Treating Carpal Tunnel Syndrome with Active Release – Part 2

Find the exact site of entrapment

Finding the exact site of median nerve entrapment is very important if you are going to resolve CTS. To do this, the practitioner must take a complete history and perform an orthopedic and neurological examination looking for indications of the exact site of entrapment.

One of the most important aspects of the examination will be a hands-on examination at sites of possible nerve entrapment. It is only with the tactile sensitivity of the practitioner’s hands that changes in tissue texture, tissue tension or abnormal tissue movements will be discovered. 

This hands-on examination is essential in discovering all the sites that need to be released.

It is not uncommon for patients to come into our clinic with a diagnosis of CTS (median nerve entrapment), yet have symptoms of either radial or ulnar nerve entrapment. This is because physicians do not always perform a complete examination while paying attention to the symptom patterns.

• Median nerve entrapment patterns have definitive symptoms, as do radial and ulnar nerve entrapments.

Once the areas of restriction have been located, Active Release Techniques procedures are implemented to release the area of nerve entrapment. The actual ART procedures practitioners use will vary depending on location. The basic concept of these procedures sounds quite easy to perform. ART is essentially a process of taking the affected structure from a shortened to a lengthened position with the assistance of patient motion. In reality, getting results from these procedures take a considerable amount of experience and know-how from the practitioner.

That is why it is essential to find an ART practitioner who has not only taken the upper extremity ART protocols, but has also kept up their certification. Certification in “Long Tract Nerve Entrapment Courses” would also be a great asset.

Unfortunately, it is not uncommon to have patients presenting to our clinic with a chronic case of CTS who tell me nothing they have tried has worked, including ART treatments. In many of these cases these individuals have been treated by practitioners who have never taken an upper extremity course, and have not kept current with their ART certification. You can check for current certification at www.activerelease.com .

For more information about our publications go to www.releaseyourbody.com. 

Part 3 of this Blog covers “Treatment Expectations”.

If you would like to more information or to purchase our books please go to www.releaseyourbody.com . 

If you would like information about our clinic in Calgary Alberta please go to www.kinetichealth.ca.

(COPYRIGHT KINETIC HEALTH 2012 – ALL RIGHTS RESERVED)

Treating Carpal Tunnel Syndrome with ART

Active Release Techniques (ART) can be very successful at treating Carpal Tunnel Syndrome (CTS) because of its ability to find specific tissues that are restricted, and physically work them back to the normal texture and tension. It can also use hands-on techniques to release the median nerve from muscles, tendons, ligaments or connective structures that are causing the nerve compression syndrome.

It is essential that these procedures are implemented as soon as possible to avoid permanent damage. Nerve compression associated with a Carpal Tunnel Syndrome can cause several physiological changes to the median nerve especially if this compression is left for long periods of time. Some of these physiological changes are:

o Microvascular (ischemic) changes – Ischemic changes refer to a decrease in the blood supply to the nerve which decreases oxygen supply and vital nutrients getting to the nerve.

o Myelin sheath injury – Myelin is an electrically-insulating layer that surrounds the nerves that aids in nerve transmission. Decreased nerve transmission means decreased function.

o Demyelination – This refers to loss of the myelin covering of nerve fibers which results in their impaired function. Chronic cases of nerve compression can cause Wallerian degeneration. Wallerian degeneration is the process of degeneration of the nerve. Wallerian degeneration is also where permanent fibrotic changes can prevent reinnervation and restoration of nerve function. Reinnervation is the process that occurs when a nerve dies and a nearby nerve grows a new connection (new axon) to the affected muscle in order to take over the function of the dead nerve.

Nerve Entrapment Syndromes: James S Harrop, MD, Hanna, MD, Dachling Pang, MD, FRCS(C), Kamran Sahrakar, MD, http://emedicine.medscape.com/article/249784-overview

In Part 2 of this Blog we will cover “Finding the exact site of entrapment”.

If you would like more information or to purchase our books please go to www.releaseyourbody.com . 

If you would like information about our clinic in Calgary Alberta please go to www.kinetichealth.ca.

(COPYRIGHT KINETIC HEALTH 2012 – ALL RIGHTS RESERVED)