What is Carpal Tunnel Syndrome?

What is Carpal Tunnel Syndrome (CTS)? It is something that most of us have heard of or even suffered with. Commonly found in people using computers and other repetitive actions like playing an instrument; CTS can prevent us carrying out even the most simplest of tasks because of the pain and stiffness this condition can cause in the hand, wrist and forearm.

Symptoms –  CTS can affect both wrists but usually the in the more dominant hand. There is local pain at the wrist but also in the hand, forearm and elbow in the later stages of the condition. Movement of the wrist can be limited by pain, swelling due to pressure on the median nerve and hypertonicity (muscle tightness) of the forearm flexors through overuse. Pain can be experienced at night. Pins & needles, tingling and numbness can be experienced in the thumb and first two and half fingers with some sufferers experiencing weakness in the thumb and weakness in their grip.

What is the carpal tunnel? – The carpal tunnel is a fibrosseous canal formed by the carpal bones of the hand covered by a dense fibrous band attaching two carpal bones on the ulnar side of the wrist and two carpal bones on the radial side of the wrist. The structures that feed through the carpal tunnel are the median nerve and a number of muscle tendons and ligaments making it a tightly packed area of the wrist.

Compression of the median nerve generally occurs in two ways:

  • The size of the carpal tunnel decreases – for example, rheumatoid arthritis can result in changes to the carpal bones leading to an increase in fluid in the tunnel.
  • The contents of the carpal tunnel increases in size – thickening of the tendons, swelling.

It is not usual for both causes to occur at the same time.

Causes – CTS is thought to be caused by the compression of the median nerve in the wrist. It is related to highly repetitive flexion and extension actions of the wrist which can affect those working in repetitive action jobs. Other conditions can cause CTS such as diabetes, pregnancy, hypothyroidism (under active) and menopause but it is also thought to be genetically linked i.e. a parent or close relative can also suffer from the condition. The overuse of the arm flexors and extensors can cause swelling due to the thickening of the tendons in the wrist reducing the size of the carpal tunnel which is thought to be a common cause of the compression of the median nerve.

Prognosis – Medical intervention is necessary for the longer term treatment of carpal tunnel syndrome. Medical treatment may include splinting of the wrist with it being held in a neutral position at night to prevent the wrist being flexed. This prevents further compression of the carpal tunnel. Oral anti-inflammatories and even steroid injections are prescribed but these are not suitable for a long term treatment, only giving temporary relief from pain. Surgery can be done on more severe cases where the ligament/s are cut to take the pressure off the median nerve which has a good success rate. According to patient.co.uk, 1 in 4 cases eventually go away without treatment within a year for mild cases.

Can remedial massage help? – Massage therapy can help reducing local oedema (water retention), reduce hypertension (tightness) in the muscles of the forearm working on trigger points if found which can contribute to the pain of this condition. With the help of the therapist, massage can help bring the client’s awareness to the proper biomechanics of the wrist and arm. Causes of the condition should be taken into consideration as this will determine the treatment. Working on fascial restrictions can help with range of movement of the wrist and it is thought that massage works most effectively on CTS caused by overuse or repetitive activity.

What else can be done to help / prevent CTS? – It’s essential to learn correct posture when preforming activities that aggravate the condition. Computer workers need to keep their wrists in a neutral position so should have their work stations assessed to ensure they are sitting correctly and have a wrist support for their keyboard. Ideally arms should be supported by arm rests on a chair and a computer mouse should also be positioned so the wrist is kept in a neutral position. Whatever the task / job that is aggravating the condition, it would be essential to take regular rest periods throughout the day.

It would also be beneficial to ice the affected wrist/s frequently. Stretching of the forearm flexors often will keep the wrist movement freer. Likewise, stretching the forearm extensors is equally important. Once wrist movement has improved then the next step is strengthening exercises for the forearms once a day. Elastic bands can be useful to strengthen the thenar (heel of thumb) muscles by placing it around the thumb and fingers. This works using resistance by gently opening and closing the thumb and fingers.

If you have suffered with this condition and recovered from it, please do share your experience of what worked or didn’t work for you.

