Preventing and healing*
Carpal Tunnel Syndrome
& Repetitive Stress Injuries

by Ellen Serber,
illustrations by Daniel Will-Harris 

Carpal tunnel syndrome and repetitive stress disorders are preventable. The best possible scenario is never to develop symptoms, to work  intelligently and to respect your body's needs. But if trouble does begin it is extremely important to act immediately, before the symptoms become a big problem. Pain and burning are the #1 indicators that something is wrong. The  discomfort and pain can be in your fingers, hand, wrist, forearm, elbow, shoulder, neck, upper back or lower back. It is much better to take these preventative steps while you are pain-free, instead of waiting for major dysfunction. And if  you are experiencing symptoms, you should see a health care professional immediately. 

Checklist for Prevention:

The most important thing to do is to  get up from your desk and move around every 1/2 hour. Take your eyes off your computer screen and gaze into the far distance. Drink a glass of water. Some computers  have alarm clock functions which can be set to remind you to get up. If you don't have such a function there are shareware programs you can download which will act as a timer (there are many to choose from, go to www.shareware.com and search for "timer" and you'll see a large selection of free timers you can run on your computer).  

 Stay aware of your posture while you are sitting at your desk working and observe your attitude about task completion. It is as important to take care of the "tool", your body, as the task.

Do not eat your lunch at your desk. During your lunch break do an activity that involves physical exercise: walking, go to the gym, shopping.

Include full body stretches in  your daily activity, emphasize the upper body. Stretch before you go to sleep at night.

Observe your sleeping position. Don't curl up your wrists or put your arm under your head when sleeping on your side.  Make sure that you have the right pillow height for sleeping. The neck should be supported, but too many pillows will create problems as well. You want the head to rest comfortably. The neck should be in line with the rest of the spine.

Check that your work station is set up correctly. Monitor screen should be eye level or below eye level. New keyboards and mouse designs can help prevent strain. (See SoreHand for suggestions.)

Develop an exercise program that includes upper body strength, so that you can sit comfortably in an upright  position without slouching. The program must also include exercise for flexibility, to stretch out the contracted muscles of the wrist, arm, shoulder, neck and upper back. 

If pain persists, go to a competent health-care professional who is experienced in treating carpal tunnel and repetitive stress disorders.

Exercises

Here are some yoga-based exercises which you can do in the  office during the course of the day to help prevent carpal tunnel and repetitive stress injuries. Hold the positions for a few breaths and let the stretch increase but do not force it. The most important part of each exercise is to become  aware of your body and your breathe.

1. Full body stretch at the wall & Stretching the shoulders

Stand up facing the wall and reach your fingers up as far as you can. While you stretch up also stretch down by placing your feet firmly into the floor. Firm up your legs, extend the side of the  torso and bring the shoulder blades towards the wall. Breathe fully as you stretch, walking your fingers up the wall.

Move little away from the wall so that your torso is diagonal to your hips and press both palms into the wall equally. Press into the ground with your feet, firm up your legs and  release your tailbone away from the wall. Lift up the ribs and let your head drop slightly. You can also do this with the back of a chair. Place your hands on the chair and walk back until your torso is extended parallel with the  floor. Firm up the legs, lift up your abdominal muscles and lift the ribs while releasing the spine, tailbone away from the chair and top of the spine towards it.

2. Forearm
and wrist

Place the right palm at the wall, spreading your fingers equally. Extend your elbow and  press the palm fully into the wall. Wait a few breaths and then turn your head to the left, bringing the tip of the right shoulder blade in towards the front of your body. Hold and breathe.

3. Extended full body stretch

Take your arms out to the sides with the palms facing down. Extend your fingers and  stretch through the elbows. On an exhale rotate your shoulders back and bring the palms facing up.

On your next exhale bring the arms up  overhead with the palms facing each other. Again, press the feet into the floor and firm up your legs, stretch the side torso.  After a few breaths, interlock your fingers and press the palms up to the ceiling, stretching the  fingers and palm open.  Hold this stretch and then, on an exhale, curve to the side . Repeat on the other side. This can also be done seated at your desk. If you are seated, make sure to press the thigh bones deeply  into your chair as you stretch up.

 4. Sitting posture

Practice sitting with an upright torso, the sides of the torso extending and the head resting comfortably on the neck. Bring  your hands down to the seat of the chair and roll the shoulders back, bringing the shoulder blades into the back.

Some of the following poses can  be done either standing or sitting. If you are seated, move forward on your chair and place your feet firmly in the ground, press your thigh bones into the chair and extend your torso upwards with your shoulders  dropping down. If you are standing, remember to keep your feet planted firmly in the ground and your legs strong.

5. Opening the chest

Interlock your fingers behind your back with the palms facing the torso. Roll the shoulders back, but keep the ribs from poking forward. Stretch your  elbows and arms on the exhale and hold it for a few breaths. On the exhale, bend your elbows and bring your wrists to the right side waist, gently pressing the right elbow towards the left. Release and do the other side,  then repeat still again with the fingers interlocked with the opposite thumb on top.

6. Opening the mid-back

Hug your body, placing the right hand on your left shoulder and  left hand on your right shoulder. Breathe into the area between your shoulder blades. On the exhale, bring the lower arms perpendicular to the floor, the palms facing each other. Stretch the fingers up, and on the next  exhale, raise the elbows up to shoulder height. Hold for a few breaths and then repeat on the other side.

