Now that you are fully rehabilitated from carpal tunnel syndrome (CTS), we are ready to progress to strengthening your grip again. If you are still feeling or begin feeling symptoms of CTS, read my previous blog here for some rehabilitation exercises.

The primary muscles involved in determining grip strength are your forearm, hand and finger muscles. These muscles are often indirectly engaged during your typical workout routine. The performance of rows, pull downs and bicep curls assist these muscles to a certain extent, however, further training would need to be performed to maximize grip strength.

Whether individuals want to improve grip strength for a competitive sporting event or for daily activities, adequate grip strength will greatly benefit the individual. Most sports require the athlete to hold an object or equipment and it can often be the determining factor in the amount of power being generated. On the other hand, gripping exercises are used in almost all day-to-day activities. Whether opening a jar of peanut butter, carry grocery bags from your car or washing dishes, grip strength is necessary to complete these actions. A nice firm handshake can also showcase confidence and add personality to your character.

Aside from improving grip strength, having conditioned forearms can greatly benefit the connective tissue such as your ligaments and tendons.

Muscles involved in Grip Strength

Interossei (Dorsal and Palmer) muscles – The dorsal interossei enables us to spread our fingers apart while the palmer interossei pulls our fingers close. They are located in between your finger joints at the base of the hand.

Hyperthenar + Thenar muscles – The hyperthenar muscle group forms the majority of the pinky side of the hand and enables movements on that area. The thenar muscle group is responsible for movements on the thumb side.

Flexor digitorum profundus/superficialis – These muscles are responsible for flexing the finger muscles and enable you to make a fist with your hands

Extensor indicis, extensor digiti minimi, extensor digitorum – These muscles are responsible for extending the finger muscles and allow you to spread your fingers apart

Lumbricals muscles – These muscles are located at the base/middle portion of the hand is is responsible for straightening the fingers

Adductor pollicis muscles – This muscle is located between your pointer finger and your thumb and enables you to pinch objects.

Flexor carpi radialis, flexor carpi ulnaris, flexor pollicis longus muscles (flexor muscles of the forearm) – These muscles are located on the inside of your forearm and are all used to flex the hand (bringing the palm of your hand towards the forearm).

Extensor carpi radialis brevis/ longus, extensor pollicis brevis/ longus muscles (extensor muscles of the forearm) – The extensor muscles allows the hand to perform extension (lifting the back of the hand towards the forearm).

Here is a link with diagrams and more information about the muscles I have listed above.

Exercises to Improve Grip Strength

Farmers walk

Perform 3 sets of 45-60 seconds

• Grab a dumbbell or kettlebell of the same weight in each hand
• Begin walking from point A to point B OR perform a loop around your gym floor with weights by your side and palms facing inward
• Each length should be at least 45-60 seconds in duration for maximum effect

Tip: Have a strong grip on the weight to fully engage your forearms during this exercise

Dead hang

Perform 3 sets of 30-60 seconds

• Standing below a bar that enables you to stay elevated above the ground when hanging on
• Jump up or use a stool to reach the bar, grasping slightly wider than shoulder width apart
• Hang for 30-60 seconds before releasing

Tip: Try to minimize swinging by keeping your legs crossed at the bottom or using an object to prevent swaying.

Stress ball or grip strength tool

Perform 3 sets of 15 reps per hand

• Using a stress ball or grip strength tool
• Fully contract the hand creating as much tension as possible before releasing and repeating
• Switch hands

Tip: As your grip strength improves, gradually use denser objects for this exercise. Begin with a stress ball and work your way towards a tennis ball. Ultimately a lacrosse ball or similar material object will be used. Alternatively, different weighted grip strength tools can be purchased to match power.

Dumbbell shrugs

Perform 3 sets of 12-15 reps

• Grab dumbbells with palms facing inwards and standing shoulder width apart
• Let dumbbells hand by your side
• Contract the trapezius muscle by bringing your shoulders towards your ear lobes
• Hold this position for .5 – 1 second before relaxing the muscle
• Return to starting position and repeat

Tip: Ensure dumbbells are facing forward and not slanted by externally or internally rotating shoulders.

