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Carpal Tunnel Syndrome During Pregnancy

During pregnancy, a woman’s body changes in many different ways. Some of these changes are due to hormonal fluctuations. Others are caused by the additional mechanical stress on the musculoskeletal system of carrying another human being in one’s uterus. It is important to be aware of what these changes are so that you can better understand what’s happening in your body and learn ways to support the changes to be as comfortable as possible.

Carpal tunnel syndrome (CTS) is common among pregnant women. Approximately 34% of women report symptoms of CTS during pregnancy. Compare this to the 4% of non-pregnant women who experience CTS. Most of the symptoms emerge in the third trimester and occur in both wrists. The most common symptom is tingling of the fingers at night. Though this sounds like not a big deal, it can be incredibly uncomfortable, distracting and get in the way of daily activities. Other symptoms include weakness of grip, stiffness of fingers and numbness in the thumb side of the hand. Even though over a third of pregnant women report symptoms associated with CTS, these complaints are often not addressed either because the woman’s care provider does not ask about it, or because the symptoms are considered mild and are not brought up by the expecting mother. However, mild to moderate discomfort in the hand and wrist could have implications beyond the musculoskeletal component and should be addressed before those issues emerge.

Carpal tunnel syndrome is caused by compression of the median nerve in the carpal tunnel. The carpal tunnel is a small passageway in the wrist that is bordered by bone and an inflexible ligament called the carpal ligament. There are several structures that run through the carpal tunnel, including muscle tendons that attach onto the fingers, and the median nerve, which provides sensory and motor innervation to the thumb side of the hand. The symptoms associated with carpal tunnel result from compression and impairment of the median nerve. This compression can be caused by an increase in fluid, resulting in edema (swelling) in the wrist joint. It can also result from inflammation of the synovial sheaths surrounding the muscle tendons. This inflammation is usually caused by repetitive movement of the fingers when the wrist is in an extended position, such as when typing on a keyboard without wrist support. During pregnancy, the most likely cause is swelling due to fluid retention in the body, which can be exacerbated by repetitive movement. An increase of fluid retention is one of the symptoms that correlate strongly with symptoms of CTS in pregnant women. There is a normal amount of swelling that is expected during pregnancy, and even within this normal range, CTS can occur.

On the whole, the severity of symptoms in pregnant women tend to be less than those in non-pregnant women, even though more pregnant women have symptoms. However, since most of the symptoms in pregnant women occur at night, they can interfere with women getting a restful night sleep. So even if the CTS symptoms themselves are mild, the consequences of the lack of sleep can be more severe. Poor sleep can put patients at risk for mild depression and anxiety. It makes a huge difference for women to transition to motherhood as well rested as possible, so even mild cases of CTS should be reported to one’s doctor so that symptoms can be addressed and relief found.

Luckily, there are some easy and effective methods of alleviating symptoms. Using a wrist splint at night proved helpful to 80% of participants in a recent study. Dietary factors that can reduce swelling include lowering the amount of sodium intake and increasing the amount of potassium intake. Bananas are a favorite source of potassium for many people. Inactivity is also a contributing factor. Yoga can also provide relief through movement.


Recommendations to reduce symptoms of CTS:

1. Wear a wrist splint at night.

2. Eat more potassium. Sweet potatoes, spinach, tomato sauce, black beans, white beans, butternut squash and watermelon are all great sources.

3. Eat less salt

4. Light exercise

Please make sure to check with your doctor and let her know about any symptoms you have related to carpal tunnel syndrome or to excessive swelling due to fluid retention. With some minor changes, women can find a lot of relief and increase enjoyment of their pregnancies!
carpal tunnel.001Image 1: Front of wrist showing the bones and ligaments of the carpal area. The carpal ligament lies on top of several muscle tendons, shown in gray, and the median nerve, in yellow.


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Image 2: Cross-section of the wrist showing the area of the carpal tunnel bordered in blue. You can see the muscle tendons and the synovial sheaths covering them as well as the median nerve (in yellow).

