Tag: wellness

Carpal Diem

Well, my annual trip on the medical merri-go-round has been interesting. I went to my pprimary care doctor for a referral to a hand surgeon to fix the trigger finger on my right hand.

The hand surgeon gave me a cortisone injection at the base of my middle finger. It appeared to work as expected. Alas, the hand surgeon also asked several questions about my fingers and hand. I told him I have numbness at the tip of my middle finger which I attributed to the removal of a cyst before the pandemic.

He said that wasn’t likely and did a simple diagnostic test and said, “you have carpal tunnel syndrome.” This would explain the general numbness and aching I have been getting in my hand for the last year or so. Occasionally the pain wakes me up.

The doctor gave me a splint (looks like a roller blader’s wrist guard) to wear while sleeping. Off I went to a neurologist for an electromyography (EMG), a systematic test of nerve function. I’ve had one before and it was extremely painful. This time the test wasn’t nearly as bad, only slightly worse than getting a series a static electric charges. More annoying than painful.

The test results essentially confirmed the hand surgeon’s diagnosis. The nerves in both my hands are a little weak but test of the median nerve (the one that sends signals to most of the fingers) came back “NR”. This means “no response.” Derp.

(I asked if this meant the neurologist botched the test. The hand surgeon said that this was not likely. “She’s really good.” That’s the sense I got from the neurologist, too. Dang Doesn’t hurt to ask, I suppose.)

If I do nothing, the numbness and general weakness in my hand is likely to get worse. So I am scheduled for surgery in a couple of weeks. Barring some unforeseen problem, the surgery is likely to last about ten minutes. The doctor will be using a laproscope. This means the surgical incision will be about and inch or so wide. Using the scope, he will cut through a ligament that runs across the base of my hand. The tiny incision should greatly speed my recovery. Assuming nothing goes wrong, I should be good to return to normal activities in a few days. Of course, for me, “normal” means riding my bike. I suspect that I’ll be limited to my recumbent for a while. The doctor said the success rate is about 90 percent. That’s confirmed by all the videos I’ve been watching online.

I had hoped to do a supported, spring tour of the Natchez Trace. Two of the three tours I was looking at have already sold out. The last one is in early April. I will wait until my post-op visit with the surgeon and, with luck, sign up. Otherwise I’ll do it in the fall.

If any of you have had carpal tunnel release syndrome or know someone who did, let me know in the comments.

There’s the rub and other things

Deep tissue massage

As my tour launch date approaches, I have been increasingly concerned about my various physical problems. The tension in my neck muscles and, more importantly, the limited range of motion in my neck have been making just moving around a literal pain in the neck. I have also become increasingly bent over, an affliction I have been attributing to my lumbar spinal stenosis.

On the recommendation of Casey, a friend from Friday Coffee Club, I booked an appointment with a message therapist for a deep tissue massage. I figured one of three things could happen. Worse case scenario: my neck and back get much worse and I end up at a surgeon’s office. Neutral outcome: as with all the other various kinds of massages I’ve had, the massage feels good but not much changes. Best case scenario: I actually feel considerably better.

(What comes next is an over simplification of the message session. I am an anatomy ignoramus and I know even less about the specifics of message techniques.)

The appointment started with a long interview about my activity and my physical woes, focusing on my neck. I also mentioned my spinal stenosis issue. Just before the hands-on part of the session, the therapist pointed out that I had obvious tightness in my psoas muscles. (The psoas muscles are an important connection between the upper and lower body. They are notoriously difficult to loosen.) I was sitting on the massage table but instead of being upright, my torso was at a 45 degree angle to my thighs. I hadn’t even noticed.

In fact, that’s my default setting; bent over as I watch TV, read, drive, and use my phone. By riding my bike tens of thousands of miles in the last few years, I’ve managed to managed to train my muscles to assume the riding position when I’m off the bike. Once you’re bent over, bent over is the norm. In fact, I can’t straighten up. I’m locked in.

We began with massaging my tight neck muscles. This involved finding knots in my muscles and pressing on them (a technique called pinning) then slowing stretching the muscle, breathing in during the stretch and exhaling on release. The therapist worked on my neck, my shoulders, my head, and my jaw. Back and forth and all around. I’ll admit some of this was pretty painful. With each pressing of a knot, the pain lessened until it was gone and the muscle was freed up.

After that the therapist worked on loosening my pectoral muscles, the ones across my chest. Riding a bike causes these muscles to be tight, pulling my upper body over when I stand. Some of this involved simply pulling on my chest muscles to the outside. The therapist also worked on knots around the edge of my scapula, a bone that sits on the outside of the chest cavity in back.

There was also a last adjustment to my psoas muscle. One leg straight. The other bent and drawn upward, just as I had been doing on my back. She pressed another point somewhere above the hip. Then the other side.

At the end of the session, I stood up. Straight. Without the slightest bit of tension pulling my shoulders forward. My lower back felt completely free of tension as well.

After the session I went to the drugstore. I parked over a block away and walked to and from the store without a cane. No problem at all. No pain. No tightness in my lower back.

I’ll be damned if the massage didn’t work.

The therapist told me I’d be sore for a few days. Day two was the worst. My neck and lower back were aching after a 50-mile ride. Today is day three and my neck feels fine. My back soreness went away. The range of motion in my neck is still a bit limited but the pain is all but gone. More importantly, I know that the stretching I had been doing will be much more effective if I pin the tight muscle down when I stretch it. As for my lower back, the onset of discomfort seems to be taking significantly longer, a very welcome development.

I’m going to go back for another session after my tour. In the meantime, I’ve added pinning to my neck stretches. Also, I have two stretches for my pectoral muscles that are pretty easy to do. The scapula stretching requires a tennis ball and a sock (to keep the ball from falling as I work with it). I haven’t tried that but I have a massage gizmo that can do the same thing. So far all the stretches for the psoas muscles seem to require the body of a contortionist. (Lunge, raise your arm, lean back. Fall over.)

Other news

I decided to change my rear tire. I removed the Schwable Marathon with about 6,000 miles and replaced it with an comparably old Schwalbe Marathon Plus. The latter last several thousand more miles and are extremely resistant to punctures. I will notice more rolling resistance but that’s the price you pay for not having to deal with flats every 1,000 miles. (Knock wood.) The beefier tire should serve me well on the rough roads of eastern Kentucky.

When changing the tire, I used a new tire lever that I recently picked up at Bikes at Vienna. The tire and rim combinations make for difficult installation, frequently resulting in loss of skin on my thumbs. Although the copy in the link says this lever is designed for narrow tires, it worked fine on my 700×35 Marathon Plus tire. My thumbs are grateful.

Going longer

In the last nine days, I’ve done 323 miles with rides of 42, 50, 52, and 53 miles and a day off. The 52-miler was yesterday. I could have easily gone farther. Every year I get to late April and think, I’ve lost it. Every May, I find it.

I haven’t picked a launch date yet.