​Carpal tunnel pain is a very common symptom and is characterized by pain and/or numbness and tingling in the wrist, hand, and fingers and is sometimes accompanied by loss of strength in the hand and wrist. The "carpal tunnel" is a narrow passageway on the palm side of the wrist through which the medial nerve and the 9 tendons that flex the fingers travel. The pain and numbness associated with carpal tunnel syndrome is caused by compression of the median nerve as it passes through the carpal tunnel. 

Carpal tunnel syndrome is often blamed on excessive use of a computer and/or mouse, using small hand-held tools, using vibrating hand tools, or repetitive flexing of the wrist such as assembly line work. Carpal tunnel syndrome is more common in women than men, can be caused by fluid retention as in pregnancy, or caused by inflammatory conditions. 

When dealing with carpal tunnel it's important to ask the right questions. Here are some of my favorites:

• Why do I only have carpal tunnel pain on one hand?
• Why do only some pregnant women get carpal tunnel syndrome?
• How come I didn't have any pain for 40 years but now I started having pain this year?
• If my carpal tunnel is small and that's the reason I have pain, wouldn't I have always had pain then?
• If computer use is to blame for the pain, how come it hurts more when I sleep than when I'm actually using the computer?
• If I have permanent nerve damage, how come the pain and weakness comes and goes?
• I understand corticosteroid injections might decrease the inflammation, but what is causing the inflammation in the first place?
• If I wear a wrist brace won't the muscles get weaker and lose flexibility over time and isn't that a bad thing for long-term health?
• The surgery cuts the transverse carpal ligament, but isn't that ligament important?
• Isn't the surgery only helping relieve the symptom and not addressing the cause of the pain and numbness?

When the shoulders move out of their design position and round forward, they cause internal rotation of the humerus and arm. Internal arm rotation creates a pronated hand position which deceased the efficiency of the elbow and wrist. Over time this shoulder, arm, and hand position can create stress and wear and tear on the elbow, wrist, and hand. 

We must remember that the human body works as a unit and the simple motion of picking something up with your hand or typing on a computer requires your hand, wrist, elbow, and shoulder to all work together. When the shoulder is out of proper position, it is unable to help and the workload of hand movements gets shifted to the elbow, wrist, and hand. Rounded shoulder posture causes carpal tunnel syndrome and can also cause tennis elbow, golfers elbow, basal joint arthritis, forward head posture, text neck, and even negatively affect your running performance.

As a Postural Alignment Specialist and Advanced Exercise Therapist, when working with a client with carpal tunnel syndrome I always move away from focusing on the symptom and take a step back and look at their entire body and movement patterns. When a client has carpal tunnel symptoms in the right hand it is often the case that their right shoulder will be more forward and down than the left. This forward rolled shoulder position limits the ability for the shoulder to help the elbow, wrist, and hand in every day movements like typing on a computer, holding a glass to drink out of, and carrying groceries. 

Now we also have to ask "why is one shoulder in a different position than the other shoulder?" Again the body is a unit and often if one hip is elevated or rotated compared to the other the upper body will compensate for this imbalance by pulling one shoulder down. Hip elevation or rotation is often caused by an inability of one hip to flex or extend during everyday movements like walking or sitting and standing out of a chair. ​

The key to figuring out what is causing your carpal tunnel syndrome is to do a full postural evaluation and some functional testing to see what your body is doing and why. After determining the postural imbalances and movement dysfunctions in your body, I am able to instruct you in the corrective exercises that will immediately start improving your postural alignment, movement patterns, and decreasing your pain. Contact me if you are interested in a free posture evaluation and consultation which can be done in my office in Portland or over Skype from anywhere in the world. 

Related articles/videos:
Thoracic kyphosis, sitting posture, and shoulder pain
How to fix neck and shoulder pain
Tennis elbow - why tennis isn't to blame
Why sitting is bad for you

As the video shows, high heels can cause all sorts of foot problems like calluses, corns, bunions, hammer toes, Achilles tendonitis, stress fractures, and nerve impingements. Beyond causing foot problems, high heels throw off the balance of the body as William Rossi famously explained with this graphic: 

As you can see elevating the heel causes changes at the ankle joint, knee joint, pelvis, lumbar spine, thoracic spine, cervical spine, shoulders, and head. These changes in position, pressure, and range of motion can cause knee joint osteoarthritis, lumbar stenosis, cervical disc herniations, among many other things. The infographic below helps explain how some of these issues are created:_

High heels may make your legs look longer, but fashion often comes with a physical price as explained in this article about Fashion and Foot Deformity. While there is little harm in wearing high heels on occasion, daily and prolonged use will result in changes to foot shape and function along with changes in your body posture and movement patterns. To prevent pain and disability, contact me today to get a personalized menu of posture exercises designed to counteract the harmful affects of high heel use. 