Wrist curls (Supinated & Pronated)

Perform 3 sets of 12 reps for each exercise

• Start with a light dumbbell in each hand and go into a kneeling position
• Place forearms on a bench, perpendicular to the length of the bench about shoulder width apart
• Begin with palms facing up (supinated position) and let the wrists drop
• Curl the wrist up by flexing the dumbbell towards you
• Switch and perform the same exercise with palms facing down (pronated position)

Tip: Make sure to maintain proper posture and keep back straight

• Perform the exercise slowly to feel the burn in your forearm extensor and flexor muscles
• Ensure dumbbells are horizontal and do not tilt excessively
  

  

Pull ups or chin ups

Perform 3 sets of 12 reps

• Standing below a bar that enables you to stay elevated above the ground when hanging on
• Jump up or use a stool to reach the bar, grasping slightly wider than shoulder width apart OR use a chin up handle bar with palms facing each other / yourself
• Retract shoulder blades and pull yourself until your chin is over the bar
• In a controlled manner lower your body back down until fully extended at the bottom

Alternatively this exercise can be done on a assisted pull up / chin up machine or with a resistance tube under a single foot

Hammer curls

Perform 3 sets of 12 reps

• Grasping dumbbells with palms facing the body and being seated on a 90 degree bench
• Place feet about shoulder width apart and plant firmly into the ground
• Flex at the elbow joint bringing the forearm towards the upper torso
• Hold for a brief moment at the top of the lift before lowering the weight down slowly
• Ensure palms are facing each other throughout the lift

Tip: make sure back is pressed firmly against the bench and no arching persists

Plate pinches

Perform 3 sets of 30-60 seconds

• Holding a plate (preferably a bumper plate, however, a regular plate will do) with palms facing each other
• Pinch the plate with thumbs and four fingers
• Hold this position for 30-60 seconds
• Switch hands and perform the exercise again

Tip: If your grip strength is strong enough, you can perform this exercise with both hands simultaneously.

Get Fat grips

Fat grips can be used to wrap around dumbbells, barbells and cable attachments to provide a greater difficulty for the exercise. They increase grip strength by increasing the width around the weight requiring greater effort upon lifting. This increases forearm muscle activation and enhances the stimulation of muscle fibers.

Kevin Kwok – Studio Coordinator

Kevin enrolled in numerous sports program as a child, which exposed him to an active lifestyle early in life. He played ultimate frisbee competitively at the junior level while in high school. Kevin now focuses his training exclusively on dragon boating. He has been paddling for the past 3 years and hopes to make the Canadian National Team in 2019. He hopes he can motivate others to accomplish their short and long term fitness goals!

The post Carpal Tunnel Syndrome – Part 3: Exercises to Improve Grip Strength first appeared on Le Physique | Vancouver Personal Training.

In my previous blog, I discussed the symptoms and risk factors of carpal tunnel syndrome (CTS). Remember:  check with your doctor or a medical professional to determine if CTS is the medical condition you have.

In the second part of my blog series, I will list and demonstrate exercises intended to rehabilitate and diminish the symptoms associated with CTS, including pain in the hands, wrists and forearms. In order to see the best results, these exercises should be performed daily, and will only take 10-15 minutes out of your day. The exercises can be repeated with the other hand if CTS is prevalent.

Muscles in the hands and forearms

Below are muscles that are found in the hands and forearms. By identifying the location and actions of these muscles, it may provide a better understanding on why the exercises I have chosen below can help manage pain from CTS.

Interossei (Dorsal and Palmer) muscles – The dorsal interossei enables us to spread our fingers apart while the palmer interossei pulls our fingers close. They are located in between your finger joints at the base of the hand.

Hyperthenar + Thenar muscles – The hyperthenar muscle group forms the majority of the pinky side of the hand and enables movements on that area. The thenar muscle group is responsible for movements on the thumb side.

