Find relief from Carpal Tunnel Syndrome through the New Gentle Rolfing in downtown Austin.

Rolfing provides not only relief from the pain of Carpal Tunnel Syndrome (CTS), but more importantly addresses the underlying cause of pain. Because the touch of Rolfing is generally deeper and slower than massage, underlying layers of contracted tissue are released which may have been held in the body for years, if not decades. While the New Gentle Rolfing is not painful, it still penetrates far deeper than other body work modalities, resulting in a feeling of profound letting-go in the deepest layers of the body. When Rolfing is coupled with exercises targeted to maintain flexibility, the results are long-lasting and offer a dramatic short-cut to a speedy recovery.

The Anatomy of the Carpal Tunnel

Illustration courtesy of carpal-tunnel-symptoms.com

The anatomy of the carpal tunnel can be easy to understand if you remember we are dealing with a tunnel of sorts, or a canal like structure in your wrist.

The anatomy of the carpal tunnel is such that you have 8 small wrist bones called carpals (pronounced-Car-pulls) that make up 3 sides of the tunnel and a thick rubber-like ligament called the TRANSVERSE LIGAMENT, (or sometimes referred to as the Transverse Carpal ligament). This ligament makes up the other side. So, as you can see the Carpal tunnel anatomy is kind of like a ring or a tunnel. Illustration is courtesy of carpal- tunnel-symptoms.com .

At my Rolfing studio in downtown Austin I see many people whose work and social lives have been curtailed by the pain of CTS. More often than not my clients are surprised to experience relief quicker than expected, often in just a session, as a result of me releasing deep underlying contractions that are causing the transverse carpal ligament to squeeze down on and inflame the medial nerve running on the underside of the wrist to the hand.

Development of RSI and CTS

To better understand how CTS develops and what you can do to find relief, I have provided an excerpt from an article appearing in Save Your Hands Carpal Tunnel Syndrome And Related Conditions Are Easier To Prevent Than Cure by Siana Goodwin & Jeffrey Burch, Published in Massage & Bodywork, Dec/Jan 2003.

“Irritation from overuse or pressure within the carpal tunnel can cause tendons to become inflamed. Even a slight swelling from inflammation can affect all the structures within the carpal tunnel, impairing the movement and function of both tendons and nerve. A vicious cycle of re-injury can be set in motion as one continues to use their hands and irritate the tendons.

“At this point, there may be pain, stiffness, and numbness in the hands and fingers caused by pressure within the carpal tunnel. This condition may be diagnosed as tendinitis or repetitive motion injury. When prolonged swelling of the tendons and irritation of the median nerve results in impairment of the median nerve function, full-blown carpal tunnel syndrome develops. The symptoms of CTS include persistent numbness and pain in the hands that is unrelieved with rest. In advanced cases the muscles of the thumb, which are innervated by the median nerve, may atrophy.

“It is often difficult to successfully treat CTS. Anti-inflammatory medication may be useful, but cannot be used over a long period of time. Direct injections of anti- inflammatory steroids into the wrist area is painful, and, again, is not a procedure that can be repeated frequently. A surgical approach is to lengthen the ligament forming the palmar boundary of the carpal tunnel, thereby increasing the volume in the tunnel. As this surgery has gotten more refined with arthroscopic techniques, it is quite often successful. However, given that a great deal of pain and restriction of motion may lead up to this surgery, it’s better to consider prevention rather than cure!

“To develop a plan to prevent RSI, think again of how this cycle of injury develops by irritation of tendons and nerves through repeated motion. Obviously, avoiding repetitive movements is one way to minimize the danger of developing RSI. However, there are other factors to be considered as well. Irritation of tendons and nerves often starts because there is a poor blood supply to the hands. When blood supply is restricted by static body posture and/or poor body mechanics, the danger of developing RSI is increased.

“Prevention of RSI includes avoiding repetitive motion whenever possible, taking care to stretch stressed areas or balance repetitive motions when you can’t avoid them, using good body mechanics, and resting appropriately.

“Working on a keyboard In the days before computers, when typewriters were in use, CTS was rare. Typists’ hands were always in motion, moving slightly up and down the keyboard, and suspended above it. With computer keyboards, we are much more likely to rest our hands when we type. RSI may easily develop from the combination of enforced stillness and the possibility of restricting circulation. This is exacerbated when the hand or wrist rests on a hard surface.

“It may seem that one solution, then, is to rest the hands on a soft surface! Soft rests have been developed to put under the base of the hand and wrist when using a keyboard. Initially these may provide some relief from RSI symptoms. However when the base of the hand is rested on a soft surface the bones on the sides of the tunnel sink in and the central span of the tunnel may receive more pressure.

“If you use a keyboard treat it like a typewriter. If it is adjustable set it to require more force. Keep your wrists above the keyboard. This usually requires lowering the keyboard below the desk surface height, easily accomplished with a sliding keyboard tray. Additionally, using a chair with arms that support the elbows allows the wrists to have more mobility.

FIG. 5A: Resting the wrist on a hard surface may feel uncomfortable over the bones, but protects the carpal tunnel.

FIG. 5B: Resting the wrist on a soft surface feels good over the bones, but puts more pressure on the carpal tunnel.

“A second kind of RSI problem can occur when the base of the hand at the little finger rests continually on either a hard or soft surface. The ulnar nerve is relatively close to the surface of the body at the medial side of the palm, and can be pressed against the hamate bone when this part of the hand is continually pressed against some surface, especially if weight rests on it. Since this doesn’t involve restriction at the carpal tunnel, it’s often overlooked, but pain, numbness, and tingling in the ring finger and little finger can often be traced to compression in this area.

“Wrist extension is more harmful than flexion. The carpal tunnel is under the least strain when the wrist is near a neutral position. When the wrist is flexed, compression on the carpel tunnel is increased. However, when the wrist is extended compression on the carpel tunnel is three times as great as when the wrist is flexed.” Three great exercises for carpel tunnel syndrome here. See how in-house Rolfing for carpal tunnel saved one company millions of dollars here.

Len Worley, PhD
Certified Rolfer
Downtown Austin
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About Gentle Rolfing: Rolfing still has a reputation of being extremely painful, even if extremely helpful. In some ways the reputation is deserved since many practitioners of the early form of Rolfing went far deeper and quicker into contracted tissue than what nature intended, thus not allowing the body to open organically. Most Rolfing practitioners today have graduated to a more respectful approach, still applying effectively deep pressure but doing so gradually and progressively in a way that allows the body to open naturally. The rule of thumb for me is that Rolfing body work should always be satisfying and never dreadful.