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Conquering Carpal Tunnel Syndrome and Other Repetitive Strain Injuries: A Self-Care Program?
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I couldn't touch my toes when I started either. The secret to yoga is that you aren't stretching your muscles so much as relaxing them until they get longer. Basically, when your muscles are tight they are chronically clenching* in certain spots. If you get really mindful and relaxed you can notice where they are tight and just... stop clenching. Then they easily get longer and you can reach further without ever pulling or yanking on them.
Probably the best explanation for this and what made it click for me was not actually a yoga resource, but this book. This review refers to what I'm talking about, which I think is in the introduction:
> But the real gem is the part in the beginning of the book where the author talks about how to do the stretches correctly. She calls it, "finding the 'stretch point' ". Basically, the stretch point is all about doing the stretches with much less vigor than most people think of doing during a stretch. I think the stretch point is critical to getting the most relief, especially if you are suffering from pain at all.
*I don't know if they are literally clenching or if something else is going on physiologically, but that mental model works for me.
I'm really sorry you're going through that. I spent a few years with some pain myself that I thought was going to be permanent. Hope you get it figured out.
Three things that helped me were physical therapy, mindfulness (both as in meditation and as in mindful REALLY REALLY gentle stretching -- e.g. as in this book) and active-isolated stretching. That was a long time ago and now I'm all about SMR (foam roller, lacrosse ball, etc.) but I just use that for little aches and pains, nothing serious.
I'd really consider trying more therapy too.
I'd suggest two things:
Contrast Baths
Set up two long shallow tubs of water in your bathroom, long and wide enough to fit both arms up above the elbow comfortably. Fill one with cold water, the other with warm water. Extreme cold and extreme heat isn't any more useful - just make sure the cold one is cool, and the warm one is warm enough to stay nice and warm for more than the ten minutes you'll be using it.
Set a time for 1 minute and submerge both arms in the warm one, then a minute in the cold one. Do this for 11 minutes, so that you end with the warm one.
Do this 2-3 times a day, and ideally before you play/practice. If you empty out the cold one, and let the other sit until it is cold, then the water won't get stale and have things growing in it.
The other thing
Get this book and do the exercises in it, specific to the pain you are experiencing:
https://www.amazon.com/Conquering-Carpal-Syndrome-Repetitive-Injuries/dp/1572240393
Good luck.
I was diagnosed with early Tendonitis last year. Went to the doctor, he just prescribed me some anti-inflammatory, and absolute no guitar playing. The no guitar playing for almost a month drove me nuts. I also used (on my own) this book which I believe helped - I still use many of the stretches in there daily.
If you're serious about stretching I recommend this book, especially if you're feeling RSI symptoms:
https://www.amazon.com/Conquering-Carpal-Syndrome-Repetitive-Injuries/dp/1572240393
The book covers stretches across your full body since tension in other areas can affect your hands and arms. This book has so many stretches to choose from that you can really tailor a warm-up to suit your needs. After you try a bunch, you'll be able to see which stretches are the most helpful. I've narrowed it down to about 10 stretches that I do each night before bed and when I'll be playing for extended hours. Only takes about 5 minutes and I really feel a difference compared to when I slack off and don't do the stretches.
Looks like you are getting lots of good advice. When you are dealing with this problem it does seem very difficult. I remember times when just using a mouse or a keyboard would hurt. And my fingers would tighten up every night. I couldn't even hold a toothbrush in the morning. I was very scared. I bought a lot of books and tried a lot of things. When I got Sharon Butler's book, Conquering Carpal Tunnel Repetitive Strain Injuries, one of the stretches in there gave me immediate relief. I then knew that this was all about tension in the muscles - deep chronic tension. It took awhile to completely recover, but I was no longer scared and I knew that surgery and drugs were not the answer. This is actually a very simple problem to solve.
Basically it is all about stretching, strengthening and bodywork (massage). Sharon Butler's book is all about gentle stretching. Here it is on Amazon: https://www.amazon.com/dp/1572240393/ you can get used copies pretty cheap. You might also find examples of all kinds of stretches online for hands, wrists, forearms. Just find ways to stretch and keep doing it. Wrist curls have been suggested. So all you need is a light dumbbell for that. Or something like a soup can, or a broomstick, or a broomstick with some weight attached. But what might be most effective is massage. And you can do this to yourself. There are devices to help with this, such as the Armaid or the Rolflex. But you can massage one forearm with your other hand. Just dig in deep. Muscles can become tense over time and this tension can become chronic - no so easy to just relax it. You have to work deeply. It may seem painful - but it is a different kind of "pain" - a release of tension. Same concept as pressure points or trigger points.
