00:23
Julie Pitois LMT, CAMTC
Okay. So welcome today to tissue talk. I don’t really understand it, but I just work here.
Hey, so listen, today we are going to talk about why our fingers keep falling asleep.
Why we have pain running down our arms, where we’re getting this radicular pain.
What is the pain running down my arms?
00:44
Mike Julian LMT, CAMTC
That radicular pain is ridiculous.
00:47
Julie Pitois LMT, CAMTC
Well done. Well done. Okay. How many of you guys have you ever fallen asleep?
You go to sleep at night and then you wake up in the middle of the night and you are suddenly freaking out because you think somebody has broken into your house and they are like, they are trying to touch you.
You have a hand just like sitting like this, but you have no idea whose hand it is.
When you really wake up and you realize it’s your own hand, because it’s cotton, it’s falling asleep and it’s like dragging across, or you try to turn over and your whole arm is just like,
01:19
Mike Julian LMT, CAMTC
I had this one, I was asleep like this. I woke up, I thought somebody had my hand and it was me. I had a full dead hand. Oh, scary.
01:27
Julie Pitois LMT, CAMTC
Yeah. Or what about when you’re driving and you’re driving for a long distance and your fingers start to tingle.
01:34
Mike Julian LMT, CAMTC
Shaking them out.
01:35
Julie Pitois LMT, CAMTC
Like, you’re always like, oh my God, my arms are going numb. This is horrible.
Or you feel tingles and you just have no idea why. And you’re like, Hey, is this right? What is happening to me?
Like these three fingers fall asleep or these fingers are hurting and falling asleep.
Today we’re going to talk about these three little nerves in our body that make big issues for our arms and hands right.
02:00
Mike Julian LMT, CAMTC
There. A lot of problems.
02:02
Julie Pitois LMT, CAMTC
Before we get to the fingers, let’s start from the beginning. Cause you know that I liked the anatomy.
We’re going to talk about the brachial plexus and where do these nerves actually show up from? Because we don’t just have nerves that are just hanging out, sitting in the middle of our arm or sitting here.
It’s the nerve just doesn’t start and end here. There’s always a nerve line and a nerve pattern that goes all the way up and all the way back down.
They always start from the nerve root, which sits into the vertebrae. You all right. Today we’re going to start about, we’re going to talk about the brachial plexus.
The brachial plexus is a group of nerves that come from the spinal cord in the neck and they travel down the arm and into the hand, these nerves control the muscles of the shoulder, the elbow, the wrist, and the hand.
02:54
Julie Pitois LMT, CAMTC
They also provide all the feeling in the arm.
A lot of, we don’t even think about the fact that we have nerves that start all the way up here. These nerves are really, really important because they innovate the entire arm, shoulder, wrist, and hand, like I just said, right?
The nerves run past the elbow to the risks and the hand. There’s three main nerves that we’re going to talk about. You have your median nerve, you have your older nerve and you have your radial nerve. Okay?
The median nerve, it passes down the inside of the arm and crosses the front of the elbow so that all their nerve passes down the inside of the arm.
The radial nerve passes down the back side of the arm and to the outside of the elbow. Now that we know that we have three big nerves that are little nerves, but they make big problems.
03:53
Julie Pitois LMT, CAMTC
We need to talk about these nerves and where they run, right?
Because each nerve has a different pattern. It has a different nerve line. Where the median nerve comes down to the center, the ulnar nerve is actually the one that’s going to affect the little pinky guy and the ring finger a lot of the time.
You have the radial, sorry, the, The owner of the, of your radial nerve, sorry. I just had a total brain aneurysm in the middle of like Facebook live.
You have your radial nerve that comes around the back and it comes down and affects these guys. So we have radial ulnar, and median.
So, depending on where the pain is and where the discomfort is and the numbness and the tingling in your arm and where it lines up in these guys and your little piggies and fingers. Yeah.
These are toes, huh?
04:54
Julie Pitois LMT, CAMTC
Nevermind. Whatever. It’s been a day already. It’s only 1230 anyhow, when they line up into the fingers, that’s where we’re going to know where we’re going with it. Right.