Source: http://Patient.co.uk, Clinical Massage Therapy, 2000, F. Rattray & L. Ludwig



My tips for preventing / fighting the common cold

Tea with honey, lemon and ginger I wanted to share with you my tips for preventing / fighting the common   cold. We’ve got to that time of year when the bugs are out in full force but   in my job as a self-employed massage therapist, I just cannot afford to    get ill – I don’t work, I don’t get paid! So these are some things I do  to reduce the risk of getting ill but if I do get ill then some of these actions  are a must for me:

  •  Allicin Max garlic powder capsules – I’m not getting any kind of  kick back from this company but it is my number one natural remedy to  take if I’m feeling ill. I always have these in my cupboard. As soon as I get  that itchy throat feeling I take 6 capsules. Yes 6!!! The company advises  up to 10 a day. I have found that it stops my cold from coming out. I take  two a day throughout the winter as a preventative. This is a British made  product which they claim ‘is the only supplement to provide the body  directly with real allicin, extracted from garlic.’ Check out their website    for more information allicinmax.com or email them at  info@allicinmax.com
  • Echinacea – you can get this in most pharmacies and health shops now and it’s become a popular remedy used for boosting the immune system. You can get it in tablet, liquid and spray form. The idea is to start taking it at the start of the winter season when colds are more prevalent but you can also take it at the start of a cold which will hopefully cut it short. I take it in tablet form and I also have a throat spray containing echinacea which I use just when I get a sore throat.
  • Honey, fresh lemon & fresh ginger – If my throat is sore, making a tea from these ingredients really helps soothe my throat. If I have Manuka honey in the cupboard, I take a spoonful straight on the tongue and swallow it as it has fantastic antiseptic properties.
  • Rest, rest and more rest – I can’t say it enough. Your body needs time to recover. As much as it pains me to have to turn down or cancel my clients but if I get ill, that is exactly what I will do. Why? Because I don’t want to pass on whatever I’ve got and I cannot give my 100% best effort when I’m ill and this isn’t fair on you, the paying client. Getting plenty of rest WILL speed up your recovery. But during the winter months listen to your body and if you’re beginning to feel run down, take a break, take a day off and just chill.
  • Plenty of fluids – hot drinks, mainly herbal teas when I’m not feeling well. It also helps to flush out your system and keep hydrated, keeping those headaches away.
  • Avoid dairy – I avoid this like the plague if I have a bad cold – it just produces more phlegm which you don’t want to do when your body is producing enough of the stuff anyway when you have a cold!! This will help your poor sinuses from getting too blocked and painful.
  • Olbas oil – my sinuses get really sore when they’re congested but I hate taking decongestant tablets because they just make me feel sick. I put a few drops of olbas oil on a tissue and breathe in the fumes through my nose which helps soothe my sinuses.
  • Use cotton hankies – I mean the ones your nan used to give you for your birthday!! I find these are far less drying on your skin and I never get that horrible flaky skin round my nose after a heavy cold.

I’d love to hear about remedies and things you do for treating or avoiding colds so please share with me!

Don’t think you’re active enough to try sports massage? Think again

Sport & remedial massage for twitterDon’t think you’re active enough to try sports massage? Think again. This is not an elite therapy for the athlete, footballer or regular gym user. Far from it. Neither is it going to be a jaw-clenching, painful massage being bruised and battered by your therapist. I can’t speak for others but that’s certainly not how I operate!

Having recently qualified in a Diploma in Sport & Remedial Massage from the long established (25 years long!) London School of Sports Massage after a year of hard slog and two nerve wracking exams, lot’s of people have asked me ‘So what are you going to do now? Try and work at a sports club or gym?’ Of course I’m keen to start working with more ‘sporty’ people and I have a link with a very good personal training gym (My PT Studio) in Croydon but I have helped plenty of non-sporty people using these fantastic techniques I have learnt in the last 12 months. The sort of non-sporty people who don’t do any exercise or maybe walk the dog everyday but don’t go to the gym – ever. I have treated people with symptoms of tennis elbow who haven’t been near a tennis racket!

The problem is, we are all prone to postural imbalances which occurs through how we use our bodies on a daily basis. Occupational habits can cause muscle overuse and strains in muscles which may manifest over a number of months compared to someone training for a marathon who pushes themselves too hard too quickly – can develop an injury in a number of days or weeks. Both suffer injury through bad postural habits or training techniques. Both qualify for remedial massage because it works directly on the problem area  – for the non-sporty, this could be tight neck and shoulders from sitting at a desk for long hours or in the case of the marathon runner, this could be knee pain they’ve suddenly developed through their IT band being too tight. Sport and remedial massage combines general and deep tissue massage with specific stretching and muscle contraction techniques to improve muscle health.

So, in answer to the question, I’m going to carry on doing what I’m doing; helping those in pain from injury, bad posture or over-doing it in the gym and I welcome more newcomers to my practice – the sporty and non-sporty alike!


Here’s 5 simple things you can do for better back health.

