but…
Apparently, symptoms of Carpal Tunnel Sydrome eventually return to 85% of people who have had the surgery – and many people have repeat surgeries despite Physicians claiming high success rates. https://www.mycarpaltunnel.com/carpal-tunnel-surgery-success-rate.shtml
Apparently Physicians consider the surgery successful if there is “ANY improvement” after surgery (at least according to that linked article above). Does that mean a 25% improvement? This I don’t know – it’s certainly something to ask your Surgeon.
The Medical community knows that their claimed success rate of 75-90% needs to be more thoroughly evaluated, especially for long-term success rates. The American Association of Hand Surgery publishes an intriguing report stating that, “Resolution of symptoms and recovery of function after CTR have not been as thoroughly addressed in the long-term as they have in the short-term.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3418353/
What is a successful result to the Patient? Most of us want our pain gone or significantly improved, right? We’d like to not have to wear that splint or worry about finding a new career, or giving up our favorite sport. The fact is, that nobody can guarantee a result.
So, I’m not telling you NOT to have that surgery – you might be pleased with the result. It’s possible to work with you even after having the surgery. You’ll just have to make sure that your Physician clears the activity and provides any restrictions or special directions.
The next million dollar question is: What are alternatives to surgery; and can I do these things after surgery? I’ve listed a few options to explore:
1. Specialized, advanced massage techniques. I attended an amazing training in Haase Myotherapy which has a protocol for Carpal Tunnel Syndrome, among others. Indeed – Robert Haase said in our training that so many of his clients CANCELED their carpal tunnel surgeries after working with him, that a local Surgeon came to visit. I can offer this therapy to my clients, as a Licensed Massage Therapist (MAT#6286) who is also Board Certified by NCBTMB (307766-00). https://www.haasemyotherapy.com/
2. Laser Therapy: I use the laser for different reasons, with my awesome Chiropractor, Dr. Paul Thurlow. Recently, I asked if his Laser would help with Carpal Tunnel Syndrome – even for someone who has had an unsuccessful surgery. Dr. Thurlow told me that it’s possible to get a 70% improvement in symptoms according to research. At any rate, you can also see in his website some statistics with the laser therapy. http://lasertherapyhawaii.com/
3. Therapeutic Movement and Breathing. This is where I integrate a highly modified type of Pilates exercise with Osteopathic Sciences and gentle hands-on therapy that my massage license allows. www.lahelafit.com.
While the Physician is focused on the hands and wrist, I like to point out things that he/she is not noticing:
1. Your Posture and how it affects tension in the neck and shoulder. How people sit, stand and move – that’s an integral part of my practice. Can you reach the top shelf easily? Do you slouch at your desk all day? Do you shrug your shoulders while tapping away at your laptop or moving your mouse? Or – egads – try to hold your phone between your ear and shoulder while trying to work with your hands? Do you sleep on your belly?
Why would any of that matter for the wrist? Well, it does. I show you why. I look for things that can be improved and show you how that is possible, with repetition and time.
2. Full, healthy, and functional BREATHING makes a world of difference and can help you improve your posture, flexibility, mobility, and affects you from head to toe and from hand to foot. I can quickly show you how different it feels to breathe fully, compared to the shallow and tension-filled breathing that many of us unknowingly have (I sure had it for years before discovering Osteopathic Sciences).
Quick rant about “regular” Pilates: This discipline often teaches improper breathing. If you’re a Pilates fanatic already, you likely have heard your teacher exhorting you to “suck in the belly, belly button to spine;” “feel as if you’re in between two panes of glass,” and maybe “exhale through pursed lips.” I’m sorry to disappoint you, but it’s quite dysfunctional. Not all Pilates methods do this type of breathing, but many thousands of teachers were trained this way, especially if we trained at least 10 years ago.
Perhaps you’ve seen a little teaser article about Breathing in an earlier publication? I guarantee that I’ll be writing more about Breathing in my website. Stay tuned!
I also teach people a bit of anatomy, especially their nerves, in a way that’s easy to digest. You know – I’m not sure why Doctors wouldn’t realize why the collar bone is such an important thing to notice, and how it applies to breathing, posture, and pain (or relief from pain). Are you curious? Good – stay tuned for more on that, as well.
More than anything – A proper Pilates session focuses on improving your every day posture and habits – especially your Breathing. Imagine how often you breathe – on average 22,000 times per day. Imagine how many times you use your hands, in conjunction with your arm and shoulder. I can’t even begin to count. Now imagine if we can improve bit by bit, those things that we do often, every day. Add it up. Then you can get a picture of how you get started in relieving your aches and pains. For me as a Pilates teacher, a successful result is if you walk away feeling taller, more flexible, and with less pain (perhaps none at all).
It’s been my adamant position, ever since massage school almost 20 years ago, that Carpal Tunnel involves a lot more than just the wrist. I look forward to writing more and staying in touch with you all. Please do visit my website and shoot me an email!