05:04
Mike Julian LMT, CAMTC
Gives you a roadmap for where you want to start looking.
05:06
Julie Pitois LMT, CAMTC
So let’s talk about the brachial plexus. The brachial plexus is actually a shoulder girdle, right? We have different flex sides in our body, depending on where the bundle of nerves come out and intervene. It’s a bond.
05:23
Mike Julian LMT, CAMTC
It was a bundle. It’s where all the nerves are kind of going.
05:25
Julie Pitois LMT, CAMTC
He’s determined to like annoy me today. I just don’t know why he’s doing a good.
05:28
Mike Julian LMT, CAMTC
Job here, professional.
05:32
Julie Pitois LMT, CAMTC
So let’s talk about brachial plexus. So we know where it runs, right? We know that it innervates all the way down, provides all the feeling in the arm.
The Brachial Plexus Provides Feeling In The Arm
Because we have these nerves that run through here, state this way, they run there, they come underneath this clavicle, your collarbone, and they run under this big muscle called your pectoralis minor.
A lot of times when we’re really way tight in here and or we have this nice little first rib that tends to get a little.
06:01
Mike Julian LMT, CAMTC
Bit high, all sitting right on top of.
06:04
Julie Pitois LMT, CAMTC
Your rib cage. The rid, the first rib tends to get a little high what’ll happen is what’s called thoracic outlet syndrome.
What this is it’s a group of disorders that occur when the blood vessels or nerves in the space between the collarbone and the first rib, your thoracic outlet.
It becomes compressed and, or pec, minor gets way too tight and compresses, you have artery and nerves. When this compresses like this, It innovates in a noise that, so your hand problem is actually potentially a net problem.
Yes, they’re there. It doesn’t mean that where it is where it is where it starts from, right?
06:51
Mike Julian LMT, CAMTC
It’s a guidepost.
06:53
Julie Pitois LMT, CAMTC
It really is. So thoracic outlet syndrome. If you tend to have it, or there’s a potential that you do have it, these guys will be your guide.
These will tend to have a tendency to fall asleep, get numb, get tingling. It’ll be your last three fingers in your hand.
If you have these three fingers that are falling asleep all the time, or get numb or get pins and needles in them, or you’re kind of feeling a little like numbness, that’s these guys. That’s most of the time coming from this area right here.
Median nerve entrapment now, so you have median nerve entrapment syndrome, which now we’re talking about which nerve is the median nerve, okay.
That affects movement or sensation in the hand. It’s caused by compression in the median nerve, in the elbow or down into the forearm enrich risks, which with the forearm and wrist, which gives you symptoms in the median nerve distribution.
07:58
Julie Pitois LMT, CAMTC
You’ll have it that runs all the way through, right? And so it’ll run through this way.
A lot of times the median nerve can be trapped in four different locations in the elbow.
You have the distal humerus, you have the proximal elbow. It distal means the end of your humerus, the end of your upper arm to the upper part of your elbow, the proximal side of your elbow.
You have that where the two bones meet, which is the elbow joint in and of itself and or this pronator teres muscle, which is the most common cause of median nerve compression.
Yeah pronator teres allows the body or allows the forearm to actually Perone and move down,
08:48
Mike Julian LMT, CAMTC
Put your hand on the keyboard or mouse or anything like that. That’s.
08:51
Julie Pitois LMT, CAMTC
Right. So why is that important for us?
The median nerve, because media nerve compression is also a carpal tunnel syndrome. Carpal tunnel syndrome also called median nerve mark median nerve compression, right?
It is a condition that causes numbness, tingling, or weakness in your hand. What had happens is because of the pressure on your median nerve, which again runs the length of your arm.
It goes through a passage of your wrist right here called the carpal tunnel. You add this little part of your wrist right in here, and you have all these little risks, these little bones, carpal bones, and you have this little tunnel ie the carpal tunnel and it ends in your hand.
The median nerve controls the movement and the feeling of your thumb and the movement of all your fingers, except for your pinky.
