138: Carpal Tunnel Crash Course (with Whitney Lowe & Til Luchau)

Carpal tunnel syndrome is one of the most common nerve compression issues—but how can massage and manual therapy help? In this in-depth episode, Whitney Lowe and Til Luchau break down the anatomy, risk factors, and assessment strategies for carpal tunnel syndrome, exploring its causes, differential diagnosis, and effective hands-on approaches. They discuss the importance of nerve mobility, client education, and activity modifications to relieve symptoms and improve function.

Whether you’re a hands-on therapist looking to refine your treatment strategies, or someone experiencing wrist and hand discomfort, this episode offers valuable insights into understanding and managing carpal tunnel syndrome.

🌟 Highlights:

•Carpal Tunnel Basics (02:50) – Understanding the anatomy and mechanics of nerve compression.

•Risk Factors (04:00) – Why some people are more prone to carpal tunnel syndrome.

•Differential Diagnosis (12:00) – How to distinguish carpal tunnel from other nerve compression issues.

•Assessment Questions and Tests (13:40) – Key evaluation techniques to identify carpal tunnel syndrome.

•Nerve Fiber Distribution and Symptom Progression (18:30) – How symptoms develop and why sensory signs appear first.

•Soft Tissue Goals (21:40) – The role of manual therapy in relieving pressure and improving mobility.

•Activity Modification and Client Education (31:30) – Helping clients make lasting changes to prevent symptom recurrence.

•Night Splinting and Nerve Healing (38:00) – How positioning at night can aid recovery.

•Nerve Gliding and Neurodynamics (43:50) – Gentle movement strategies to improve nerve function.

•Massage and Manual Therapy Outcomes (54:10) – Research-backed benefits of hands-on treatment.

💡 Join the Conversation: Have experience working with carpal tunnel syndrome or dealing with it yourself? Share your story with us!

📌 Sponsored by: ABMP and Books of Discovery

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Episode image ©Primal Pictures, used by permission.

📄 Get the full transcript at Til or Whitney's sites! 

• Whitney Lowe’s site: AcademyOfClinicalMassage.com 
• Til Luchau’s site: Advanced-Trainings.com 

Resources mentioned in this episode:

• Til's carpal tunnel ball technique: Advanced Myofascial Techniques, volume 1

• Research into massage and manual therapy's effectiveness with CTS:

• 1. Reduction of Pain and Symptoms

  •Massage Therapy: A 2013 study evaluated the efficacy of massage therapy as a treatment for carpal tunnel syndrome (CTS), finding it beneficial in reducing pain and improving function.

  https://pubmed.ncbi.nlm.nih.gov/23768278

  •Manual Therapy: A 2021 systematic review and meta-analysis assessed the effectiveness of manual therapy on pain and physical function in CTS patients, concluding that manual therapy can significantly reduce pain intensity and improve hand function.

  https://link.springer.com/article/10.1007/s00264-021-05272-2

• 2. Improvement in Median Nerve Function

  •A 2017 systematic review analyzed the effectiveness of nerve gliding exercises on CTS, indicating imp