Resting is not the answer. You may need to avoid for a while things that cause pain. But just resting will not remove the tension, which is the cause of the condition. Surgery is not the answer. There is nothing wrong with your anatomy that caused this. Drugs will not help, except to temporarily ease pain. And Sarno's TMS concept seems quite wacky to me (although many people have found this helpful).
Another part of this is that muscles can get "glued together". As muscles become chronically tense, they stop moving like they are designed to. All muscles are surrounded by fascia. Fascia can thicken and it can glue to itself. So you can have muscles or tendons that are supposed to slide against each other which have become stuck together. They can become unglued by massage and by stretching and strengthening.
There are many types of RSI of the hand and arm. The principles are the same. Stretch, strengthen, massage.
I put up a web page long ago with some of my story and some resources: http://www.terryslade.com/hands.htm maybe a bit out of date, but maybe some helpful stuff there.
It might take a while and it might be gradual, but you can totally fix this.Some books, tools, therapists might be useful, but you can do this without spending any money. Once you understand the concepts, it is just a matter of putting in time on self-therapy and being patient.
Also - everything in your body is interconnected. So if you are having hand issues, you can't just focus on your hands. You need to apply stretching, strengthening and massage to your whole body. Upper arms, shoulders, back, chest, abs, legs, etc. It can actually be a lifelong process for most us to keep getting better.
Have faith. You can heal yourself!
Check out this book. You can get it for super cheap used on amazon.
https://www.amazon.com/Conquering-Carpal-Syndrome-Repetitive-Injuries/dp/1572240393
I switched to evil/spacemacs a few years ago when my RSI was worsening to see if it helped. It helped for a short time but then my RSI started coming back. Vim keybindings can also cause RSI.
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However I don't regret learning evil. I really enjoy modal editing. Also, trying out spacemacs exposed me to lots of cool packages I didn't know about before. Though I'm using my own config these days, whenever I'm trying out a new language I usually check the spacemacs config to see what packages are installed there.
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Over the years I've tried various things that have been more or less helpful for RSI:
- Conquering carpal tunnel syndrome and other repetitive stress injuries
- Voice coding (https://www.youtube.com/watch?v=8SkdfdXWYaI, https://github.com/dictation-toolbox/aenea)
- Mind-body prescription (it's a bit wacky, I don't agree with all of it, but I think there's something to it & a lot of people seem to find it helpful)
- Standing desk
- Back massage (https://www.amazon.com/Tiger-Tail-Ball-Roller-Corded/dp/B0078PX01G/ref=sr_1_4?keywords=ball+rope+back+massage&qid=1558366141&s=gateway&sr=8-4)
- Exercise
These problems have to do with accumulated muscular tension which over time becomes "permanent". It can be removed but it will not go away on its own. Muscles will start to stick together and more and more movement patterns are impaired. In the body, everything is connected to everything, so it is more useful to work on realigning the body as a whole.
As you have found, most regular doctors know nothing about such things and have no interest in learning.
You must now embark on a Healing Journey. You can take a self-help approach or you can spend a lot of money paying various therapists to help you. Or you can do both. The types of therapists that may be helpful will be various kinds of "bodyworkers" - massage therapists, myofascial therapists, Rolfers, Hellerworkers, etc. Maybe some chiropractors. You might look into yoga and other types of stretching. You need to spend time checking into various approaches and helpers to see what and/or who works for you. You can make all the progress you want on this. Its just a matter of how much you want to learn and how much time you want to spend learning about and working on yourself.
Here are some very special books that I highly recommend: (there are countless more)
- Conquering Carpal Tunnel Syndrome and Other Repetitive Strain Injuries - Sharon Butler
- https://www.amazon.com/dp/1572240393/
- Author's Website: http://www.selfcare4rsi.com
- Deskbound - Kelly Starrett
- https://www.amazon.com/dp/1628600586/
- Author's website: http://www.mobilitywod.com
- also search Youtube for Mobility WOD videos
- Pain Free - Pete Egoscue
- https://www.amazon.com/dp/0553379887/
- Author's website: http://www.egoscue.com
- The Endless Web: Fascial Anatomy and Physical Reality - R. Louis Schultes
- https://www.amazon.com/dp/1556432283/
- Discovering the Body's Wisdom - Mirka Knaster
- "A Comprehensive Guide to More than Fifty Mind-Body Practices
- that Can Relieve Pain, Reduce Stress, and Foster Health,
- Spiritual Growth, and Inner Peace"
- https://www.amazon.com/dp/0553373277/
Note the reviews on these books. And note that you can get them cheaper used.