If you’re having a lot of pain or weakness or numbness, or tingling right here, you can still say classy because you still have the pinky, but you may have a potentially median nerve compression, which a lot of times gets misdiagnosed as carpal tunnel.
10:11
Mike Julian LMT, CAMTC
Syndrome. A lot of misdiagnosis and.
10:13
Julie Pitois LMT, CAMTC
Carpal tunnel syndrome is one of the most misdiagnosed pathologies that we have a lot of peat people where if they’re doing this all the time, they’re feeling it down here.
This gets irritated, but it might be coming from even all the way up into the neck.
10:32
Mike Julian LMT, CAMTC
It could be just a simple strain pattern. That’s going on way up higher.
That’s causing all that pain and discomfort, or just discovered not necessarily painting just the numbness and tingling.
10:41
Julie Pitois LMT, CAMTC
I was very fast that way. You said that like a hundred.
10:43
Mike Julian LMT, CAMTC
Miles an hour.
10:45
Julie Pitois LMT, CAMTC
Where I know we’re going to give you guys assessments on how to assess yourself down the line. Right now we’re going to go through a couple of the other impingements.
Some of the symptoms of carpal tunnel burning and tingling and itching or numbness in your poem, thumb index, and middle fingers.
If you’re adding berness burning, tingling, numbness, itching, those are things to look forward right here at shock, like feelings that move into your fingers when you’re like, huh?
Oh my God, that got me. Oh my God. Oh, that got me or tingling that moves up your arm.
It might be also that you’re normally, you’re noticing your fingers are falling asleep and they become numb at night.
If they’re not here and they’re here, this is more of the median nerve, thoracic outlet, median nerve. It’s like a puppet show, thoracic outlet, median, nerve Sherbrooke.
11:42
Julie Pitois LMT, CAMTC
Okay. So, sometimes you’ll go to sleep and you’ll wake up.
Depending on where you’re numb at night, it’s going to give you a pattern as to what’s happening earlier on.
You can stretch, move, shake them out, and it’ll start to feel better. As the wear and tear comes on, and as the compression happens, it will continue.
It will be like, I don’t, I can’t get rid of it. It’s all day long. As carpal tunnel syndrome gets worse, you may lose grip strength. As things get a little worse, you might lose of the grip strength.
Ooh, because the median nerve can’t work the way it’s used to because it’s not being innervated.
The problem with nerve compression, I’m like, so up in the camera here is that once you compress the nerve, you’re not sending a full signal. It’s like bad wifi.
You guys. If you don’t have really, when you have good wifi, your computer runs fast.
12:39
Julie Pitois LMT, CAMTC
Like you can get things done like this, you start losing the signal.
The nerve gets impressed. The wifi goes bad. It’s sketchy, right? It kind of goes and comes. It takes longer to get there.
Hey, bad wifi, horrible ruin your whole day. Nerve compression is kind of like that.
The thing with nerve compression is the longer it stays the weaker it gets. We want to make sure that we are addressing these problems right away.
How do we know if we have this? There is a test that you can do you guess you’re like, whoa, she told me one of these fingers.
You’ll end up giving me another finger that we haven’t even really talked about yet. That’s for later tests, it is a different type of median nerve that’s for sure.
We’re going to go with the Phalen’s test and a distinct this, see if you can distinguish between whether you have it or not.
13:42
Julie Pitois LMT, CAMTC
So the Phalen’s test,
13:44
Mike Julian LMT, CAMTC
Put your hands, rub them all down and bring your chest and then try to press your risks together.
Just like this. I’m starting to get a compression right here. I’m getting more just as a strain pattern for me, the string. Good job. Nice drawing.
14:03
Julie Pitois LMT, CAMTC
Okay. Let me, so let me tell you how the Phalen’s test works.
I understand you today. The Phalen’s test, there’s two ways of doing it. The first one you can just hang out and put your hands straight down like this.
What you’re going to do is you’re going to bend the wrist. If you have compression going on in here and nerve compression. After about 60 seconds, you’ll have numbness and tingling in these fingers.
The other way is what Mike was showing you, where you bend and you press it together. And that compression will impinge that nerve.