7. Releasing the neck

Shrug the shoulders high up to the ears and then release and drop. Repeat at least 3 times.

8. Releasing the side of the neck

Sit forward on the seat of your chair with your feet planted firmly in the floor.  With your right hand reach back to the seat back or the  rear of the seat itself. Extend the torso and drop the chin into the chest. Pull diagonally to the left and place your left hand on the right side of your head, gently pulling the head away from the right shoulder. Hold and breath,  stretching from the base of the skull to the shoulder. Repeat to the other side.

 9. Twisting the torso

With the feet planted firmly in the ground, and the thigh bones pressing into your chair, exhale and lift and turn the belly to the  right. Let your hands help you turn by pressing into the seat or the back of the chair. Gradually increase the twist and let your eye gaze turn to the right around your shoulder. Repeat to the other side. Remember to keep  breathing slowly and deeply as you twist.

10. Stretching forearms

Bring your palms together in front of your chest in a prayer position stretching all the fingers fully. Relax your shoulders. Slowly stretch the  heel of your palms down until they are the level of your wrists. If you can do this stretch without discomfort you can increase the stretch by moving the hands over to the right and holding for a few breaths. Repeat to the left.  Stretch slowly and carefully, observing the sensations of your forearm and wrist.

11. Stretching the wrist

Make fists of your hands and place them, thumb up, on the desk top . Support your lower arm on the desk. Slowly stretch the fist to the right, without  moving your lower arm, and then to the left.

Lift your arms off the desk top and make slow circles with your wrist, keeping your hands in closed fists. Circle both directions.

Release your fingers and place them, tips up, on the edge of your desk. Press into the desk with the fingers. Try this first with the fingers together and then spread apart.

12. Stretching the fingers

Place the index finger on the edge of your desk, keeping your wrists straight. Gently push into  the desk and hold for a few breaths. Repeat with all the fingers except the thumb.

13. Stretching the thumb

Place your right palm on the desk top with your wrist straight. Relax all your fingers. With your left hand slowly stretch the right thumb away from  the forefinger. Hold for a few breaths and then release and do the other hand.

14. Shaking out tension

Shake out your wrists and arms, letting them dangle from your shoulders.

Rotate your shoulders
forward and back.

15. Relax the eyes and breathe

Turn your head right and left, looking into the far distance with your eye gaze. Close your eyes and take some deep, slow breaths with your belly soft.

Resources:

Sorehand, from the University of California at San Francisco is one of the best resources on the web for those suffering from CTS and RSI.

For further information on yoga go to The Yoga Research Center

"Occupational Hazards", MacWorld Magazine, November, 1998, by  Franklin N. Tessler, M.D.

"Yoga-Based Intervention for Carpal Tunnel Syndrome" Journal of American Medical Association, November 11, 1998-Vol.280, No.18

Conquering Carpal Tunnel Syndrome, Sharon J. Butler (New Harbinger Publications, Oakland, Ca. 1996) ISBN 1572240393

Life is a Stretch, Easy Yoga, Anytime, Anywhere, Elise Browning Miller and Carol Blackman (Llewellyn Publications, St. Paul, MN. 1999) ISBN 1567180671

How to Use Yoga: A Step-by-Step Guide to the Iyengar Method of Yoga for Relaxation, Health and Well-Being, Mira Mehta  (Smithmark. New York, NY, 1994) ISBN 0962713864

Back Care Basics. Mary Pullig Schatz, M.D. (Rodmell Press, Rodmell Press, Berkeley, Ca. 1992) ISBN 0962713821

Repeptitive Stain Injury, A Complete User's Guide. Emile Pascarellii, M.D. and Deborah Quilter (John Wiley & Sons, 1994) ISBN 0471595330

Repetitive Strain Injury Sourcebook, Sandra Pettie (Lowell House, 1997)  ISBN 1565657918

End Your Carpal Tunnel Pain Without Surgery, Kate Montgomery (Rutledge Press, 1998) ISBN 1558535918

Thanks to Amy Schiftman, P.T. for her helpful suggestions.

* The fine print: These exercises are suggested exercises which may help prevent and heal CTS and RSI. But if you are experiencing any symptoms, such as pain or burning in your hands, wrists or forearms, you should give your hands a rest and see a health professional before attempting these exercises. And while these exercises may be helpful, they are no substitute for personal care from your doctor, chiropractor, acupuncturist or other professional. Our lawyers tell us we need to say that these exercises are provided as-is, with no warranties expressed or implied.

Ellen Serber is a yoga teacher, certified in the Iyengar tradition and a Tai Chi Chu'an teacher, certified by Sifu Kuo Lien Ying.   She has been teaching in Northern California since 1970.  Her writing has appeared in Somatics, Yoga Journal and International Journal of Yoga Therapy.  She can be contacted via email.

Daniel Will-Harris is the editor of eFuse.com. He is a writer and designer whose work can be found at his Web site. His site features TypoFile Magazine and EsperFonto, the Web's only typeface selection system. He may be reached via e-mail at daniel@will-harris.com.

Desktop Yoga
RSI & Carpal Tunnel

(c) 1999, Ellen Serber & Daniel Will-Harris, all rights reserved. No portion of this may be duplicated without express written permission. For permission, please email Daniel Will-Harris