Have faith. Good luck!
I would suggest that gentle stretching and bodywork (massage) will be the best things to do. You may need to continue physical therapy (strengthening) on your whole body, but take it easy with amount of weight and frequency. and you may need to hold off on strengthening work in general until it is not painful.
Get this book - Conquering Carpal Tunnel Syndrome and Other Repetitive Injuries - by Sharon Butler
https://www.amazon.com/dp/1572240393/
This is basically a manual of gentle stretches for the upper body. Easy to read, easy to use - read carefully. If you are low on money, get a used copy. If you can afford it, you may want to work directly with the author - http://selfcare4rsi.com
unless you live in a tiny town, there will be lots of bodyworkers around, with many different approaches. I suggest do a bit of research on who is around and try a few different therapists. Rolfers, Hellerworkers, Myofascial therapists, etc. Or just "massage therapists". You can also dig in and work on yourself. Some tools might be useful. Check out the Rolflex - http://irolflex.com
and of course put a high priority on 8 hours sleep a night - if you have trouble sleeping at least stay in bed for 8 hours. and of course pay attention to good diet. if you can make some progress, then you are on the right track - keep going. you may need to think of this as a lifetime program rather than some kind of quick fix.
all of the above assumes that this is all related to deep chronic tension in muscles. there could be something else going on, but I would still start with stretching and bodywork. you might want to look into some gentle yoga.
doctors usually have no concept at all of muscular tension, and thus no understanding of the cause of such problems or the importance of stretching and bodywork. the PT that they prescribe might be making things worse. and the physical therapists are from the same school of thought. so you need to find massage therapists - a whole different way of looking at this.
good luck!
Let me ask you - HOW are you doing your stretches? I learned a new way of stretching where you have to first feel the slightest bit of tension then wait 10-15s for it to go away (if it does go away. If not repeat the day after) then go ahead and start further extending the stretch. A single stretch can take up to 15 minutes like this and way longer (weeks) to full do the stretch but it pays off A LOT. If you just go ahead and do the stretch all the way with lots of tension then you actually make things WORSE which blew my mind. You also have to do multiple types of stretches, every other day so it has to be consistent (that's a big thing, it can take a week or two for me to fully get rid of a flare up. If I just do it every now and then it won't do too much). Another thing you should consider is isometric exercises that will toughen you ligaments and tendons. If you do any heavy weight lifting, you need to rethink that also. Your muscles may be ready for the job but not the rest of the body so switch to body weight exercises and master them before moving on. Another thing that helped A LOT is a lacrosse ball that I roll around on my forearm focusing on tense/semi-painful spots (myofascial release) for 15m. It made a world of difference. I've attached the resources that really helped me out. Things that only helped a but not as much as the above were playing in the classical position and trying to pick NOT parallel to the strings but perpendicular ala Michael Angelo Batio.
I'll tell you right now, that not only have I greatly reduced pain from tendonitis (which has been with me since my teens) but also carpal tunnel syndrome, cubital tunnel syndrome but I've also been making measurable gains in high speed soloing. The worst thing you can do is take some NSAIDs and "wait it out". It took a year and a half of waiting with a tonne of desperation that lead me to dedicating my mornings to my overall health. Oh and forget about just guitar man...you'll need to take care of this if you want to be able to even work a desk job.
Yes, it is very simplistic to say that "smashing" is "self-rolfing", but I am saying that as an easy way to emphasize that smashing is DEEP-TISSUE SELF-MASSAGE, which I take to be a new and totally revolutionary concept. THANK YOU Kelly Starrett! THANK YOU Jill Miller!
I do definitely recommend going to see a Rolfer or any kind of bodyworker over a doctor for most musculoskeletal issues. I actually have an appointment with an Advanced Rolfer in a few days. I had the ten sessions about 40 years ago. My Rolfer was new and not a good one. Didn't do much for me. Of course all bodyworkers will be different. Theoretically Rolfers are the top-level elite of bodyworkers but that is not always true. I am very excited about being able to see this Rolfer. But I am even more excited to have discovered smashing and Kelly Starrett. My Rolfing session will cost $155.00 and I am not a rich person. So I am very oriented to self-help methods. Youtube videos are free and a lacrosse ball is $3. This knee issue has really sidetracked me and I have taken more and more desperate measures, the Rolfer being the latest. I went to a massage therapist a few weeks ago. That was good, but I figured I needed the skill of a Rolfer to really solve this puzzle. But then it was just yesterday that I finally got the smashing thing. My knee is way better today than it has been in 3 months and I am just getting started. If I hadn't found this Rolfer I would probably be OK, but I trust he will speed me up a lot.