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Benefits of a Prenatal Partner Class - or Why Should I Drag my Partner to Yoga on a Saturday Afternoon?

by Andrea Dixon When I first started teaching prenatal partner yoga classes, I was pregnant with my first child. Since I was pregnant along with my students, my husband came with me to be my partner in the partner classes. I knew it wasn’t his first choice of things to do on a Saturday afternoon, but he was agreeable and sweet about it. After our son was born, he confessed that he actually hadn’t really wanted to go at all, but he was glad he had since what he learned was so helpful to him when he supported me in labor! I’ve heard similarly from many other students and their partners through the years, so I know my husband is not alone in his experience. Partner prenatal classes offer ways to support your shared experience of awaiting your child, connect with each other and with your baby, as well as tangible tools, poses, and ideas for partners give supportive during pregnancy and birth. Read More

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Prenatal Teacher Training weekend 3 recap

What an amazing weekend. The community this group has created is a joy to be a part of! Sara joined us to kick off our weekend with a discussion on mindfulness, using the text, The Miracle of Mindfulness, as a starting point. It was a rich, emotional and tender discussion, and it brought up ideas and concepts that we returned to throughout the weekend. Later in the weekend, we did other mindfulness exercises, including the Raisin Meditation (from Mindful Birthing, one of my all-time favorite books). Read More

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Teacher Training weekend 9 recap

This was the last weekend of teacher training for these wonderful students! It was a fun but busy weekend. On Friday night we talked about ethics as a yoga teacher. There are several ways in which we need to pay attention to ethical considerations. In no particular order, there are the ethics of the student/teacher relationship, the ethics of professionalism, and the ethics of knowing your limits as a yoga teacher. I like to tell the students that there are some things that should be obvious, but are not. For example, it should be obvious that a yoga teacher (who is not also a doctor) is not qualified to give medical advice. However, students will ask you all the time what they should do about various injuries. It's always important to listen to their concerns, ask if they're seeing a medical professional, and advise them against doing anything that aggravates their injury. But trying to diagnose or treat any condition is outside the realm of what a yoga teacher is qualified to do. Read More

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Prenatal Teacher Training weekend 2 recap

This is always my favorite weekend of the prenatal teacher training, because our main focus is birth! Throughout the weekend we talked about birth from various perspectives – historical (what influences and developments have brought us to what we have today in the US), cultural (how we tend to view pregnancy and birth), medical (what options women have in childbirth), and of course what actually happens in a woman’s body during labor and birth. Throughout the weekend we return many times to the questions of: what does this mean for our pregnant students? how does this show up in a prenatal class? And – most importantly – how can we best support our pregnant yoga students to have the most embodied, powerful, and positive experience, regardless of what unfolds during her transition to motherhood? Read More

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Teacher Training weekend 8 recap

On our second-to-last weekend together, we talked about teaching yoga basics. Teaching yoga to new students can be one of the most rewarding aspects of being a yoga teacher. Yoga can bring so many benefits in both physical and mental realms and it’s wonderful work to bring those benefits to beginner yogis. But teaching yoga basics is also a huge challenge, and not one that should be taken lightly as a teacher. Read More

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Teacher training weekend 7 recap

This past weekend was our 7th weekend together. It was somewhat of a catch-up weekend, allowing us to revisit some poses and concepts in a little more depth. Our teaching practice focused on longer holds and getting comfortable with silence. We also had a couple of wonderful guest teachers who shared some special teachings. Read More

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Teacher Training weekend 6 recap

This past weekend was our sixth weekend together. The asana focus was on seated poses, primarily twists and forward folds. These poses are important for everyone, although they are often not given the same amount of attention as the other pose groups. Seated poses are important for creating and maintaining openness in the hips. It is hard for many people to sit on the floor and we have limited mobility in the hip joints due to constantly sitting in chairs. So work on this can help to keep us healthy through old age. Read More

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Teacher Training weekend 5 recap

The asana focus of our 5th weekend of teacher training was arm balancing and inverting. This is always a fun weekend to teach because there is always one or two breakthroughs with the students. Sometimes it is overcoming fear, sometimes there was a simple piece missing in a pose that made all the difference. It’s also a good opportunity to talk about honoring your own path and not being distracted by the journey (or handstand) of another student. We also continued to make our way through Pada 2 (Sadhana Pada) of the Yoga Sutras by Patanjali. Read More

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Teacher Training weekend 4 recap

During our 4th weekend together for the 200hr Teacher Training, we focus on back bends. This can be a difficult weekend physically because back bends require a lot of strength and concentration. We also discussed the anatomy of the back and how to stay safe in your asana practice. At the end of the weekend, Jacque gave a guest lecture on yoga therapeutics. On Friday night, we reviewed sequencing of standing poses, and then talked about sequencing an entire class. There are different strategies to putting together a class. You can build towards a peak pose, focus on an anatomical area, build a class around a philosophical theme, or just offer a generalized class. No matter what type of class you are building, you are trying to create a certain experience for you students. And the experience comes in part from how the class is put together. A class that starts with headstand is going to be a very different experience than a class that starts in child's pose. A class with 20 vinyasas will be a different experience than a class with 20 bridge poses. So we talked about strategies for putting together an effective class that would offer a positive experience for students. Read More

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