Confessions of a barefoot failure


Me & Bobby McGee. Trying to solve the problem.

In early 2010, I drank the barefoot running Kool Aid. I’ve written about that part of the story before, but I’ll briefly review it for those of you who may not remember.

After reading the book Born to Run, I decided to start running barefoot on my treadmill. I felt good, so I bought some “Barefoot Shoes”. My knee pain went away, I started telling all of you to try it, blah, blah, blah. I tried to go from running as a heel striker to running as a mid-foot striker. It worked for about a year. And then some new injuries set in.

Last week (as I sit writing this) I spent Friday at my 1st grader’s field day. For those of you who don’t know, it’s like a kiddie Olympics held outside at school on a nice spring day. The kids do all sorts of things, like tug-of-war, throw the ball as far as you can, and a round-the–bases relay race.

The round-bases-race was interesting, because I got to watch kid after kid after kid run. As a student of running mechanics, it was quite enlightening.

After observing about 30 kids, I can tell you that only about 1 in thirty kids is a heel-striker. They’re almost all mid-foot strikers, and their feet are quick – touch down, pull up. They all looked smooth and efficient.

So why do the people who gather data on such matters say that about 75% of adult runners are heel strikers*? What happens? Should we all be mid-foot striking or do what comes naturally?(*reference- Foot Strike Patterns of Runners At the 15-Km Point During An Elite-Level Half Marathon HASEGAWA, HIROSHI; YAMAUCHI, TAKESHI; KRAEMER, WILLIAM J. Journal of Strength and Conditioning Research, August 2007 – Vol. 21 – Issue 3.)

The answer? I have no idea.

So I decided to go see expert running coach Bobby McGee for a 90 minute mechanics evaluation / lesson. Here’s what Bobby had to say (paraphrasing):

“For most runners, unless they want to be elite runners, it doesn’t make any sense at all to try to force a style of running. If you’re a heel striker, don’t try to force yourself to be a mid foot striker. If you are strong enough to run barefoot, great. But if you’re not, it’s a disaster waiting to happen.”

The conclusion – be who you are, and work to optimize the mechanics that you’re used to. So instead of forcing yourself out heel striking, work with it. Remember, we’re all individuals, and your unique running style is just that- yours. Don’t go changing for the sake of change. Like I did.

For the record, Bobby spent more time working on what my upper body was doing than he spent on my lower body. This made a huge difference. He also told me that my feet were not strong enough for running in so-called barefoot shoes. So there you go, I’m a barefoot failure. If you are serious about running, you might want to go spend 90 minutes with Bobby. He’s brilliant.

Low Back Pain or Hip Arthritis: Which One is it? How the Active Release doctors at Denver Chiropractic Center can help you

Low back pain (LBP) can have many causes. Our job is to identify the main pain generator(s) and manage the patient accordingly. This requires a careful history, examination, and a short trial of treatment with conservative methods, like Active Release Techniques Soft Tissue Treatment.

When first presenting for care, the patient tells us about their complaint in the history portion of our evaluation. Here, we not only ask about the main reason for their appointment or, what’s bothering them now but also their past history. We also discuss old injuries such as slips and falls, sports injuries that date back to high school, motor vehicle induced injuries, as well as family history (we ask if family members have or have had low back trouble since it’s been reported that there is a genetic link identified for osteoarthritis).

We also inquire about the patient’s current activity level and how well those activates are tolerated, often using tools completed by the patient that can be scored and compared periodically during care to track the benefits of treatment. When we finally return to the primary complaint history, we ask about the location, mechanism of injury, notable changes in the course of the condition, the onset date, pain related activities that increase or decrease pain, the quality of pain, radiation patterns, severity levels (such as a 0-10 scale), and timing issues such as, worse in the mornings vs. evenings.

When patients say, “…I have low back pain,” they may point to anywhere between the lower rib cage and their hip area. In other words, everyone interprets where their low back is located differently. So, when differentiating between low back pain and hip pain, one would think that the patient would either point to their low back or their hip, right? Well, where does hip osteoarthritis usually hurt? That’s what makes it so hard! The pain location can vary and move around in the same patient anywhere in the pelvic region including the groin (which is common), to the side of the pelvis, to the buttocks, the sacrum and in the low back.

