Stretching for Hand Health: Managing Carpal Tunnel Syndrome
Author: Justin Stehr, OTR/L, CHT, WCC, CEAS, Occupational Hand Therapist
Your Hands Deserve the Best Care 🖐️
Our hands are essential for daily life, yet conditions like carpal tunnel syndrome can make even simple tasks challenging. By understanding your hand’s anatomy, incorporating targeted stretches, and using tools like therapy gloves, you can protect your hand health and improve functionality.
The Anatomy of the Carpal Tunnel and Hand Health
🔑 Carpal Tunnel: A narrow passage in the wrist bordered by carpal bones (scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, and hamate) and the transverse carpal ligament. Swelling or inflammation within the carpal tunnel can compress the median nerve.
🔑 Median Nerve: Runs through the carpal tunnel, controlling sensation and contributing to movement in the thumb, index, middle, and half of the ring finger.
🔑 Flexor Tendons: Tendons like the flexor digitorum superficialis and profundus bend your fingers and the flexor pollicis longus bends the thumb.
🔑 Palmar Aponeurosis: A thick connective tissue in the palm that can tighten without regular stretching.
The transverse carpal ligament forms the “roof” of the carpal tunnel, a narrow space at the base of the palm. This ligament stabilizes the wrist and protects vital structures—including the median nerve and flexor tendons—that pass through the tunnel.
When this ligament becomes tight or thickened from repetitive stress or inflammation, it reduces space within the tunnel. That pressure can compress the median nerve, leading to symptoms like numbness, tingling, and hand pain—classic signs of carpal tunnel syndrome.
The Benefits of Stretching the Transverse Carpal Ligament
Throughout the day, we constantly grip objects—whether it’s holding a phone, typing on a keyboard, or carrying items. While gripping, we engage our flexor and adductor muscles to close our fingers, but when we release, we rarely forcefully extend or stretch them. Instead, we relax the fingers to let go.
These repeated motions create “flexor dominance,” where the flexor muscles and tissues (including the transverse carpal ligament) become tight and overused, while the extensor muscles remain under-engaged. Over time, this imbalance can contribute to stiffness, reduced mobility, and discomfort in the hands.
Stretching the transverse carpal ligament helps counteract this imbalance. It promotes more space for the median nerve, supports better nerve mobility, and may reduce the risk of surgery down the line. Stretching also balances the flexor and extensor muscles, reduces tightness, and supports better overall hand health.
Carpal tunnel stretches can be particularly helpful for anyone with repetitive strain injuries, desk work, or poor wrist posture.
Step-by-Step: Transverse Carpal Ligament Stretch Technique
Carpal Tunnel Stretch (Wall-Based)
- Place your palm flat against a wall with the wrist extended to 90 degrees, fingers straight and thumb extended.
- Use the other hand to gently pull back on the base of the thumb, focusing on a stretch near the wrist.
- Hold for 30 seconds, repeat 4x daily.
This stretch targets the transverse carpal ligament , which covers the carpal tunnel and protects the 8 finger flexor tendons, the thumb’s flexor tendon, and the median nerve.
Safety Tip: You should feel a firm stretch—not sharp pain. If numbness or tingling increases during the stretch, ease off and consult a hand therapist.
Complementary Stretches for Total Hand Health
To support a more complete recovery, it’s important to combine your transverse carpal ligament work with carpal tunnel exercises that address mobility and tendon glide. Here are two effective stretches for your hand health:
Intrinsic Finger Stretch
- Begin in the hook fist position: Bend your fingers at the PIP and DIP joints, keeping the MCP joints straight.
- Use your opposite hand to gently push the MCP joints into hyperextension, maintaining flexion in the other joints.
- Hold for 5 seconds, repeat 5–10 times per hand.
The Digit Tendon Glide Sequence
This sequence enhances tendon mobility and reduces stiffness:
1️⃣ Straight Hand: Fingers fully extended (high-five position).
2️⃣ Hook Fist: Bend the fingers at the middle (PIP) and end (DIP) joints.
3️⃣ Full Fist: Curl all joints (MCP, PIP, DIP), pressing fingertips into the palm.
4️⃣ Straight Fist: Extend the DIP joints while keeping the MCP and PIP joints bent.
5️⃣ Tabletop (Flat Fist): Create an “L” shape by extending the MCP joints and bending the PIP/DIP joints.
Repeat 5–10 times per hand, 3x daily, holding each position for 5 seconds.
Recommended Stretching Protocols for Carpal Tunnel Relief
Consistency is everything in symptom management. Clinical research suggests daily practice of carpal tunnel stretches can reduce inflammation and improve nerve function over time.
Most people benefit from performing various stretches 3–4 times per day. While results vary, some report reduced tingling and improved comfort in 2–3 weeks, especially when stretches are paired with supportive tools.
The key is long-term commitment—even small, consistent efforts can bring lasting pain relief and help avoid more invasive options like carpal tunnel release procedures.
Tools That Enhance Stretching Outcomes
While stretches form the foundation of hand therapy, the right tools can take your progress further. Protect and support your hands with rehabilitation gear like the MetaFlex Glove:
✅ Protect skin and reduce joint pressure.
✅ Improve circulation by keeping hands warm.
✅ Promotes gentle venous return without impeding vascular in-flow.
✅ Enhance grip with textured fingertips.
✅ Stretch while you sleep with elastic extension straps that gently stretch the flexor tendons, palmar aponeurosis, and tendon sheaths overnight.
Pairing gloves with a wrist orthosis during sleep keeps the wrist in a neutral position, helping reduce nighttime compression on the median nerve. Nighttime stretching also improves compliance, because your body stretches while you rest—no extra time required.
Take Charge of Your Hand Health
The best way to care for your hands? Make support part of your routine—not just something you do when symptoms flare up. By combining anatomy-focused stretches, tendon gliding exercises, and tools like the MetaFlex Glove, you can manage conditions like carpal tunnel syndrome and trigger finger. These strategies improve flexibility, reduce inflammation, and support overall hand functionality.
A few minutes of stretching in the morning, again in the evening, and wearing your glove overnight can go a long way. It’s not about doing everything at once—it’s about being consistent.
👉 Your hands work hard—give them the care they deserve.
References
Carpal Tunnel Syndrome: A Summary of Clinical Practice Guideline Recommendations—Using the Evidence to Guide Physical Therapist Practice. Journal of Orthopaedic & Sports Physical Therapy . 2019;49(5):359-360. doi: 10.2519/jospt.2019.0501
Pompeu Y, Aristega Almeida B, Kunze K, Altman E, Fufa DT. Current Concepts in the Management of Advanced Trigger Finger: A Critical Analysis Review. JBJS Reviews . 2021;9(9). doi: 10.2106/JBJS.RVW.21.00006
Shem K, Wong J, Dirlikov B. Effective self-stretching of carpal ligament for the treatment of carpal tunnel syndrome: A double-blinded randomized controlled study. Journal of Hand Therapy . 2020;33(3):272-280. doi: 10.1016/j.jht.2019.12.002
Erickson M, Lawrence M, Jansen CWS, Coker D, Amadio P, Cleary C. Hand Pain and Sensory Deficits: Carpal Tunnel Syndrome: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Academy of Hand and Upper Extremity Physical Therapy and the Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association. Journal of Orthopaedic & Sports Physical Therapy . 2019;49(5):CPG1-CPG85. doi: 10.2519/jospt.2019.0301