Woman sitting at desk with back acheDoes this picture look familiar to you? It’s a problem that most of us have at some point in our lives; we cause too much stress to our backs whether it be carrying heavy bags, carrying heavy toddlers or sitting for long periods hunched over a desk. According to a recent article published by the Daily Mail, these are some alarming facts they discovered about back pain:

  1. 4 in 5 adults suffer from back pain at some point.
  2. 100,000 people see their GPs every day about musculoskeletal problems, mainly low back pain.
  3. Back pain is more likely to affect those aged 30-50.
  4. 1 Briton in 6 blames their back pain on their office chair.
  5. Almost 31 million days of work were lost last year because of back, neck and muscle problems.
  6. Back pain is rising in young adults due to a more sedentary lifestyle.


So what can you do?
Here’s 5 simple things you can do for better back health:

  1. Take a Pilates class every week. I tell a lot of my clients to do this because Pilates helps strengthen the core muscles. The core is made up of some of the back extensor muscles, transverse abdominals and pelvic floor muscles. When these muscles are equally balanced then the core is strong and helps support our movements and posture. Quite often the abdominals are weak which leads to the back muscles being over-used and causing back pain. Check out Body Control Pilates to find a mat class near you.
  2. If you sit at a desk and use a computer, there are some simple things you can do to keep your back, neck and shoulders freer from tension:
    • Take regular breaks; stand up, walk around and stretch your legs.
    • Make sure your work station whether at home or at the office is correct for your posture.
    • Keep hydrated and keep a litre sized bottle of water on your desk and drink regularly from it. Once emptied, refill, aiming for 2 litres a day. Keeping the body hydrated will help stiff, sore muscles.
  3. Try the chair twist exercise to help mobilise and relax the spine: sit sideways on your chair with the chair back to your right. Feet are flat on the floor and knees in line with your hips. Grasp each side of the chair with a hand on each side and gently rotate your torso towards it, pushing the right hand away and pulling the left hand in towards you. Look over your right shoulder and hold the posture for 20-30 seconds, breathing freely. Repeat facing the other way. This is an easy exercise to do at work.
  4. Core strengthener: If you can’t get to a Pilates class, try this exercise at the office or at home while watching TV. Sit upright on your chair with the weight spread evenly on both feet on the floor. Without letting your pelvis tilt or your back slump, lift your right foot off the floor, bringing the thigh towards the torso and keeping the tummy muscles engaged. Pause, then lower and repeat with the left leg. Do this eight times on each side and don’t forget to breathe!
  5. Move your body! Even gentle exercise keeps your body toned, gets the blood pumping round the body and improves flexibility. A lot of back pain comes from being too sedentary so even a 30 minute walk everyday will help the body stay healthy.

P.S. Get yourself a regular massage too! There’s nothing like a good massage to really get into those tight shoulders and loosen up the back and neck. 

Thank you to Sam Murphy at The Guardian for chair twist and core strengthener exercises.

Massage, music & chat or massage in silence?

Do you prefer massage with music and chat or massage in silence? The reason I ask is I’ve had a few treatments over the years with a mixture of music, no music, a bit of chat and too much chat. Personally, I like a bit of background, relaxing music and a bit of a chat with my therapist. Massage is a personal experience and I like to know a bit about who’s treating me. That’s just my preference not necessarily what is right. For my clients I usually have relaxing music on in the background at a level that isn’t too intrusive but with new clients I always ask if they mind the music – I don’t think I’ve ever had one person say ‘no, turn it off’. I only talk to them if they initiate the conversation as I feel it’s important to give people their head space to unwind. Usually clients I know well start off chatty and then slowly become silent as they relax into the treatment. For those having deep tissue or remedial massage it’s less likely they’ll fall asleep as I am having to move them around the couch and ask for feedback about pressure etc.

But is it wrong for the therapist to talk throughout a treatment? Well I suppose it depends on the individual client but in my experience as the client, I do need time to switch off and relax even in a sports / remedial type massage. I like the music in the background as it stops me focusing on noises outside the room such as traffic noise or other people coming in and out of the clinic. But there are those clients who like to get things off their chests and is an essential part of their ‘healing process’ so I will discuss their issues to a degree.

But what sort of music should one play in a therapy room? Friends always laugh about the use of ‘whale song’ in spas but what’s wrong with whale song? I suppose it is a bit stereotypical but if it helps people relax then so what? There’s also the Cafe Del Mar and Buddha Bar collective which I favour – again, could be seen as typical chill out music or even better, there are CDs composed purely for relaxation and meditation. I like these because the music is calming and gentle and perfect for zoning-out.

I suppose in the end, us therapists need to treat each client as an individual –  ask what the client would prefer – back ground music or not; we need to sense whether our clients want to talk or not and be mindful of their emotional state. In the end, isn’t that what makes a great therapist, not just your hands-on skills?