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The human hand is uniquely designed to combine power with precision. The animal kingdom has nothing nearly as good for wielding weapons, handling tools, playing musical instruments, or creating art.
The star of the show in this design is the wrist. The intricate arrangement of the eight bones of the wrist (carpal bones) along with the associated ligaments, tendons, muscles, and nerves make the feats of the human hand possible.
When you look at the palm of your hand, you can notice that it is not completely flat. It has a slightly curved surface that begins at the wrist. This is because the wrist bones (carpals) form an arch, with a broad ligament creating a floor (or a ceiling, depending on which way you are holding your hand). This results in a tunnel – the carpal tunnel. This tunnel is a passageway for tendons, blood vessels, and nerves.
As well-designed as the wrist is, we often ask too much of it. The intense personal peril of hand-to-hand combat is different from the high stakes tension of the military drone pilot remotely controlling his or her vehicle. As different as these situations are, they can both lead to wear and tear on the muscles and tendons (strain), injury to the joints and ligaments (sprain), and crowding of the nerves passing through the carpal tunnel and other regions of the wrist.
The same is true of many activities shared by the military and civilian worlds. A slip-and-fall injury on an outstretched hand, an awkward lift of heavy gear, long periods of woodworking, mousing, typing, and writing are just a few examples of how we place excessive demands on the wrist.
Self-Care: Reduce Over-Use and Compression
Frequent breaks when doing wrist-intensive work is wise. Supporting the wrists with elastic braces can help as well. As every boxer knows, taping the wrists before subjecting them to fast, heavy impact is mandatory.
Some people push off with their hands to rise from a sitting to a standing position. This compresses your wrists. If you have a lower body injury, pushing off with your hands may be unavoidable, but if it is a habit, change your action to use your leg muscles as much as possible.
Self-Care: Strengthen and Decompress
If compressing your wrists is harmful, decompressing them while strengthening them is helpful. One way of achieving this is to stand or sit while holding a weight in each hand. These can be quite light at first. In fact, if you have been recently injured or if you are badly deconditioned, start with a pair of one-pound bags of beans.
Hold the weights with your arms at your sides, using a strong enough grip to prevent them from slipping out of your hands, but not much stronger than that. Curl your wrists toward your palm, then towards the back of your hand, then towards your thumb, then towards your little finger. That’s one repetition. When a 20-rep session feels too easy, increase the weight.
Free the Joints to Free the Nerves
When wrist bones are stuck in misalignment, a chiropractic adjustment can often help free their motion. This is very helpful for the wrist’s “machinery”. In addition this machinery, doctors of chiropractic are concerned with the nerves from the cervical spine and upper back that supply the wrist – the “circuitry”. Adjustments to these areas of the spine as well as the shoulder and elbow may be necessary to reduce irritation to the nerves serving the complex machinery of the wrist. The importance of this multi-pronged approach has been long recognized and is discussed in several research papers.
About the Author
While serving as a medical specialist (MOS 91-B) in the U.S. Army Reserve, Dr. Masarsky earned his Doctor of Chiropractic degree from New York Chiropractic College in 1981. He is in the private practice of chiropractic in the Virginia suburbs of Washington DC with his wife and partner, Dr. Marion Todres-Masarsky. Visit his practice’s website: www.viennachiropractic.com.
Sources Consulted for this Article:
Taylor D. Management of Carpal Tunnel Syndrome with Conservative Multimodal Therapy: a prospective case series of outcomes with concurrent wrist and cervical manipulation. J Clin Chiropr. 2019;2(1):123-130. https://journal.parker.edu/article/78069-management-of-carpal-tunnel-syndrome-with-conservative-multimodal-therapy-a-prospective-case-series-of-outcomes-with-concurrent-wrist-and-cervical-ma
Valente R, Gibson H. Chiropractic manipulation in carpal tunnel syndrome. J Manipulative Physiol Ther. 1994 May;17(4):246-9. https://www.ncbi.nlm.nih.gov/pubmed/8046280
Mariano KA, McDougle MA, Tanksley GW. Double crush syndrome: chiropractic care of an entrapment neuropathy. J Manipulative Physiol Ther. 1991 May;14(4):262-5. https://www.ncbi.nlm.nih.gov/pubmed/2066684