To make it even more challenging, degenerative or injured disks in the lower lumbar spine can refer pain directly into the hip area and also create localized low back pain. In fact, patients often have BOTH conditions simultaneously. Usually, during examination, we move the hip in the socket and feel for reduced motion and watch for pain patterns in certain positions. When comparing the two sides, we both can feel, “…a difference between the two.”

The osteoarthritic (OA) hip is comparably more tight and painful with rotation movements. For example, the patient is seated with their leg crossed, trying to touch their knee to their opposite shoulder. In the OA hip patient, they may only be able to get it half way there compared to the other side and often complain of groin pain. The “ultimate test” is the x-ray that reveals the loss of the joint space – the “cartilage interval” – which narrows on the OA hip side.

How often is hip OA found? In a recent article, after reviewing 2000 patient files and 1000 x-rays of patients 40 years or older, 19% (~1 out of 5) demonstrated x-ray findings of hip OA. THAT’S A LOT!  At Denver Chiropractic Center, management of hip OA includes mobilization, manipulation, stretching the muscles surrounding the hip joint with Active Release Techniques, exercise/stretch instruction, nutritional strategies and others. If/when the time comes, we will help set up a referral to the orthopedic surgeon for joint replacement, as any “quarterback” of your care should.

In our experience, using Active Release Techniques to manages the soft tissues (muscles, tendons) that are associated with the hip joint –and there are a lot of them – is the best option to both manage the pain and stiffness in the hip joint.

It all starts with the initial exam. To schedule yours (or schedule one for someone that you care about), call us at 303.300.0424.

Our 14th Anniversary and This Week’s 1-Page Health News

Those of you who want these weekly 1-Page Health News emails sent directly to your email can go to denverback.com and fill out the little form on the upper left part of the page.

May marks another year for Denver Chiropractic Center. For those of you keeping score, that’s 14 years down, and now in our 15th year.

Last week was the busiest week we’ve ever had. Ever. And we’d like to thank you. Your trust, support and referrals are what make our existence and growth as a business possible. We look forward to being here to help you for a few more decades. Once again, thanks.

We’d also like to wish all the moms out there a Happy Mothers Day.

Here’s this week’s 1-Page Health News:

Mental Attitude: Berry Good News. Men who regularly consume foods rich in flavonoids (such as berries, apples, certain vegetables, tea and red wine) may significantly reduce their risk for developing Parkinson’s disease. Flavonoids are naturally occurring, bioactive compounds present in many plant-based foods and drinks. Neurology, April 2012

Health Alert: Stressed? The risk for coronary heart disease and stroke increases by 30% in a person whose partner has cancer. The cause is probably the negative stress to which the cancer patient’s partner is exposed. Previous studies show that stress can affect the nervous system, blood pressure, and inflammation, increasing the risk of developing coronary heart disease and stroke. Centre for Primary Healthcare Research in Malmö, April 2012

Diet: Pain Relief. The supplement Methylsulfonylmethane gave osteoarthritis patients relief from symptoms of pain and physical dysfunction. Osteoarthritis Cartilage, 2008 Exercise: Being Fit. Improving or maintaining physical fitness appears to help obese and overweight children reach a healthy weight. During a four-year study, obese and overweight girls and boys who achieved fitness were 2.5 to 5 times more likely to reach a healthy weight than those who stayed underfit. Obesity, April 2012

Active Release Techniques: Sciatica. Many people with sciatica are worried that it’s coming from a ruptured disc. While this is sometimes true, in most cases, muscles are pressuring the sciatic nerve and causing symptoms down the back of the leg. The piriformis is a likely suspect, as are the hamstrings. Using Active Release Techniques to relieve the tension in these muscles can take the pressure off of the nerve and fix the problem.

