Just in North America alone, over 260,000 Carpal Tunnel Release operations are performed each year, and over 47% of these cases are reported as being work-related! The costs due to CTS are substantial - both for the patient and for the employer.

The classical medical definition of Carpal Tunnel Syndrome (CTS) says:

‘The impairment of motor and/or sensory function of the Median Nerve as it traverses through the Carpal Tunnel.’

Research is now showing that this traditional emphasis upon the Carpal Tunnel area is not only inaccurate, but that it also ignores the bigger picture, in which the Median Nerve is often entrapped along other areas from the wrist to the neck.

Conventional treatments rarely address these other entrapment sites, choosing instead to focus solely upon the carpal tunnel region. This means the real entrapment site is often ignored, resulting in ongoing “carpal-tunnel-like” syndromes, and little or no resolution.

Unfortunately many practitioners are unaware of this information and continue to use standard medical tests and procedures that focus solely upon the area of the carpal tunnel.

Non-specific, inaccurate testing methods often lead to the misdiagnosis (and treatment) of just a single entrapment site at the Carpal Tunnel, when in fact, nerve entrapments can occur along the entire length of the Median Nerve, from the shoulder to the tips of the fingers. Thus, it is no surprise that most medical procedures achieve very poor results when treating CTS.

Other Nerve Entrapment Sites

From an Active Release Techniques (ART) perspective, CTS is often caused by entrapment of the Median Nerve at several common entrapment sites:

1. Median Nerve at the Thenar Muscles.
2. Median Nerve at the Carpal Tunnel.
3. Median nerve at the Pronator Teres and Flexor Digitorum Superficialis.
4. Median Nerve at the Ligament of Struthers.
5. Median Tract at the Coracopectoral Tunnel.
6. Median Nerve at the Scalenes.

For a practitioner to achieve long term, positive results, he or she must consider these other areas of possible entrapment, rather that focusing exclusively on the Carpal Tunnel area.

To be successful at treating CTS, the practitioner must do several things, including:

• Identify both the primary, and the antagonistic, muscles that are causing the injury.
• Locate the restrictive adhesions that have formed, as well as the direction in which these adhesions are aligned.
• Determine which other soft-tissue structures along the kinetic chain are affected by these adhesions.
• Use a hands-on approach, such as Active Release Techniques, to release the restrictions that are the cause of the problem.
  

Peripheral Long Tract Nerve Release - About A Recent Development for Treating CTS

One of the most significant advances in treating Carpal Tunnel Syndrome (CTS) is a new procedure in Active Release Techniques® (ART) called “Peripheral Long Tract Nerve Release”

In contrast to the basic ART procedures, the primary focus of this new technique is to move the nerve through the tissue. In these procedures, the practitioner tensions the soft tissue structure involved, and then performs procedures that enable the nerve to be pulled though the soft-tissue structure, thereby releasing the nerve from surrounding adhesions.

The true power of this procedure is that it enables the practitioner to pull the nerve through any site of entrapment, alleviating even significant amounts of nerve compression.

What can you do to help yourself?

During the early stages of nerve entrapment, some simple exercises can often help you to release the nerve, and thereby prevent the occurrence of CTS.

Try the following nerve flossing exercise, which actually moves or slides the Median Nerve through the surrounding tissue layers, and helps to keep it from becoming entrapped.

Flossing the Median Nerve

Yup...just like flossing your teeth, you can floss your nerve and keep it from getting jammed between tissue layers. Try this simple exercise and feel the movement of your nerve through the tissue layers.

But take your time, and don't force it. Be gentle!

Part One
Stand in a relaxed posture with the affected arm extended parallel to the floor, with your palm facing up. Bend the elbow so that the forearm extends perpendicular to the arm, and bend your wrist to stretch the fingers of your hand away from the body at a right angle. Keep the upper arm parallel to the shoulder. Keep your other shoulder relaxed. Bend your head your head towards the affected side – ear to shoulder with no rotation. Hold for a count of eight.
Part 2 Bring your arm down to your side, rotate your arm in with your palm facing up. This position is like a waiter waiting for his tip. Bend your head your head towards the opposite side – ear to shoulder with no rotation. Hold for a count of eight. Repeat parts A and B four to six times.

Check the web site at www.activerelease.com to find a certified practitioner for "Long Nerve Entrapment" in your area.

For more exercises to help you prevent Carpal Tunnel syndrome, read our best selling book - Release Your Pain .

All the best in health
Dr. Brian Abelson

Dr. Brian Abelson is the Clinical Director of Edgemont Chiropractic Soft-tissue Management Systems, in Calgary, Alberta. 

Dr. Abelson is a native Calgarian who attended the University of Calgary, majoring in Biosciences, before graduating from Palmer College of Chiropractic West, California with an award for Clinical Excellence. He holds advanced certification in all levels of Active Release Techniques, is trained in Biomechanics and ART, is an accomplished ART Instructor, and is licensed to the ART Elite Providers Network.

He is co-author of "Release Your Pain" the first book for the public about Active Release Techniques. He is also the co-author of the award-winning information websites: www.drabelson.com and www.activerelease.ca.