I had not heard of theiasi.net - interesting. My top recommended book for Carpal Tunnel and such problems is by a Hellerworker - Conquering Carpal Tunnel Syndrome and Other Repetitive Strain Injuries - Sharon Butler. https://www.amazon.com/dp/1572240393/ I did not find the client handbook you mentioned at hellerwork.com but did find out about 4 books there that I did not know about. Hellerwork is very interesting, but also expensive and they are even harder to find than Rolfers.
I think most people would benefit greatly from any amount of bodywork and certainly from a full set of sessions from a Rolfer or Hellerworker. But we can also learn to work on ourselves. I used to think yoga was the way, but I now think that bodywork (including self-work, especially "smashing") is as important as stretching and strengthening.
You can totally fix this. Resting is not the answer. Gentle stretching and deep tissue massage is needed - and you can do both to yourself.
Get this book - Conquering Carpal Tunnel Syndrome and Other Repetitive Strain Injuries - Sharon Butler. https://www.amazon.com/dp/1572240393/
I got over 100 books when I was dealing with hand problems. This was the only one I needed. The author has a website here and you can buy a more indepth program from her, but the book should be all you need. http://selfcare4rsi.com
Here is another book:https://www.amazon.com/dp/1457525771/ I have not yet seen this, but I have others by this author.
Self-massage may also be very helpful. A device called the Armaid is useful for that: http://armaid.com
Check out Youtube for lots of videos. There was no Youtube back when I went through this. This is easy to fix, but may take some time for you to figure out what to do. Do not go to a doctor, do not have surgery. If you need help, go to a massage therapist or a Rolfer or a physical therapist.
Actually reading back over your post, you most likely have a lot more going on than just hand issues. Same stuff applies - you just need to find and remove deep chronic muscular tension. There is a self-help revolution going on right now - Kelly Starrett is showing people how to effectively Rolf themselves using lacrosse balls and other tools (foam rollers). Get a lacrosse ball ($3) and start in. His books are all good - his new one is Deskbound - https://www.amazon.com/dp/1628600586/ Check out his youtube channel - https://www.youtube.com/user/sanfranciscocrossfit/
If this is all too overwhelming, just find a good massage therapist, ask around or try a few. But they do cost some money. Self-treatment is FREE.
Get this book:
Conquering Carpal Tunnel Syndrome and Other Repetitive Injuries - Sharon Butler
http://www.amazon.com/dp/1572240393/
Note the 5-star reviews at Amazon. This is the only book you need. She is the top expert on self-healing RSI.
I had some serious hand problems 15 years ago. Spent 2 years looking for solutions. Bought 200 books. This book will put you on the right path. The author has a website here:
Lots of info there. And you can buy a program from her with more detail than the book, but the book should be all you need. The path is simple - find the right stretches and do them effectively. This can take a long time to figure out (or not - RTFM). Bodywork can be helpful (massage or self-massage). The Armaid is a useful tool - http://armaid.com - but you can do without it. Doctors have no knowledge of these types of problems - caused by accumulated deep chronic muscular tension, which sets in and becomes "permanent" with help of fascia (it is not permanent - but it won't go away by itself). The tension must be removed - by stretching (and/or bodywork). On one hand, you can fix this and be done with it, on the other hand - you really need to make a commitment to lifelong health and healing. (eating well, good sleep, exercise, stretching, etc)
You should be able to get to where you can use keyboard, mouse, etc with no problems. No need for special equipment, etc.
Chinese proverb - When healing patient, better not to use knife.
You can heal yourself! Good luck...
Check out this book: Conquering Carpal Tunnel Syndrome and Other Repetitive Strain Injuries - Sharon Butler https://www.amazon.com/dp/1572240393/
More info here: http://www.terryslade.com/hands.htm
You can fix this yourself. It is a matter of stretching and working to explore your own body. Pain Free by Pete Egoscue is also an excellent book. The worst thing you can do is go to a doctor. They will prescribe pain medication, which does nothing to fix the problem. Then they will recommend surgery, which may give immediate relief, but to some extent "cripples you for life". (Chinese proverb - "When healing patient, better not to use knife")
It may not be quick or easy, but you can fix this.
You can fix this yourself.
