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Dealing with Carpal Tunnel Syndrome (CTS)
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tj2870


Jun 24, 2011, 7:32 PM
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Dealing with Carpal Tunnel Syndrome (CTS)
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For those that climb with CTS: how do you manage to climb for long periods of time? I mostly boulder and range from V5s to V6s, but I feel that I could progress faster without CTS in my right wrist. I can get some good quality climbs in for about an hour, usually with anywhere from 3-10 minute breaks in between, but then I just can't trust my grip with my right hand. It's really frustrating.

I do a core yoga routine about 3 times a week that has some stretches that hit my right shoulder and stretch my arm (to the point where I get the nasty tingling sensation throughout, as you CTS people know of very well). If anyone has any other suggestions as to how to manage rock climbing with CTS, please let me know! I prefer to stay away from surgery.

Thanks.


qtrollip


Jun 24, 2011, 9:29 PM
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Re: [tj2870] Dealing with Carpal Tunnel Syndrome (CTS) [In reply to]
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Hi Tj2870
Have you been specifically diagnosed with Carpal Tunnel Syndrome yet? It should give you pins and needles or burning or tingling only in the palm side of your hand in the thumb and next 2 1/2 fingers (and only the last phalanx on the back of the hand).

If there is numbness etc higher up than the wrist or on the pinkie or biggest part of the back of the hand it is probably not CTS.
(Sorry, I couldn't get where exactly your symptoms were from your post).
Symptoms like those throughout the arm could be more something like TOS (Thoracic Outlet Syndrome)

For CTS some stretches, night splint etc can help but if really bad would probably require surgery (which is not very invasive).
I would not however recommend surgery for TOS, try to manage this conservatively.

Best thing would be to see your physiotherapist (my biased opinion).

Good luck!


PS. Do you get burning at night in the part of your hand as I mentioned above, what type of work do you do, any previous wrist/elbow/hand or neck injuries or problems?


tj2870


Jun 25, 2011, 7:29 AM
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Re: [qtrollip] Dealing with Carpal Tunnel Syndrome (CTS) [In reply to]
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qtrollip wrote:
Hi Tj2870
Have you been specifically diagnosed with Carpal Tunnel Syndrome yet? It should give you pins and needles or burning or tingling only in the palm side of your hand in the thumb and next 2 1/2 fingers (and only the last phalanx on the back of the hand).
My family doctor diagnosed it about three years ago. The pins and needles are in my thumb and the next two fingers over (heavily in my thumb). When I stretch my arm (palm against the wall with fingers facing behind, body tilted) I get a tingly sensation all the way up my arm into my rear shoulder area, where the median nerve stems out. When I climb, the numbness and thingling flare up in the three digits that I mentioned, and then my wrist just gets very weak. It makes sense, since the median nerve is likely inflamed and enlarged in the tunnel. Do you recommend I see a specialist for a better diagnosis? My chiropractor has been pretty helpful, usually with adjustments targeting my thoracic section.

qtrollip wrote:
For CTS some stretches, night splint etc can help but if really bad would probably require surgery (which is not very invasive).
I would not however recommend surgery for TOS, try to manage this conservatively.

PS. Do you get burning at night in the part of your hand as I mentioned above, what type of work do you do, any previous wrist/elbow/hand or neck injuries or problems?
I do wear a splint at night when my symptoms return. Maybe I should just wear it every night regardless. It was only really bad, with a painful burning sensation, one time in my life. I don't think I'm at the point where I need surgery. I'm normally pretty good at managing the symptoms through stretches, but with climbing it takes a few days of no activity to calm the problem area (three fingers and wrist). Unfortunately I'm right-handed and that's where the issues are.
I am a high school mathematics teacher, and I spend a good deal of time on the computer every day. Grading requires hunching over, which is great for your thoracic region, naturally.

I don't like waiting a few days, but I always take at least a one-day break between days that I climb. I wish I didn't feel like I can't improve my climbing endurance because of this. Frown


MS1


Jun 25, 2011, 4:30 PM
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Re: [tj2870] Dealing with Carpal Tunnel Syndrome (CTS) [In reply to]
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tj2870 wrote:
qtrollip wrote:
Hi Tj2870
Have you been specifically diagnosed with Carpal Tunnel Syndrome yet? It should give you pins and needles or burning or tingling only in the palm side of your hand in the thumb and next 2 1/2 fingers (and only the last phalanx on the back of the hand).
My family doctor diagnosed it about three years ago. The pins and needles are in my thumb and the next two fingers over (heavily in my thumb). When I stretch my arm (palm against the wall with fingers facing behind, body tilted) I get a tingly sensation all the way up my arm into my rear shoulder area, where the median nerve stems out. When I climb, the numbness and thingling flare up in the three digits that I mentioned, and then my wrist just gets very weak. It makes sense, since the median nerve is likely inflamed and enlarged in the tunnel. Do you recommend I see a specialist for a better diagnosis? My chiropractor has been pretty helpful, usually with adjustments targeting my thoracic section.

qtrollip wrote:
For CTS some stretches, night splint etc can help but if really bad would probably require surgery (which is not very invasive).
I would not however recommend surgery for TOS, try to manage this conservatively.

