CARPAL TUNNEL SYNDROME – MASSAGE THERAPY

We are all familiar with the concept of massage – well we think we are. Yet massage is a complex subject not least because there are so many different kinds of massage: there are dozens of different types of massage, including Swedish massage, Shiatsu, Thai massage, hot stone massage, deep tissue massage, sports massage – which varies from sport to sport – reflexology, pre-natal massage and so on.

Each technique has its own adherents and each technique is also appropriate for achieving different kinds of outcomes. This means that we need to choose very carefully the massage technique that is right for us and for what we want to achieve.

Introduction:

Massage is defined as: the rubbing and kneading of muscles and joints of the body with the hands. It is the manual manipulation of the soft body tissues – muscle, connective tissue, tendons and ligaments – in order to enhance a person’s health and well-being.

People seek massage therapy for a variety of reasons:  to reduce stress and anxiety, relax muscles, rehabilitate injuries, reduce pain and generally to promote thier overall health and wellness. It is extremely beneficial in dealing with the problems associated with carpal tunnel syndrome. (Please see Trigger PointTherapy.)

Massage for carpal tunnel syndrome:

Along with simple hand exercises, massage is a good way of obtaining relief from the pain of carpal tunnel syndrome.

In fact, the right kind of massage can be of great benefit, not only in in treating the more obvious symptoms of Carpal Tunnel Syndrome but also in getting down to tackling the root cause of the problem.

In general, massage therapy for Carpal Tunnel Syndrome would include manual massage of the forearm and hand.  In particular, a massage therapist would generally work on the flexor and extensor muscles of the hand, wrist and fingers.

Getting down to it:

In principle, the kind of massage that is going to be of use in helping with carpal tunnel problems is not the relaxing massage one can get at a health spa. It is deeper, myofascial massage – often called deep tissue or neuromuscular therapy. 

A clinical treatment of this kind would probably include orthopedic massage techniques such as myofascial release through stripping, compression and active engagement. 

Deep tissue massage:

Deep tissue massage therapy is similar to Swedish massage but here the focus is on the deepest layers of muscle tissue, tendons and fascia – the protective layer surrounding muscles, bones and joints.

Deep-tissue massage focuses on relieving tension deep within the body’s musculature. To give a good deep-tissue massage, a therapist needs to know the basics of human muscle anatomy, how to properly apply deep pressure without causing pain, and how to identify areas that need more attention.

In this type of massage, the therapist uses deep finger pressure and slow, firm strokes.  When applied by an experienced orthopedic massage therapist, this deep tissue massage therapy can remove adhesions and resolve other problems with the ligaments and muscles in the hand, wrist, arm, shoulder and neck.

This deeper pressure is particularly beneficial in releasing chronic muscle tension. Some massage therapists also use Essential Oils to help relax muscles and reduce inflammation.

Deep tissue massage is one of the few treatments that can provide real, long term relief from Carpal Tunnel Syndrome. 

Neuromuscular Therapy (NMT):

This is an approach to soft tissue massage therapy in which quasi-static pressure is applied to soft tissue to stimulate skeletal striated muscle. This approach is designed to: alleviate – and even eliminate – pain and restore the full range of motion.

Through applied knowledge of Trigger Points, neuromuscular therapy addresses postural distortion, biomechanical dysfunction, nerve compression and ischemia – shortage of oxygen.

In NMT, pressure is applied perpendicular to the skin surface to stimulate the muscle.

Most factors that cause pain and dysfunction can be grouped into 3 general headings: biomechanical, biochemical, and psychosocial factors – with the interface between these being profoundly related.

Most practitioners apply strategies from only one of these categories, often resulting in improvements that plateau before full recovery. However, a synergistic effect is obtained when all three categories are addressed.  This may required a multidisciplinary approach.

NMT assessments and examinations primarily address

Ischemia: tight tissue with reduced blood flow

Myofascial trigger points: hypersensitive points within muscles that give rise to referred phenomena, including pain

Neural entrapment:  pressure on nerves by muscles and other soft tissues

Nerve compression: pressure on nerves by osseous and other bonelike tissues, such as cartilage or  discs.

Postural assessment: assessment of the position of the body as a whole

Dysfunctional gait patterns: manner of movement when walking

There is also constant consideration for many other perpetuating factors, such as hydration, nutrition, breathing patterns, and psychologic stress.

NMT is highly effective for clients who have chronic pain and is often successful in reducing or eliminating even longstanding painful conditions. Some of the techniques can also be applied to acute injuries and for post-surgical care; many help to improve performance in sport or dance and to prevent injuries due to these activities.

