Carpal Tunnel. What is it?

Carpal Tunnel: What is it?

In the United States Carpal Tunnel syndrome affects 1 in 3 per 1000 people.  It is an upper extremity condition that affects the median nerve with symptoms of numbness, tingling, burning and aching which affects the thumb, index, middle and ring fingers. 


Once symptoms occur, there are multiple different treatment options which include splinting, resting, icing, Occupational and Physical Therapy, cortisone injections by an MD, and surgical intervention. Diagnosis comes from a team of specialists including Neurology, Primary Care providers, Orthopedic Surgeons, and Physical/Occupational Therapists. 

In Occupational Therapy we start with splinting utilizing thermoplastic material to make a custom splint to support and decrease compression to the median nerve. 

Interventions such as stretching, pain and edema management, and nerve glides are utilized to minimize symptoms and symptoms are monitored creating a treatment plan which best fits the individual. 

The good news is- Carpal Tunnel can be treated, and this is not a pain that you have to live with!


Tiffany Benoit, OTR/L

Tiffany is an Occupational Therapist at Dan Wyand, PT & Associates. She joined the team in the spring of 2013 as a Physical Therapy Aide assisting clients with their workouts in the gym. 

She graduated from Lyndon State College in 2103 with a BS in Exercise Science with a concentration in pre-professional Physical Therapy. She completed the Masters in Occupational Therapy Program at Utica College and now provides inpatient Occupational Therapy for patients at NVRH, and outpatient Occupational Therapy for Dan Wyand, PT & Associates.

Tiffany enjoys staying active and spending time with her family.

Coaching the Split Squat

Coaching the Split Squat

Working with clients over the years I have found that most struggle initially with the split squat movement.  As a coach I want my clients to be able to perform a split squat before a lunge movement and it was surprising to me how many struggled with this.
Over the past few months I have been working in the clinic with a lot of knee replacement patients and these patients have to re-learn a lot of movements but also retrain their bodies to utilize muscles they may not have previous to their surgery.  
For these patients, and honestly for a lot of clients I had in the gym, being able to perform daily activities with relative ease is very freeing to them, especially after a major surgery.  
In regards to the split squat, for a patient to get down and back up off the ground is a huge accomplishment and how I teach that is initially for the patient to perform a split squat with or without a modified depth goal (depending on the patient).
The important thing to remember with the split squat is that it is a 2 leg exercise.  You MUST use both legs in order for it to work effectively.  And this is a common mistake that a lot of my clients initially performed before correction.  I want to primarily discuss the back leg in the split squat (this also carries over to the lunge movement). 
The first thing I tell my clients is that the back leg initiates the movement of the split squat.  I tell them that because it keeps the front knee in a good place and keeps your body weight over your hips where it should be.  Bending the front knee first pushes weight forward onto the front knee more than you want.  The second cue I tell my clients is to lift the back heel but keep the toes planted.  This foot position keeps the back leg engaged and prepared for the lift phase of the split squat (getting off the floor).  The video below shows the two foot positions; the first one is a non engaged back leg for lift off and the second foot position is an engaged back foot position for lift off. 
So to review: 
Once in split position, keep back foot engaged by planting toes and heel elevated of back leg.
To initiate the movement, bend the back leg knee first to keep weight centered over the hips and utilize both legs in the movement.
To lift from the ground push through the front leg heel and the back leg toes to engage both legs.

Ben Warstler, CSCS, NSCA-CPT, USAW-1, KBA, YFS-1

Ben, former owner of Fortitude Fitness Systems, INC (Bens Bootcamps) for 12 years is returning to his roots in rehabilitation. Ben graduated from the University of Maine at Presque Isle with a degree in Athletic Training in 2001. 

Expanding his Sports Medicine skill at Amherst College for 2 years working with 40 varsity athletic teams, Ben moved more into the strength and conditioning field but has always pulled on his athletic training background. He enjoys seeing his clients realize their potential and break through previously thought barriers in their movement and abilities.

Ben, originally from Maine, moved to Vermont in 2005 and lives in Lyndonville with his 4 children, and wife Nedah. In his free time Ben enjoys weightlifting, spending time with his family, and upcycling furniture.

Staff Spotlight: Neil Abella

Staff Spotlight: Neil Abella

Neil Abella is our newest Physical Therapy Assistant and is based out of the St. Johnsbury clinic. Neil took units in Master of Physical Therapy from Southwestern University after graduating from his 5-year Bachelor of Science in Physical Therapy course from Misamis University in the Philippines.  

Neil graduated from the Physical Therapist Assistant Program from River Valley Community College in Claremont, NH in 2017.  He has had various exposures in acute/subacute care, community-based rehabilitation, outpatient, skilled nursing facility, and home health settings in the Philippines and in the US for the past 20 years.  

Neil is also a certified First Aid instructor in the Philippines and held an EMT license here in the US.  He recently got certified this year for the LSVT BIG Program to help People with Parkinson ’s disease.

Neil greatly enjoys mountain biking, stand up paddling, and hiking with his family.  He gets immense pride in defeating his 9-year-old and 22-year-old sons in games of chess and he loves to walk his high energy dog, Rocky twice a day.