PS. Do you get burning at night in the part of your hand as I mentioned above, what type of work do you do, any previous wrist/elbow/hand or neck injuries or problems?
I do wear a splint at night when my symptoms return. Maybe I should just wear it every night regardless. It was only really bad, with a painful burning sensation, one time in my life. I don't think I'm at the point where I need surgery. I'm normally pretty good at managing the symptoms through stretches, but with climbing it takes a few days of no activity to calm the problem area (three fingers and wrist). Unfortunately I'm right-handed and that's where the issues are.
I am a high school mathematics teacher, and I spend a good deal of time on the computer every day. Grading requires hunching over, which is great for your thoracic region, naturally.

I don't like waiting a few days, but I always take at least a one-day break between days that I climb. I wish I didn't feel like I can't improve my climbing endurance because of this. Frown

You should see a neurologist and ask about your options. I used to have chronic CTS, and when I went in I was told mine was bad enough that if left untreated I would have permanent nerve damage, including loss of grip strength and sensitivity, in my hands. Two years out from the surgery I am symptom free.


qtrollip


Jun 25, 2011, 8:53 PM
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Re: [tj2870] Dealing with Carpal Tunnel Syndrome (CTS) [In reply to]
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@tj2870
Yes it fits in with a median nerve irritation, as you say the irritation is at the wrist which would make this CTS.
It sounds pretty bad though, so yes have it checked out again to see if surgery is indicated.
Depending on where you are, they may do nerve conduction studies to assess the degree of it.

In the mean time, do a lot of forearm stretches, pectoral stretches, and neck stretches.
Also look at your ergonomics at the computer, not only your spine but also your wrist. I suppose this is your mouse using wrist?
make sure the wrist is in neutral position (not flexed or extended) when using the mouse. You could use a mouse pad with a wrist support to prevent wrist extension while using the mouse. Neutral wrist would ensure more optimal range for the wrist extensors and flexors to work in. Also dont hold your shoulders next to your ears when on the computer.
Ice can help with pain relief.

But definitely have it checked out by the neurologist!!

Good luck.


geeyoupee


Jun 26, 2011, 12:55 AM
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Re: [tj2870] Dealing with Carpal Tunnel Syndrome (CTS) [In reply to]
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What about trying extensor workouts? I'm not sure if I had CTS but my wrist felt tight and numb. I would use a rubber bands to put around my finger and thumb and start opening my hand. I would also use my other hand to create resistance so that it would sort of work the same as the rubber band. Hopefully this makes sense. I use to also ride my bike with my hands upside down and my fingers on top of the handle bar. I this would give my forearms a burn while riding to class.


troutboy


Jun 27, 2011, 6:21 AM
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Re: [geeyoupee] Dealing with Carpal Tunnel Syndrome (CTS) [In reply to]
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You have two options, one will provide short term relief, the other will fix the problem in about 45 minutes with a short recovery.

1) Ice. The CTS in my right hand never actually bothered me while climbing though, only after (although it was a bitch during more mundane tasks, like typping on a keyboard). But it was a bitch at night, especially after climbing, using a saw, or hammer - you get the drift. Lots of ice as soon as possible after the activity helped a lot. It was that or sleep with my arm hanging off the bed all night (I know you know what I mean).

2) Just have the damn surgery. Easy as pie. Symptom free as soon as you wake up, never tobe bothered by a numb hand again. Back to normal easy stuff in a few days, moderate activity in a couple weeks (easy climbing etc), Total strength regain in about 2 months.

Couple other thoughts:

1) You can do permanent damage to the nerve if you let this go too long.

2) The nerve conduction velocity test can, in some cases, be extremely painful. Google it and read a little, but don't let the internet testimonials scare you off from the surgery (which is quick and painless). My NCT involved little pain, only a little more than a regular shot. I could tell from how the procedure was done that a bad technician (it's actually really a neurologist doing it usually, not a "tech") could make it very painful, while a good one can make the procedure much less of a PIA. I would ask around for some recommendations and ask the person who had it done how painful they thought it was. If you are anywhere near Philly, I can give you a good recommendation.

Bottom line:
As severe as your symptoms are, def schedule the surgery ASAP. You won't believe the difference between before and after.

TS


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