Get this book:
Conquering Carpal Tunnel Syndrome and Other Repetitive Strain Injuries - Sharon Butler
http://www.amazon.com/dp/1572240393/
This is the best book on CTS/RSI. includes many specific stretches for upper body RSI. The first part of the book is the best thing you can read on self-healing of RSI. Notice the word CONQUERING in the title. This book is all about how to fix this yourself.
The Armaid is an excellent tool for self-massage of the arm:
http://www.armaid.com/page/853-3029/armaidhome
You can dig in to your arms pretty good without this tool, but this is a good way to get in very deeply.
It may be important to address issues throughout your whole body. Everything is connected to everything. (yoga, weight training with a personal trainer, etc).
If you are not seeing results after working with Sharon Butler's book, you might want to check out her website for more info and maybe purchase one of her program for forearm pain: http://www.selfcare4rsi.com
You can totally fix this. Stay away from doctors and get off those pills.
Get this book:
Conquering Carpal Tunnel Syndrome and Other Repetitive Strain Injuries - Sharon Butler
http://www.amazon.com/dp/1572240393/
That may be all you need. You might also check out the author's website: http://www.selfcare4rsi.com
I may have more info here: http://www.terryslade.com/hands.htm
I would not suggest going to see a doctor for this. And don't let anyone talk you into surgery.
You can fix it! good luck
Conquering Carpal Tunnel Syndrome and Other Repetitive Strain Injuries - Sharon Butler
This is NOT a scam. Sharon Butler is one of the top experts in the world on upper body RSI. She is the author of this book: Conquering Carpal Tunnel Syndrome and Other Repetitive Strain Injuries.
http://www.amazon.com/dp/1572240393/
Check out the reviews there. I suggest just get this book. You can get a used copy very cheap at Amazon. She later developed the programs she sells on her website since she found that most people don't have the patience to figure out how to apply the information in the book to their specific situation (even though it is carefully written to be very user-friendly). So the programs on her website are very specific instructions for very specific conditions. I struggled with hand problems after starting to do yardwork 16 years ago. Using a weedeater caused me to be unable to bend my fingers every night. I tried many things. One of the stretches in her book was the most useful thing in my healing, along with the general understanding from reading the first section in the book. In the 2 years that I was intensely focused on fixing my hand problems, I corresponded a bit with Sharon. She is a certified Hellerworker and has a lot of experience helping people with RSI problems. Just look around on her website and you can see that there is a lot of information and understanding there. But I would suggest that the book is probably all you really need. I think her programs used to be $35, so I was surprised to see the price at $97. But she has been at this awhile and I trust that she has priced it where she needs it to be. But again, her book can give you all you need, and you can get it for a few dollars. I have several copies and often loan them to people. I also like Pain Free by Pete Egoscue. I have some pages on my website with more info: http://www.terryslade.com/hands.com
This is the book of "yoga" for Carpal Tunnel Syndrome:
http://www.amazon.com/dp/1572240393/
Conquering Carpal Tunnel Syndrome and Other Repetitive Strain Injuries - Sharon Butler
I fixed mine long ago.
Do you wear the braces even when you're playing? I've tried that and wasn't really sure if it was helping the problem or just causing a new one.
If you've got CTS and are looking for some good ways to manage I'd recommend these two books:
Over the past few months I've been using their techniques and gradually building up my computer usage back to normal.
I have been diagnosed with chronic pain syndrome. I barely register injury on EMG tests (unilaterally, and not correlative with the bilateral pain: it's incidental injury).
I'm afraid I haven't found a 'cure': there isn't one yet. Furthermore, don't be surprised if you >never< meet anyone with your specific set of symptoms, so you will need to tailor your treatment regimen according to how well it is helping you.
Avoid stress as much as possible, try and get your body into peak physical condition otherwise. Contrast baths and trigger point massage are the quickest way to pain relief for me. Make sure you are getting an appropriate amount of good quality sleep. I recently started taking melatonin an hour or so before bed, along with magnesium, calcium and zinc at bed time, and the difference in my energy levels (chronic pain syndrome usually comes with fatigue and concentration issues) is night and day.
The good/bad news: I had this once when I was your age, and managed to get rid of it for 10+ years. Now, I'm facing my second bout, it's much harder this time, it may be my lot in life.
Books you need:
http://www.amazon.com/Conquering-Carpal-Tunnel-Syndrome-Repetitive/dp/1572240393/ref=ntt_at_ep_dpt_1
That second one, will only be of benefit if you can find a good trigger point massage specialist. If you are near San Francisco I can recomend one. Good luck.
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