Lumbricals muscles – These muscles are located at the base/middle portion of the hand is is responsible for straightening the fingers

Adductor pollicis muscles – This muscle is located between your pointer finger and your thumb and enables you to pinch objects.

Flexor carpi radialis, flexor carpi ulnaris, flexor digitorum profundus/superficialis, flexor pollicis longus muscles (flexor muscles of the forearm) – These muscles are located on the back side of your forearm and are all used to flex the hand (lifting the back of the hand towards the forearm).

Extensor carpi radialis brevis/ longus, extensor pollicis brevis/ longus muscles (extensor muscles of the forearm) – The extensor muscles allows the hand the perform extension (bringing the palm of your hand towards the forearm).

Here is a link with diagrams and more information about the muscles I have listed above.

Carpal Tunnel Syndrome Exercises

Wrist extension and flexion with pull

This exercise will help relieve tension in the flexors and extensors in your forearm. These are the muscles responsible for pointing your fingers to the sky and down towards the ground. Through excessive typing, these muscles can often become tight and require stretching.

– Place one arm straight in front of you at shoulder level
– Keeping your arm in place, raise your finger tips towards the sky
– Using the other hand pull the fingers backwards towards you until a stretch is felt
– Hold for 30 seconds
– Alternatively, you can point the fingers towards the ground and use the opposite hand to pull

Tennis ball or stress ball contractions

Performing finger contractions is beneficial in improving finger strength as well as forearm strength. This can help promote blood flow to the forearms and wrist, which can assist the recovery of CTS. Alternatively, this can be done with any item (ideally a ball) – with a harder item providing greater resistance. As your symptoms get better, gradually increase the resistance used for this exercise.

– Using a tennis ball or stress ball
– Squeeze the object for 5-10 seconds before releasing
– Perform 15-20 repetitions

Finger touches

This exercise can improve mobility in the finger joints and counteract built up stiffness in the area.

– Place one hand in front of you in a comfortable position
– Take your thumb to touch and hold the tips of each finger for 3 seconds
– Make sure to apply a slight force at each finger
– Repeat and cycle through 3-5 times

Fist to extension

Similar to the first exercise, this one assists with the flexors and extensors of the forearm. Because tenderness is often felt in this area at the onset of CTS, this exercise can help relieve these symptoms.

– Place one hand in front of you in a comfortable position
– Make a fist with the hand hold for 2 seconds
– Extend fingers out wards and hold for 3 seconds
– Repeat for 12-15 repetitions

Finger slides

This exercise is excellent in maintaining mobility in your finger joints and ensures that you can perform a fluid motion with your fingers. It also stretches the extensor muscles at the end of the movement.

– Place one hand in front of you in a comfortable position
– Fold your fingers over and try to reach as far down your hand as you can
– Slide your fingers up along the hand until fully extended
– Repeat for 12-15 repetitions

Elastic finger expansions

Several contraction exercises have been listed above, so this exercise will help balance the strength in your hand by targeting the opposing muscles. Simultaneously, the extensor muscles are also engaged.

– Place one hand in front of you in a comfortable position
– Place thumb and fingers in contact with each other
– Using a hair tie or elastic band, wrap around the fingers
– Expand the fingers and thumb as much as you can and hold for 3-5 seconds
– Repeat for 12-15 repetitions

External rotation wall gliders 

Wall gliders can improve flexibility in the wrist as well as the shoulder joint. A stretch can be felt immediately in the fingers and the forearm upon rotation of the fingers in a downward direction.

– Standing a single arm span away from a wall, fully flex your arm up until parallel with the ground
– Place palm flat on wall with fingers pointing up
– Rotate fingers backwards until fingers face the ground
– Hold for 3 seconds and repeat for 12-15 repetitions

Shaking it out

Shaking your hands will provide temporary relief to the aching areas.

– Having hands in front of you shake hands in a controlled manner
– Shake hands to allow for wrist movement as well as below the elbow to engage forearms
– Shake for 5-10 seconds

A consistent rehabilitation schedule will yield the greatest results. Taking time during your commute or lunch break to perform these exercises can greatly benefit and relieve symptoms of CTS.

