138: Carpal Tunnel Crash Course (with Whitney Lowe & Til Luchau)

Carpal tunnel syndrome is one of the most common nerve compression issues—but how can massage and manual therapy help? In this in-depth episode, Whitney Lowe and Til Luchau break down the anatomy, risk factors, and assessment strategies for carpal tunnel syndrome, exploring its causes, differential diagnosis, and effective hands-on approaches. They discuss the importance of nerve mobility, client education, and activity modifications to relieve symptoms and improve function.

Whether you’re a hands-on therapist looking to refine your treatment strategies, or someone experiencing wrist and hand discomfort, this episode offers valuable insights into understanding and managing carpal tunnel syndrome.

🌟 Highlights:

•Carpal Tunnel Basics (02:50) – Understanding the anatomy and mechanics of nerve compression.

•Risk Factors (04:00) – Why some people are more prone to carpal tunnel syndrome.

•Differential Diagnosis (12:00) – How to distinguish carpal tunnel from other nerve compression issues.

•Assessment Questions and Tests (13:40) – Key evaluation techniques to identify carpal tunnel syndrome.

•Nerve Fiber Distribution and Symptom Progression (18:30) – How symptoms develop and why sensory signs appear first.

•Soft Tissue Goals (21:40) – The role of manual therapy in relieving pressure and improving mobility.

•Activity Modification and Client Education (31:30) – Helping clients make lasting changes to prevent symptom recurrence.

•Night Splinting and Nerve Healing (38:00) – How positioning at night can aid recovery.

•Nerve Gliding and Neurodynamics (43:50) – Gentle movement strategies to improve nerve function.

•Massage and Manual Therapy Outcomes (54:10) – Research-backed benefits of hands-on treatment.

💡 Join the Conversation: Have experience working with carpal tunnel syndrome or dealing with it yourself? Share your story with us!

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Episode image ©Primal Pictures, used by permission.

📄 Get the full transcript at Til or Whitney's sites! 

• Whitney Lowe’s site: AcademyOfClinicalMassage.com 
• Til Luchau’s site: Advanced-Trainings.com 

Resources mentioned in this episode:

• Til's carpal tunnel ball technique: Advanced Myofascial Techniques, volume 1

• Research into massage and manual therapy's effectiveness with CTS:

• 1. Reduction of Pain and Symptoms

  •Massage Therapy: A 2013 study evaluated the efficacy of massage therapy as a treatment for carpal tunnel syndrome (CTS), finding it beneficial in reducing pain and improving function.

  https://pubmed.ncbi.nlm.nih.gov/23768278

  •Manual Therapy: A 2021 systematic review and meta-analysis assessed the effectiveness of manual therapy on pain and physical function in CTS patients, concluding that manual therapy can significantly reduce pain intensity and improve hand function.

  https://link.springer.com/article/10.1007/s00264-021-05272-2

• 2. Improvement in Median Nerve Function

  •A 2017 systematic review analyzed the effectiveness of nerve gliding exercises on CTS, indicating improvements in nerve conduction and symptom severity.

  https://pubmed.ncbi.nlm.nih.gov/27842937

• 3. Decreased Swelling

  •An article from Medical News Today discusses that massage therapy can improve lymphatic drainage and reduce swelling in the carpal tunnel area, which may help alleviate pressure on the median nerve.

  https://www.medicalnewstoday.com/articles/carpal-tunnel-massage

• 4. Improved Grip Strength and Function

  •A 2021 systematic review and meta-analysis found that manual therapy effectively improves physical function in CTS patients.

  https://link.springer.com/article/10.1007/s00264-021-05272-2

• 5. Enhanced Overall Quality of Life

  •The American Massage Therapy Association notes that massage therapy can be of great benefit for people dealing with pain from carpal tunnel syndrome, potentially improving their quality of life.

  https://www.amtamassage.org/publications/massage-therapy-journal/massage-and-carpal-tunnel-syndrome

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• Academy of Clinical Massage: Grab Whitney's valuable Assessment Cheat Sheet for free at: academyofclinicalmassage.com/cheatsheet

About Whitney Lowe  | About Til Luchau  |  Email Us: info@thethinkingpractitioner.com

(The Thinking Practitioner Podcast is intended for professional practitioners of manual and movement therapies: bodywork, massage therapy, structural integration, chiropractic, myofascial and myotherapy, orthopedic, sports massage, physical therapy, osteopathy, yoga, strength and conditioning, and similar professions. It is not medical or treatment advice.)