If there is a positive numbness and tingling, it becomes a positive for a Phalen’s test. That means your median nerve is compressed.
14:43
Mike Julian LMT, CAMTC
There’s an issue there.
14:43
Julie Pitois LMT, CAMTC
Yeah. That just means that we got to figure out how to get rid of that nerve.
14:49
Mike Julian LMT, CAMTC
Compression is.
14:50
Julie Pitois LMT, CAMTC
No, it means you have nerve compression of the median nerve median nerve.
There’s another thing that you can do. That’s a special test for carpal tunnel and it’s called the Tinel’s test. And test is a clinical test.
That’s there, it’s designed to detect irritated nerves. What you’re going to do is you have a partner, you’re going to have them grab onto your wrist. You’re going to hold it. You’re just going to attack that area of the median nerve.
If you’re lightening tap lightly tapping over the median nerve. Today is a day of, I can’t speak. What’s going to happen is if you have irritation, it’s gonna light it up, like fireworks on the 4th of July.
And it’s going to be really painful. It’s going to send the little shock waves and send the little tingling.
What it’s going to do is it’s going to give you right over the area that like, aha, Hey, it’s a positive test.
15:47
Julie Pitois LMT, CAMTC
So it’s 10 ELLs, 10 hours test. If you think you have it, tap on it.
If it comes up and lights up, that’s an indication that you’ve got something going on. It just is going to give you a positive assessment. That’s what we’re looking for right now.
We’ll tell you where, how, where to move into, on how to get rid of it down the line.
Listen, now we’ve done the median nerve, but remember carpal tunnel, the biggest issue with carpal tunnel is that median nerve and the median nerve entrapment most commonly is where.
16:24
Mike Julian LMT, CAMTC
The.
16:24
Julie Pitois LMT, CAMTC
Pro Nater Terese. And remember the pronator.
Terese is a muscle that actually allows you to put zero Napes. It’s all of the stuff that we do all day long, drive computers, text, phone, FaceTime, zoom mouse.
I don’t even know whatever else play the piano, screw light bulbs in and out. And I don’t know whatever ever else. So pronator teres syndrome. It is a compression of the median nerve at the elbow.
It’s rare compared to the compression at the wrist, but it actually is not as rare as you think it shows up a lot. It’s more common.
The more that we get into the technology age, a lot more common because we’re using these guys a lot more.
17:17
Mike Julian LMT, CAMTC
Well, I find out if you’re going to have any of these positive tests, you would come up to that thrown in your chair. That part of your tears is involved just about every time.
Pronator Teres Test
17:23
Julie Pitois LMT, CAMTC
Pretty much, pretty much so how do we do a pronator teres syndrome test to see if we’re positive with it? What you’re going to do is you’re going to take the person’s elbow.
17:33
Mike Julian LMT, CAMTC
Grasping.
17:34
Julie Pitois LMT, CAMTC
At 90 degrees. The elbow is bent at 90 degrees of flexion and there. Mike’s going to stabilize my hand with one side, and then he’s going to ask to perform a movement where I have to resist.
17:48
Mike Julian LMT, CAMTC
I’m going to have Julie, turn her hand down a whole arm, forearm down towards the ground.
17:52
Julie Pitois LMT, CAMTC
So I’m going to probate.
17:54
Mike Julian LMT, CAMTC
And I’m resisting that motion. I’m rotating this way as she’s trying to rotate.
17:59
Julie Pitois LMT, CAMTC
Yeah. It’s kind of like a funky handshake. What you’re doing is in resistance, I’m moving this way and he’s, he’s resisting me road rotating the opposite way.
So, and if that lights up, then it’s giving you a positive test for pronator Terri syndrome, which is really common. Then that shows you, Hey, guess what?
It could be up here. Not necessarily down there so that we’ve gone through the median nerve. We’ve gone through carpal tunnel. We’ve gone through pronator Terese.
We’ve gone through brachial, plexus and thoracic outlet syndrome. Now we’re going to move nerves and we’re moving and we’re going into, so could you say it’s like the kinks of the Gar be quiet stop.