NMT is often used in conjjunction with Myokinesthetic Therapy. This is another soft tissue treatment focusing on muscle, soft tissue and the nerves. The goal of the Myokinesthetic Therapy is to identify and address the cause of the problem within the nervous system.

A postural assessment is used to identify the nerve root that is causing the problem. By stimulating the muscles associated with a particular nerve root, the nervous system learns to send the proper signal to the muscles allowing them to respond and function properly – with a full range of motion and without tension and pain.

VIDEO

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Massage at home:

When it comes to massage, it is not possible to reproduce exactly what a trained massage therapist can do. Nevertheless, it is possible to carry out some simple massage exercises that will help reduce muscle tension and improve blood circulation.

It is also possible to carry out a form of deep massage

Massaging the arm: simple exercise

To massage your arms, start by making long flowing strokes with the opposite hand all the way up your arm, from your wrists to your shoulder. Continue to make these long strokes until you feel your arms heating up. Then, change over to making smaller little circles all over your forearms and upper-arms.

Switch back and forth between the long-flowing strokes and the smaller circles until your arms feel heated and relaxed.

Massaging the fingers and hands: simple exercise

Gently squeeze one hand by pressing it between the palm and fingers of your other hand.

Then squeeze each finger and run the thumb from your other hand along the joints of the fingers in a circular motion. Hold the finger at its base and gently pull it up so that you’re stretching the fingers upwards. Use your thumb to stroke the tendons on the back of the hands.

Use your thumb to put pressure on your palms and wrists, moving it in a circular motion.

To complete the massage, stroke your palm gently from your fingers to your wrist.

If you’re using oil, rub your hands together to massage the oil further into your hands. You can also complete this motion even if you’re not using oil.

Massage TIPS

Three tips (simple massage exercises) that can help relieve the the pressure related to Carpal Tunnel Syndrome:

TIP – Massage Exercise 1. Reducing the swelling with circular motions of your fingers.

Use the fingers of your free hand to massage your affected hand in small circular motions. Begin on your forearm and work down towards your wrist, palm and fingers in circular, vigorous movements.

Apply light, not too strong, pressure while massaging. You may want to try using the knuckles of your free hand to complete the massage as well. Continue massaging in circles on the front and back of your forearm and hand for say 3 to 5 minutes.

Now, use the fingers of your free hand to grasp, or pinch a small area of skin on the back of your affected hand. While grasping, return to massaging small circles and continue grasping and massaging various small areas of skin all over the front and back of the palm. Continue for 5 to 7 minutes. Finish with small, light pressure circles around the wrist for 2 to 5 minutes.

TIP – Massage Exercise 2. Promoting blood flow and releasing tension.

A stripping stroke is a slow and deep gliding pressure that you can use for this massage exercise. Use the thumb of your free hand and place it on the wrist of your affected hand. With slow movement and strong pressure, move your thumb from wrist to elbow. Repeat vigorously for 7 to 10 minutes.

TIP – Massage Exercise 3. Stretching your palm to release tension.

This is really a stretching exercise but is very useful in combination with the previous 2 massage exercises.

Bend the arm of the affected hand at the elbow with the palm facing up. Maintaining this 90 degree angle at the elbow while stretching the affected hand avoids over stretching and possible injury.

Hold the palm of your affected hand flat, palm upwards. Use your free hand to bend your hand down at the wrist, pointing your fingers toward the floor. You should feel a stretch in your wrist and palm. Hold the stretch for 30 seconds and release. Next, use your free hand to bend your affected hand again, but this time include the thumb of your affected hand in the stretch down toward the floor as well. In this way, the space between your thumb and pointer finger will point towards the floor.

Using the same balancing principle noted earlier, you should then do the exercise but this time bending the hand upwards.

After stretching and massaging your arms, wrists and hands, you should feel relaxed and balanced.

Deep tissue massage:

It is also possible to carry out a form of deep massage

Deep tissue, myofascial massage can really only be applied by a trained therapist; you cannot really do it yourself.  Therefore, even though this type of massage has proved to be effective in healing Carpal Tunnel Syndrome, it is not really a home remedy. 

At least it wasn’t until now! 

Recently, products have come onto the market that can simulate the rotational motion of a massage therapist.  Deep tissue, myofascial massage is becoming a DIY home product.

Used at home, these products are very affordable and can be a viable alternative to an expensive course of treatment with a massage therapist. They can be used to treat a number of conditions including carpal tunnel syndrome.

For information on massaging triigger points see Trigger PointTherapy.