Are you a bodybuilder or muscle building enthusiast who also has painful carpal tunnel syndrome?
Here are guidelines for weightlifting with carpal tunnel syndrome.
If working out with weights doesn’t antagonize your carpal tunnel syndrome, then you do not need to make any accommodations, let alone avoid certain exercises.
However, if your carpal tunnel syndrome is aggravated during your workout, you need to make adjustments.
“Bodybuilders with painful carpal tunnel syndrome should avoid exercises that place the wrist in an extended position such as pushups, bench press and front squats,” says Dr. Logan Thomas, a physical therapist in Muncie, IN.
The extended hand position, shown below, occurs with any pressing motion with a barbell or dumbbell — though sometimes one may be able to focus on keeping the wrist neutral throughout the lift.
Needless to say, these pressing motions make up a substantial portion of a muscle building regimen.
But what might happen if you just ignored the pain and performed these kinds of movements, since they are important for building chest, shoulder and triceps musculature?
Dr. Thomas explains, “When nerves are irritated they have a decreased tolerance to stretch.
“Since the median nerve runs across the palm side of the hand, wrist extension stretches this nerve and can aggravate your symptoms.
“They should focus on exercises that allow them to maintain a neutral grip such as any row variation, lat pull-downs, biceps curls, pull-ups and V-bar triceps pull-downs.”
You’re certainly wondering how on earth can you engage the chest muscles if you must avoid wrist extension?
Wrist extension also naturally occurs with the following exercises:
- Incline barbell and dumbbell press
- Overhead shoulder and dumbbell press
- Seated and bar dip
- Skull crusher
- Medicine ball press
Wrist extension may occur with the following exercises:
- Chest and shoulder press with machines
- Shoulder press with kettlebells
- Chest and shoulder press with cables
- Triceps rope press-down
For pressing motions, you don’t have to extend the wrist – but this often happens naturally, and the heavier the load, the more difficult it will be to maintain a neutral grip.
Chest and shoulder press machines can be used while maintaining a neutral grip.
Kettlebells can be pressed overhead with a neutral grip if the bell hangs in front of the palm.
Cable handles can be controlled with a neutral grip.
The rope press-down can be done with a neutral grip, even though it seems that nearly everyone does them with wrist extension.
In addition, cable crossovers for chest recruitment can be done with a neutral grip.
Lateral and front raises will target shoulder muscles, and these can be done with dumbbells and cables without wrist extension.
The bottom line is that, no matter what strength training exercise you do, avoid wrist extension if this causes pain.
This includes with preacher curls, where extension of the wrist sometimes occurs when the resistance gets too heavy.
If your carpal tunnel pain doesn’t resolve with conservative treatment, and you’re unable to perform barbell and dumbbell pressing motions, you may want to consider carpal tunnel release surgery.
Dr. Thomas is a physical therapist, and strength and conditioning coach who is passionate about patient education. He believes the most important and often overlooked step in the process to becoming pain-free is understanding the anatomy and biomechanics of your body.
Lorra Garrick is a former personal trainer certified by the American Council on Exercise. At Bally Total Fitness she trained clients of all ages for fat loss, muscle building, fitness and improved health.