You’ve got to beat me to the, my own punch mark. So.
18:50
Mike Julian LMT, CAMTC
Does your own show? Good.
18:51
Julie Pitois LMT, CAMTC
Lord. He’s oh, he’s, everybody’s trying to jump into my stuff all the time.
So now we’re gonna move. We’re gonna move. Nerves were tired of the median nerve. We’re over it.
We’re going to move into the owner nerve. Now we’re going to go into ulnar nerve entrapment. Remember owner nerve is out here guys.
All our nerve is when there’s too much pressure is put on the nerve in the elbow by it’s either your bones, your tendons, your muscles, your cartilage, and it becomes inflamed or swollen.
It’s also known as cubital tunnel syndrome, carpal tunnel, cubital tunnel, carpal tunnel, cubital tunnel. It moves out to the outside.
This can start a pinched nerve can start all over the place, right? It can start in several places throughout. It can be the joints. It can be into the muscle.
It can be into the tendon until the ligament, when a pinched nerve is in your elbow, it can leave your arm in hand, feeling sore and numb the ulnar nerve.
19:46
Julie Pitois LMT, CAMTC
It runs the length of your arm, right?
It helps control the muscles in the forum and the hand sensations affecting your ring finger and your little finger also traveled through the ulnar nerve.
These dudes right here, it is the most vulnerable point in the elbow, the owner nerve. And this is your funny bow.
20:10
Mike Julian LMT, CAMTC
And come in contact with that nerve. The.
20:12
Julie Pitois LMT, CAMTC
Funny bone, which is not very funny when you hit it and it always says you bang, it sends a tingling down, no fun.
The other thing with the older nerve you guys is, if you’re sitting on your elbows for a long period of time for sitting like this for a long period of time, if you’re leaning on your elbows for a long period of time, you’re catching your owner nerve and the owner of nerve also can move.
The ulnar nerve can actually slip out of place because it’s really superficial and actually can move in.
As soon as you lay your hand down, this happens to me a lot, actually, as soon as I lay my hand out and say, oh, oh. With the owner nerve, what happens is you can.
20:53
Mike Julian LMT, CAMTC
Have stuff doing that,
20:55
Julie Pitois LMT, CAMTC
Like doing it because it makes me a better therapist.
The other thing too is you can actually do overuse syndrome and catch that vulner nerve ulnar nerve is also where your bursa is hanging out. Bursitis an inflammation of your bursa SAC.
If you remember, we’ve talked about that little fluid filled SAC that hangs out to help with friction. If it’s inflamed, it’ll get inflamed and that’ll compress onto the owner nerve.
So there’s a lot of things. Bone spurs, arthritis. We can have a lot of stuff going on with the symptoms of an owner nerve. Older nerve entrapment, the biggest thing is weakness in your hands.
You may feel like, oh, I can’t really do a lot with these guys. I don’t have a lot of movement.
If you start to have weakness in your hand, it could be coming from your own nerve. This brings up a really good, a good point.
21:54
Julie Pitois LMT, CAMTC
It always in your fingers and your hand because it’s running into your fingers in your hand, right? So you’re having all these issues. Is it really where it is? Yeah.
22:04
Mike Julian LMT, CAMTC
Most likely not. If it’s more than likely coming from boy upstream is where the compression starting and it’s ending up down there. And I just jump on your line.
22:13
Julie Pitois LMT, CAMTC
No, you guys all jumped on my line. My line is over. So I’m going to say it again. So it’s actually not even my line.
I wish I could take credit for it though. James was, Laski is amazing in this and he always says, which I really love this line is when you are watering your garden and you have a kink in your hose, is it usually,
22:35
Mike Julian LMT, CAMTC
I would say the same. There’s several kinks, right?
22:39
Julie Pitois LMT, CAMTC
Yes.
22:40
Mike Julian LMT, CAMTC
That’s just one of several. Go ahead.
22:42
Julie Pitois LMT, CAMTC
Okay. Thanks. You have a kink in your hose and you’re watering this garden and you really want to take care of your garden, but you notice that the kink in your hose is not allowing the water to actually spray.