Kevin Kwok – Studio Coordinator

Kevin enrolled in numerous sports program as a child, which exposed him to an active lifestyle early in life. He played ultimate frisbee competitively at the junior level while in high school. Kevin now focuses his training exclusively on dragon boating. He has been paddling for the past 3 years and hopes to make the Canadian National Team in 2019. He hopes he can motivate others to accomplish their short and long term fitness goals

The post Carpal Tunnel Syndrome – Part 2: Rehabilitation Exercises first appeared on Le Physique | Vancouver Personal Training.

Carpal Tunnel Syndrome (CTS) is caused by excessive pressure on the median nerve which runs on the palm side of the hand. The nerve passes through an area of the wrist called the carpal tunnel, which is a narrow passageway. When the carpal tunnel is inflamed, it is capable of compressing vessels and nerves passing through. The median nerve innervates the hand as well as the length of the arm, and causes stress to these areas when agitated or impinged.

Why is Carpal Tunnel Syndrome Bad for You?

CTS will limit activities of daily life and hinder participation in sports and leisure events such as cooking and doing house work. It is best to treat carpal tunnel early on at the onset of detection. Prolonging the time to receive treatment will only worsen the situation, and may lead to permanent nerve damage in the future. Numbness may cause loss of sensation in the fingertips, which has a direct correlation with weakness and may result in a loss of grip strength.

Risk Factors for Carpal Tunnel Syndrome

CTS is often caused by performing repetitive tasks such as typing, assembly work, or knitting work. The use of power tools that cause frequent exposure to vibrations also increases the risk of carpal tunnel. It is crucial to take adequate rest in between work to ease up consistent tension. Previous injury to the wrist or inflammation in the area can also lead to a greater possibility of getting CTS. In addition, females are more likely to experience carpal tunnel as opposed to men. This is due to the fact that women possess a smaller opening in the carpal tunnel, which can lead to a greater risk of compression in the vessels and nerves passing through. Click here to read more about risk factors for CTS.

Symptoms of Carpal Tunnel Syndrome

Symptoms of CTS typically do not occur instantly and rather over a duration of time. Once early signs (tingling, numbness in your hands and forearms) are detected, immediately limit movements causing stress to the area. Other symptoms include wrist pain, a burning sensation, and / or swelling. If you feel tingling, numbing or persistent soreness in your hand / forearm region, please consult your doctor or a medical professional to assess whether or not you may have CTS.

Methods to Prevent and Treat Carpal Tunnel Syndrome

Non-surgical Methods

If repeated motions are mandatory, try using alternative equipment such as a different sized keyboard or changing the height of your desk. If possible, try to avoid fully flexing or extending your wrist and maintain a neutral position (see photo above). If you are having trouble controlling this motion, a splint can be purchased to hold your wrist still and prevent further aggravation. A wrist splint can be beneficial while you sleep to prevent excess flexion and extension at the wrist joint. The primary objective is to keep your wrists straight and relaxed. For temporary relief, shaking out your hand for 5-10 seconds will suppress the pain.

Other helpful non-surgical treatments include icing the inflamed area 10-15 minutes at a time. This may reduce swelling and pain by reducing blood flow to the affected area. Additionally, non-steroidal anti-inflammatory drugs such as Advil can be taken to reduce inflammation to localized areas (such as the hands).

Surgical Treatments

Surgical methods to treat carpal tunnel is often used as a last resort. When non-surgical methods are not working or existing condition goes beyond repair, surgery is the only option. Carpal tunnel release can be performed to treat the injured area. More information can be found here.

Kevin Kwok – Studio Coordinator

Kevin enrolled in numerous sports program as a child, which exposed him to an active lifestyle early in life. He played ultimate frisbee competitively at the junior level while in high school. Kevin now focuses his training exclusively on dragon boating. He has been paddling for the past 3 years and hopes to make the Canadian National Team in 2019. He hopes he can motivate others to accomplish their short and long term fitness goals

The post Do You Have Carpal Tunnel Syndrome? first appeared on Le Physique | Vancouver Personal Training.