Wellness/Prevention: Obesity and Watching TV. In a study of obesity among European children, Dr. Yannis Manios, Assistant Professor at Harokopio University in Athens, writes, “We found that many countries are lacking clear guidelines on healthy eating and active play. However, there is good evidence linking sedentary behavior (like TV watching) with subsequent obesity. Obesity Reviews, March 2012 (Um, this is not brilliant work.)

Quote: “Simple diet is best; for many dishes bring many diseases; and rich sauces are worse than heaping several meats upon each other.” ~ Pliny

Is it sciatica or Low Back Pain? How can Denver Chiropractic Center help you with Active Release Techniques?

Low back pain (LBP) can be localized and contained to only the low back area or, it can radiate pain down the leg. This distinction is important as LBP is often less complicated and carries a more favorable prognosis for complete recovery. In fact, a large part of our history and examination is focused on this differentiation. This month’s Health Update is going to look at the different types of leg pain that can occur with different LBP conditions.

We’ve all heard of the word “sciatica” and it (usually) is loosely used to describe everything from LBP arising from the joints in the back, the sacroiliac joint, from the muscles of the low back as well as a pinched nerve from a ruptured disk. Strictly speaking, the term “sciatica” should ONLY be used when the sciatic nerve is pinched; causing pain that radiates down the leg.

The sciatic nerve is made up of five smaller nerves (L4, 5, S1, 2, 3) that arise from the spine and join together to form one large nerve (about the size of our pinky) called the sciatic nerve – like five small rivers merging into one BIG river. Sciatica occurs when any one of the small nerves (L4-S3) or, when the sciatic nerve itself, gets compressed or irritated.

This can be, and often is caused from a lumbar disk herniation (the “ruptured disk”).  A term called “pseudosciatica” (a non-disk cause) includes a pinch from the piriformis muscle where the nerve passes through the pelvis (in the “cheek” or, the buttocks), which has been commonly referred to as “wallet sciatica” as sitting on the wallet in the back pocket is often the cause.

When this occurs, the term “peripheral neuropathy” or “ peripheral nerve entrapment” is the most accurate term to use. Direct trauma like a bruise to the buttocks from falling or hitting the nerve during an injection into the buttocks can also trigger “sciatica.”

The symptoms of sciatica include low back pain, buttocks pain, back of the thigh, calf and/or foot pain and/or numbness-tingling. If the nerve is compressed hard enough, muscle weakness can occur making it hard to stand up on the tip toes creating a limp when walking. In the clinic, we will raise the straight leg and if pinched, sharp pain can occur with as little as 20-30° due to the nerve being stretched as the leg is raised.

If pain occurs anywhere between 30 and 70° of elevation of either the same side leg and/or the opposite leg, this constitutes a positive test for sciatica (better termed, “nerve root tension”). When a disk is herniated into the nerve, bending the spine backwards can move the disk away and off the nerve resulting in relief, which is very diagnostic of a herniated disk. Having a patient walk on their toes and then heels and watching for foot drop as well as testing the reflexes, the sensation with a sharp object, and testing the reflexes at the knee and Achilles tendon can give us clues if there is nerve damage.

At our clinic we’ve gone beyond simple traditional chiropractic adjustments to “align the spine.” We use more advanced techniques, like Active Release Techniques to address the pressure that the muscles can exert on the sciatic nerve. We will also use motion-restoring spinal adjustments to restore healthy mobility to the spine. By utilizing these advanced techniques, we are usually able to get excellent results for our patients with low back pain and sciatica in a relatively short period of time.

It all starts with the initial exam. Call us to schedule yours 303.300.0424. We’re here to help you!

Miss Keri’s Bike Crash and This Week’s 1-Page Health News

Our awesome office manager Keri (my kids call her Miss Keri) was run off of the Cherry Creek bike trail and into a concrete half wall this weekend. Another cyclist was going too fast in the other direction, was too far over to his left, and basically forced Keri to choose between colliding with him or scraping the wall.

She chose the wall and this morning is sporting a nasty wound on her right arm. Of course, this guy didn’t bother to stop (maybe he was on his way to do Rocket Surgery). The message- be careful out there. A whole lot of morons are legally loose on our streets.

Of course, Miss Keri is tough as nails and never misses work, so she’s here today- bandaged up & ready to help you.

Here’s this week’s 1-Page Health News.

Mental Attitude: Get Your Sleep! Older adults with poor sleep habits have an altered immune system response to stress that may increase their risk for mental and physical health problems. Stress leads to significantly larger increases in a marker of inflammation in poor sleepers compared to good sleepers; a marker associated with poor health outcomes and death. Poor sleepers report more depressive symptoms, more loneliness and more global perceived stress relative to good sleepers. As people age, a gradual decline in the immune system occurs, along with an increase in inflammation. Heightened inflammation increases the risk for cardiovascular disease, diabetes and other illnesses, as well as psychiatric problems. American Journal of Geriatric Psychiatry, March 2012

Health Alert: Slow Down — You Move Too Fast? People who are considered ambitious, attend the best colleges and universities, have prestigious careers and earn high salaries don’t necessarily lead more successful lives. Ambition has its positive effects (in terms of career success, it certainly does) but ambitious people are only slightly happier than their less- ambitious counterparts and they actually live somewhat shorter lives. Journal of Applied Psychology, March 2012 Diet: Fish Oil. Six weeks of supplementation with fish oil significantly increased lean mass and decreased fat mass in test subjects. International Journal of Sport Nutrition and Exercise Metabolism, October 2010

Exercise: Good Reasons. Exercise helps you maintain proper muscle balance, reduces the rate and severity of medical complications associated with hypertension, helps alleviate menstrual symptoms and lowers your heart rate response to submaximal physical exertion. Surgeon General’s Report on Physical Activity and Health, 1996

Chiropractic: Adjustment or Microdiskectomy for Sciatica? 60% of patients with sciatica (symptoms of unilateral lumbar radiculopathy secondary to lumbar disk herniation at L3-4, L4-5, or L5-S1) who had failed other medical management (patients must have failed at least 3 months of nonoperative management including treatment with analgesics, lifestyle modification, physiotherapy, massage therapy, and/or acupuncture) benefited from spinal manipulation to the same degree as if they underwent surgical intervention. JMPT, October 2010

Wellness/Prevention: Dark Chocolate Good For The Heart. A flavonoid called epicatechin, found in dark chocolate, enhances mitochondria structure in people with advanced heart failure and type 2 diabetes. Mitochondria are cellular structures that provide the energy a cell requires in order to move, divide, and contract. Both heart failure and type 2 diabetes impair these cells, resulting in abnormalities in skeletal muscle. In individuals with diabetes and heart failure, these abnormalities in the heart and skeletal muscle cause decreased functional capacity, resulting in difficulty walking even short distances, shortness of breath, and a lack of energy. Clinical and Translational Science, March 2012

Quote: “Common sense is the collection of prejudices acquired by age eighteen.” ~ Albert Einstein

Neck Pain: Manipulation vs. Mobilization – What’s Better?

Does mobilization (MOB) get less, the same, or better results when compared to spinal manipulative therapy (SMT)? To answer this question, let’s first discuss the difference between the two treatment approaches.

Mobilization (MOB) of the spine can be “technically” defined as a “low velocity, low amplitude” force applied to the tissues of the cervical spine (or any joint of the body, but we’ll focus on the cervical region). This means a slow, rhythmic movement is applied to a joint or muscle using various methods such as stretching.

Spinal Manipulative Therapy (SMT) can be defined as a “high velocity, low amplitude” type of force applied to joint which is often accompanied by a audible release or “crack,” which is the release of gas (nitrogen, oxygen, and carbon dioxide).

Some joints “cavitate” or “crack” while others are less likely to release the gas. Studies that date back to the 1940s report an immediate improvement in a joint’s range of motion occurs when the joint cavitates. Many people instinctively stretch their own neck to the point of release, which typically, “…feels good.” This can become a habit and usually is not a big problem. However, in some cases, it can lead to joint hypermobility and ligament laxity.

As a rule, if only a gentle stretch is required to produce the cavitation/crack, it’s typically “safe” verses the person who uses higher levels of force by grabbing their own head and twisting it beyond the normal tissue stretch boundaries. The later is more likely to result in damage to the ligaments (tissue that strongly holds bone to bone) and therefore, should be avoided.

Since SMT is usually applied in a very specific location (where the joint is fixated or “stuck”, or, partially displaced), it’s obviously BEST to utilize chiropractic, as we chiropractors do this many times a day (for years or even decades) and we know where to apply it and can judge the amount of force to utilize, especially the neck where there are many delicate structures.

Back to the question: Which is better, MOB or SMT? Or, are they equals in the quest of rid of neck pain? A recent study of over 100 patients with “mechanical neck pain” (strain/sprain)  showed that those who received SMT had a significantly better response than the MOB group as measured by a pain scale, a disability scale and 2 tests that measure function!

In our clinic (Denver Chiropractic Center) we’ve found that the best approach uses BOTH. Mobilization in the form of Active Release Technique combined with safe and gentle (never forced) adjustments get better results in a shorter time frame. It all starts with the initial exam, so call us to schedule yours – 303.300.0424.

This week’s 1-page newsletter from the Chiropractors @ Denver Chiropractic Center

I don’t know about you, but I love spring weather here. On Sunday I was slaving away in the heat hauling dirt out of the garden, and today I needed boots to get through the parking lot. Ah, spring. Love it.

As outdoor sports season is ramping up, just remember we’re here for you if something starts hurting. If you happen to ride the Cherry Creek Trail you may see the Denver Chiropractic Center bike jersey, so make sure you say hi!

I (Glenn) will be on vacation next week, so if you’ve been thinking about coming in, give us a call. Dr. Stripling will be here covering for me next week (and seeing his patients as well). My kids are in a year-round school, so they get a 3-week spring break. Can you imagine?

And here’s this week’s health news for you. 


Mental Attitude: Memory and Stress. Anyone who has ever experienced chronic stress knows it can take a toll on both your emotions and your ability to think clearly.Researchers have discovered a neural mechanism that directly links repeated stress with impaired memory. This study also provides critical insight into why stressresponses can act as a trigger for mental illnesses. Neuron, March 2012

Diet: Rosemary Essential Oil On My Mind? Blood levels of a rosemary oilcomponent correlate with improved cognitive performance. Results indicate, for thefirst time in human subjects, that concentration of 1,8-cineole in the blood is relatedto an individual’s cognitive performance, with higher concentrations resulting inimproved performance. Both speed and accuracy were improved, suggesting thatthe relationship is not describing a speed-accuracy trade off. Therapeutic Advancesin Psychopharmacology, March 2012


Exercise: Yoga And Stress. Yoga may be effective for stress-related psychologicaland medical conditions such as depression, anxiety, high blood pressure andcardiac disease. The theory could be used to develop specific mind-body practicesfor the prevention and treatment of these conditions in conjunction with standardtreatments. Medical Hypotheses, March 2012


Wellness/Prevention: Irregular Heartbeat? An irregular heartbeat, atrial fibrillation, is a strong predictor of cognitive decline and the loss of independence in daily activities in older people at risk of cardiovascular disease. This is just another good reason to maintain your heart health and get checked to prevent heart problems. (note – Glenn will have more to say about heart health soon, having just found out his cholesterol was 259 and some early plaquing has developed in his left carotid artery.) Canadian Medical Association Journal, March 2012


Quote: “The more serious the illness, the more important it is for you to fight back,mobilizing all your resources – spiritual, emotional, intellectual, and physical.” ~Norman Cousins

Guess who’s doing the Leadville 100 Trail Run and this week’s 1-Page Newsletter

No, it’s not me (Glenn). But Dr. Jeff Stripling, my esteemed colleague here at Denver Chiropractic Center will be there on August 18 / 19. Dr. Stripling donated a kidney to his dad a few years ago, and will be racing in Leadville to raise money and awareness for transplant research. Stay tuned for more info on this remarkable guy and this remarkable challenge.

Here’s this week’s 1-page newsletter:


Mental Attitude: A Good Laugh. When we laugh heartily among friends, we exhale repeatedly without drawing breath. This physical effort leaves usexhausted and triggers the release of protective endorphins, one of the complex neuropeptide chemicals of the brain that regulate pain and promote feelings of well-being. Watching 15 minutes of comedy in the company of others can increase your pain threshold by an average of 10%. Laughter is 30 times more likely to happen when we are with others than when we are alone.Proceedings of the Royal Society, Dec 2011


Health Alert: Antibiotic Resistance. Overexposure to antibiotics has longbeen a concern in the medical community, most specifically the development of antibiotic resistant infections as a result of repeated use. Ophthalmologic antibiotics have been found to promote antimicrobial resistance too, prompting a call from Vanderbilt Eye Institute physicians to be more judicial in the administration of certain classes of antibiotics. Archives of Ophthalmology, Dec 2011


Diet: Protect Your Bones. A calorie-restricted diet higher in protein (mostlyfrom dairy foods) and lower in carbohydrates, coupled with daily exercise, demonstrated a major positive impact on bone health. Bone health improvements were particularly evident due to the diet’s high density of bone-supporting nutrients, such as calcium, vitamin D and dairy-based protein.Journal of Clinical Endocrinology and Metabolism, Dec 2011


Exercise: It’s Harder To Run As You Age. Runners who find it more difficult to run as they age can make the experience easier on themselves by adding strength training and flexibility exercises to their fitness routine. Journal of Strength and Conditioning Research, Dec 2011


Chiropractic: Bad Posture. Asymmetries in posture and motion can causetethering, the adverse prolonged stretching of the central nervous system. This can result in spinal cord ischemia (lack of blood flow) and consequently motor, sensory, and autonomic neurological dysfunction. Tethering of the spinal cord has been linked to demylenating diseases, such as multiple sclerosis. Koch, 2002


Wellness/Prevention: Cancer Prevention In Your 50s. Cancer is more likely to show up in men over 50 years old. That’s why the majority of cancer screening exams begin at age 50. Finding and treating cancer as early as possible is one of the best ways to beat this disease. In the case of prostate cancer (the most common cancer in men), treating the disease at an early stage means men may be less likely to experience long-term side effects, like impotence. University of Texas MD Anderson Cancer Center, Nov 2011


Quote: “Money cannot buy health.” ~ Dorothy Parker

The Neck & Shoulder Pain Relationship

In our hectic lifestyles of driving, hunching over computers, talking on the phone, not to mention stress arising from multiple sources, the muscles in the neck, upper back and shoulders seem to tighten up and hurt at the same time. The question is, between the neck and the shoulder, which one is the “chicken” and which is the “egg?”

The neck gives rise to the nerves that innervate the head (C1-3 nerve roots), the shoulders (C4-5), and the arms (C5-T2). Hence, there are 8 sets of nerves in the neck, 12 sets in the thoracic (middle back region), and 6 sets in the lumbar or low back region and 5 sets in the sacrum, all of which travel to a specific destination allowing us to move our muscles and to feel hot, cold, sharp, dull, vibration and position sense.

When these nerves get pinched or irritated, they lose their function and the ability to feel, making it challenging to button a shirt, thread a needle, or pick up small objects.  It can also make it difficult to unscrew jars, squeeze a spray bottle, or lift a milk container from the refrigerator. Hence, the nerves arising from the neck, when pinched, can have a dramatic effect on our ability to carry out our desired activities in which the shoulder, arm and hand use is required.

On the other hand, when the shoulder is injured (such as a rotator cuff tear or strain), this can also result in neck problems. There are several ways pain from the neck affects the shoulder and vice versa. When the shoulder is injured, pain “information” is relayed to the brain starting at the nerve endings located in the area of the shoulder injury, transmitting impulses between the shoulder and the neck, and finally from the neck to the sensory cortex of the brain. That information is processed and communication to the motor cortex prompts nerve signals to be sent back to the shoulder through the neck and to the injured area (in this case, the shoulder).

A reflex muscle spasm often occurs as a result, serving as kind of an “internal cast” as the muscle spasm tries to protect the injured shoulder. This can become a “vicious cycle” or never-ending “loop” until the reflex is interrupted (perhaps by a chiropractic adjustment). Another means by which both areas become injured has to do with modifications in function. We tend to change the way we go about our daily chores when an injury occurs to the shoulder, such as putting on a coat differently by leaning over to the opposite side.

These functional changes can also give rise to neck pain. Because of this reflex cycle, as well as the close anatomic relationship between the neck and shoulder, not to mention the “domino effect” of soft-tissue injuries which seem to change the function at the next joint level, it’s not surprising that both the neck AND the shoulder require simultaneous treatment for optimal treatment benefit. However, the good news is, regardless which one is the “chicken or the egg,” your treatment at Denver Chiropractic Center for shoulder injuries will almost always include the neck and vice versa.

We use a unique combination of Active Release Techniques Soft Tissue Treatment, adjustments, and physical therapy exercises. Research shows that this combination is best. We realize that you have a choice in where you get your healthcare services.  If you, a friend or family member requires care for neck pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

Carpal Tunnel Syndrome and Sleeping

Have you ever woken up in the middle of the night and noticed your hand sleeping to the point where you had to get out of bed and shake or flick your fingers to alleviate the numbness? If the numbness was primarily on the thumb-side half of your hand, it may have been carpal tunnel syndrome that woke you up. So, the question is, why is it such an issue at night?

To properly answer this question, let’s get familiar with the anatomy of the wrist.  There are 2 bones that make up the forearm – the ulna (on the pinky side) and the radius (on the thumb side). Just beyond that, there are two rows of four bones each called the carpal bones for a total of 8 small bones that make up the wrist joint. These carpal bones are arranged in a horseshoe or tunnel shape. When you look down at your wrist and wiggle your fingers quickly, you can see all the movement that occurs on the palm side of the wrist.  That’s a lot of movement!  You can also see the muscles on the upper half of the forearm moving rapidly as the fingers wiggle.

There are 9 muscle tendons that travel through the carpal tunnel, as well as some blood vessels and most important, the median nerve sits on top of all those moving tendons. Just beneath the floor of the tunnel is a ligament called the transverse carpal ligament. The tendons inside the tunnel are surrounded by lubricating sheaths that make it easier for the tendons to slide back and forth as we wiggle our fingers, grip to open a jar, type on a computer, play a musical instrument, or so on. Without the tendon sheaths, the friction between the rubbing tendons would quickly build up heat, resulting in swelling, pain and numbness.  However, in spite of the lubricating function of the sheaths, when we work our fingers and hands too much, swelling and inflammation does occur.

So, why do we have numbness at night when we aren’t working, gripping and moving our fingers repetitively? The answer lies in how we sleep. Since we are asleep, we cannot control where we position our hands and wrists. Most of us curl up in a ball and tuck our hands under our chin or someplace cozy.  Normally, when we bend our wrists, the pressure inside the carpal tunnel doubles. However, a carpal tunnel patient already has a higher level of pressure in their wrist. So, when a carpal tunnel patient bends their wrist in the exact same way, the pressure goes up even more – that is, 3, 4, 5, or more times than a normal person without their wrist bent. That is why a wrist “cock-up” splint works so well at night!  It keeps the wrist straight so you can’t bend it.  Often, this allows the CTS patient to sleep through the night instead of waking up 2, 3, or more times with numbness, tingling, and/or pain on the thumb half of the hand.

At Denver Chiropractic Center, we have extensive experience using Active Release Techniques to treat carpal tunnel syndrome. We release scar tissue in the muscles adjacent to the nerve, and can take the symptoms away by relieving the pressure of that nerve (the Median Nerve). Call us today to schedule your initial exam where we’ll tell you whether you’re a candidate for our treatment approach. 303.300.0424

We realize you have a choice in where you get your health care and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend or family member require care for CTS, we would be honored to render our services.