It’s just dripping. Do you just figure out that it’s just the kink by the nozzle or could it potentially be other kinks going up into the hose that you will have to go start from the faucet?
If you start from the faucet where the water comes out, then you may notice there are a lot of kinks in the hose before you just get to the nozzle. Boom. That’s how it’s supposed to be said.
23:25
Mike Julian LMT, CAMTC
I mean, there was pretty good. You.
23:26
Julie Pitois LMT, CAMTC
Guys all jumped on it. Try to make it your own. It’s not even mine. It’s, I’m sorry that you had some others that tried to live with.
23:35
Mike Julian LMT, CAMTC
When you were looking at those chinks, where’s our best place to start at the very end and work our way back this way or go back to the house, huh?
23:42
Julie Pitois LMT, CAMTC
No, it’s at the faucet. Always start where the nerves are coming out in the nerve root, so, Okay, so you, here’s the thing you guys with nerve impingement, even though you’re feeling it in here, this is the end of the line.
End of the, I always call it of the Bart line cause I’m from the bay area. It was always the end of the Bart line where the train stopped and had to reverse course. This is the end of your line.
If you’re having, if you’re having weakness or you’re having tingling on here, you want to make sure that you go all the way and start from the beginning all the way down and go to the end and then work your way down.
Because just because you have the three nerves here, your radio and your owner and your meeting nerve, it can be coming from your Peck, minor being too tight.
24:35
Julie Pitois LMT, CAMTC
It can be coming from your first.
24:36
Mike Julian LMT, CAMTC
I’ll just say the biggest thing is that first registered elevated up .
24:40
Julie Pitois LMT, CAMTC
Yeah. It can be coming from of a joint fixation in your neck, which could be compressing into the nerve.
It can be coming from a nerve entrapment from the muscle structure. It can be coming from old scar tissue that pulls on it.
Yeah, it can be coming from listen, have a lot of anxiety is happening these days, right? Because of all of the emotions that are going on and we tend to sit like this and everything’s all tightened up easy way to do it.
It can be coming from sitting and playing video games on your elbows the entire time. Yeah. There’s a lot that could be from this.
25:15
Speaker 4
So.
25:17
Julie Pitois LMT, CAMTC
Question.
25:19
Mike Julian LMT, CAMTC
You go get surgery right away. No, no,
25:21
Julie Pitois LMT, CAMTC
No. I think you should take, do the tests, do the test that we’ve given you, tell me how you feel. If they come up positive, what that’s giving you as a positive aha.
Of like, wow, I got nerve and trap me. What do I do next?
Follow the line all the way up. Have, have somebody take a look at your neck, go to see a doctor and have them give you a referral,
25:43
Mike Julian LMT, CAMTC
Right.
Nerve Impingement: Get A Good Assessment
25:43
Julie Pitois LMT, CAMTC
And get a good assessment. If you do a good assessment, they’re going to be able to help you on all of this.
What will happen is once the doctor gives you an assessment, they’ll be able to work on the area and move it right back down the chain.
Hopefully they’ll be able to clear you of anything that you have. So.
26:02
Mike Julian LMT, CAMTC
When you want to sip your coffee out of a straw, oh gosh,
26:04
Julie Pitois LMT, CAMTC
No, it would be awful. It would be awful. So you guys, I hope that helped.
I’m sorry that it was so disjointed today that disjointed got what I said. We’ll play our words there, but I will be back. This is what happens when I leave my hair down to talk, I, I lose all control of my body.
Anyway, at the end of the day only you guys can fix you. So really pay attention. Don’t think that every time we have a nerve entrapment in the end of the line, it means the start of what can we do?
The more that you focus on you’ll be better off for it. So I hope you guys enjoyed it. If anybody, has elbow has nerve pain, has finger pain has weakness in their hands. Please show them the video. Hopefully that can give them of health. Yeah.
26:52
Julie Pitois LMT, CAMTC
And we can help them. If not, we’ll see you next week.
Same time, same channel.
Hopefully a little less spunkiness next time. I hope you guys are having a great day. Bye guys.