Preventing Carpal Tunnel Syndrome

*IMPORTANT NOTE: The information that is contained in this post is for informational and educational purposes and should not be used as a method of diagnosis. It is pertinent that if you are experiencing and signs or symptoms of an injury or illness that you seek medical attention from a medical professional.*

By Haylesh Patel, Esports Exercise Physiologist - UCI Esports

Even with the sedentary nature of gaming and the low impact on the body as a whole it does not leave the body immune to injury.  The most common area which is reported for discomfort and pain tends to be the forearms, hands, and wrist.  There are other areas of the body such as the lower back, neck and hips that are also reported as areas of concern too.  For today, we will focus specifically on the hand/wrist area, the carpal tunnel.

Before we dive into how you can prevent the development of carpal tunnel syndrome (CTS) or other hand/wrist injuries, let us zoom in on the wrist area and see what is going on there.

Carpal tunnel is a space in between the carpal bones of your wrist. Your tendons and nerves run through this passage.  One way I like to think of this like a fiber optic cable.  There are many individual tendons feeding through here which connect your fingers with the muscle further up in the forearm (see figure 1).  There is only limited space within the passage so if there happens to be any type of narrowing, caused by inflammation or trauma, then that is when things can become compressed, rubbing against each other and restricting the free flowing movement. When there is inflammation in the area, compression can occur upon the median nerve and tendons and lead to sensations of pain, weakness, numbness, burning, tingling or any combination of these symptoms.

Figure 1. Overview of tendon organization through wrist and hand. Image source: clevelandclinic.org

Figure 1. Overview of tendon organization through wrist and hand. Image source: clevelandclinic.org

What causes it?

The cause of carpal tunnel syndrome is nonspecific. It is generally due to overuse, continual repetitive motion, trauma/injury to the wrist, or even the associated side effects of fluid retention from being pregnant.

Diagnosis

If you suspect that you may have carpal tunnel syndrome it is vital that you get it diagnosed by a medical professional. This will enable you to get on to the right treatment modality and path as quickly as possible to reduce the damage to the median nerve.  A doctor will generally perform a physical exam and have some image work completed (x-ray, ultrasound) so that they can build a good picture of what is going on in the wrist/hands and finger region. They will then provide an appropriate treatment method based on the results.

What are the treatment options?

There are two options, non-surgical or surgical

Non-surgical

  • Reducing or eliminating activities that provoke symptoms throughout the day
  • Medication - to reduce pain and swelling (anti-inflammatory drugs, steroids)
  • Bracing/support - using a bandage, splint, or some other device to provide support, rigidity and reduce the load upon the structure is common
  • R.I.C.E. (rest, ice, compression, elevation) (see figure 2)
Figure 2. The R.I.C.E method for treating injuries. Image source: https://wvorthocenter.com/

Figure 2. The R.I.C.E method for treating injuries. Image source: https://wvorthocenter.com/

Surgical

Carpal tunnel release is the most common method of surgical treatment. We will not go into details, but the basis of it is that a surgeon will cut the carpal tunnel ligament (see figure 1) that lays across the wrist, holding the median nerve and tendons in that area. This increases the space within the carpal tunnel, reducing the pressures within this area, allowing freer movement of tendons and ligaments.

Prevention

Stretching is great for not only your wrist but the entire body.  There are specific stretches for the hands, wrist and forearms that can help to maintain the flexibility and movement within these structures.

Ergonomics is the way in which we interact and apply forces from our body to tools and devices that we interact with throughout our daily lives or during work activities. Inefficient and awkward positions can lead to the development of maladaptive movements to compensate for this movement and force the body to adapt to this new movement.  Ultimately, leading to pain, inflammation and potentially injury.

Taking frequent breaks from activities that are known to load these structures is important. In the same instance that we cannot just jump out of bed and run and then continue to run all day, every day. The same goes for the use of our hands, wrists, and forearms.  We need to allow them time to relax, recover, and adapt to the stimulus that we are applying to it.  Also, taking frequent breaks can also help negate the negative side effects of prolonged sitting upon the body.

Creating a pre-game routine

When it comes to esports and gaming specifically, there are deliberate activities that we can perform or not perform that will help us to perform at our optimal level of operation. Once thing that I work on with all my esports and gaming clients is to create a routine. This routine is performed prior to playing and after a gaming session.

Different components are included in the routine, these include, WARMING UP the structures with mobility exercises or general physical movement. STRETCHING of not only the wrist and forearms but also the surrounding structures, fingers, shoulders, neck, chest and back. Checking your POSTURE/ERGONOMIC setup before playing is also a key aspect. Lastly, COOLING DOWN after you finish playing with some light stretching.

There are numerous resources out there on the internet, YouTube videos, infographics, and tutorials that all basically cover all the same things. It comes down to looking at that information, picking out items/movements and tasks that you like and creating your own personal routine to carry out. We are all unique and one approach will work for some people but not for others.  That is why I highly encourage making your own specific routine.

Here are a couple of resources to get you started with creating your own personal gaming routine.

Ergonomics

Check out this video for some simple tips on how to set up your computer/workstation ergonomically: LINK

Wrist care guide

Take a look at the details and stretching in this wrist care guide: LINK

The warmup exercises and stretches specifically target the key areas that are known to be areas of concern for gamers and serious esports competitors.

Ultimately, none of us are immune to injury or illness, however, we can take steps to help take care of our bodies, physically and mentally.  Being aware of potential activities or actions that may cause injury in the future, can allow us to be prepared and create strategies that work for us to optimize our performance, reducing the incidence of injury.  These deliberate activities will help enable us to be able to perform our desired activities as long as we want and as often as we want.

Stay active and healthy.

About Haylesh Patel

Haylesh is a Clinical Exercise Physiologist, which basically means he has a wide knowledge base and understanding of what happens to body during various states of physical activity in different environments and knows how to get the maximum potential from the body.

Haylesh has been fortunate to have experience working with a wide variety of people from diverse backgrounds and different physical starting points. Prior to moving to California, Haylesh worked for 4 years in a health and performance clinic where he provided strength and conditioning, rehabilitation and other exercise related services to clinical populations (cardiac, neurological, musculoskeletal), elite athletes and the general public looking to get healthy and improve their overall fitness. He has experience working with a whole spectrum of clients from providing youth conditioning for aspiring future athletes through to helping a 91 year old who is looking to maintain their health and fitness.