Related articles/videos:
How to fix knee pain with posture exercises
The power of the tower
How to fix neck and shoulder pain with Egoscue
Bunions - overlooking the obvious

We've seen articles that list the top surgeries to avoid before, but it's worth revisiting this latest list. 
On August 24th The Washington Post published an article by Consumer Reports titled: "If your doctor says you need surgery, you may want to explore other options." 

It listed four surgeries to avoid: knee surgery, carotid artery surgery, spinal fusion, and hysterectomy. Let's explore the two that have to do with posture and biomechanics.

1. Knee surgery, specifically arthroscopic surgery to trim or remove a torn meniscus. The article states it "is the most common orthopedic surgery in the United States. About 700,000 of the procedures are done each year, a 50 percent increase in the past 15 years. But research shows that it's often no better than physical therapy at easing symptoms." I have written about why meniscus surgery is often ineffective, what causes knee osteoarthritis, and how posture causes knee pain. Arthroscopic knee surgery is only treating the symptom of a torn meniscus but doesn't nothing about the underlying cause of the torn meniscus or pain. Correcting your posture will eliminate the cause of the torn meniscus and your pain while preventing future issues. Sounds like a win-win to me!
2. Spinal fusion to treat spinal stenosis. The articles states: "As we age, overgrowth of the bone surrounding the spinal canal can pinch nerves and cause a burning pain in your buttocks that radiates down your leg. A common treatment for that condition, called spinal stenosis, eases pressure by removing part of the bone and tissue." The problem with that statement is they are confusing correlation with causation. Aging does not cause spinal stenosis just because we see many older people develop it. The cause of spinal stenosis is something I have written about previously. The article continues: "Many surgeons combine that procedure, called laminectomy, with another one, called spinal fusion, which is meant to stabilize the spine. The number of fusion procedures jumped 67 percent among Medicare patients between 2001 and 2011. But for most people, there’s no evidence that adding fusion works better than performing laminectomy alone. Fusion also carries more risks and costs more." Both surgeries treat the symptom of bones spurs and growth around the spinal cord and nerves but doesn't nothing about the cause of the spurs - postural imbalances and improper movement patterns. The Consumer Reports article says: "There’s a good chance, in fact, that you don’t need any surgery. In a study published in April, patients who had physical therapy did as well as surgery patients." 

If you would like to see if you can avoid unnecessary surgery and would like to find out the underlying cause of your pain contact me today for a free posture evaluation and consultation. 

Related articles/videos:
Cause of back pain is never found in 85% of patients. Why?
Low back pain video
Egoscue and low back pain
Why runners don't get knee arthritis

While "text neck" is a catchy name, it could also be called "cell phone neck", "reading neck", "studying neck", "drawing neck", or simply "looking down too much neck". 

Yes, your neck is designed to look down - it's a normal human function - but problems arise when you look down for long periods of time without doing something to counter the cervical flexion. Young children (under 3 or 4 years old) naturally do this: they might be looking down for 5 minutes building legos or playing with some other small toy and then sensing that their body needs to change position, will jump up and run around, swing from their arms, reach for the sky and look up, anything that breaks the pattern of cervical flexion. It is a natural instinctual reaction that children have to vary their positions, movements, and focus. Most children as they grow older lose this natural and healthy instinctual sense, partially because adults introduce them to objects and activities that teach prolonged sitting and looking down including: 

• school - prolonged sitting still and looking down at a book, paper, or activity
• handheld video games - looking down at a small screen
• TV or video games - prolonged sitting still
• reading - looking down at a book for hours on end

None of these things are bad in and of themselves (I myself being a big fan of kids going to school and learning how to read and I personally love my cell phone), but when we do them for prolonged periods of time, without sufficient breaks and counter-acting activities, and when combined together they quickly break that instinctual sense to change position and move. 

This by the way, is a very old problem, as seen in these images from a book published in 1849: