Guide to Carpal Tunnel & Horseback Riding

Do you ride horseback a lot? Do your hands also hurt? It's not surprising because carpal tunnel & horseback riding are related.

Many people come to me about their hand pain or numbness. When I inquire about what they do with their hands, a good number say they ride or handle horses.

That's when I say, “Ah ha! Let me tell you about carpal tunnel syndrome and why you have hand pain around your horses.” 

Actually, most people who work their hands hard experience this. So it's not exclusively an equestrian matter. As a matter of fact, numbness or pain in the hand, fingers, and wrist are all signs of overworked hands or even wrist tendonitis -- not necessarily carpal tunnel syndrome.

• FIND OUT: do you have carpal tunnel? No strings attached self-test.

Handling horses requires gripping reigns, lead ropes, etc. Hence, controlling an animal that weighs about 1,500 pounds requires a real tight grip on the lines. Just riding for pleasure sometimes requires maintaining a grip on the reigns for hours at a time.

Hand pain from horseback riding is fundamentally a “gripping” problem. Gripping for long periods like this is abnormal to the human physiology. In essence, it stresses the flexor tendons, sometimes beyond their limits. These tendons are designed by Mother Nature to grip and release. But not quickly or with force – at least not repeatedly and for hours on end.

Carpal tunnel, horseback riding, and hand pain are always going to be associated. It's no different than carpal tunnel being associated with hairdressing or playing guitar (two other high risk activities).

Nor is it different from any activity where you grip something for long periods of time. It’s especially worse when you grip with force, relax, and grip again, over and over. Doctors call this repetitive stress injury or RSI.

Some scientists and doctors (me included) don't consider carpal tunnel syndrome a true RSI. However, others do. I won't get into the physiological details about why or why not. But there's no doubt that carpal tunnel syndrome is the leading cause of hand pain in the United States today, after arthritis. In fact, carpal tunnel syndrome occurs in about 5% of the population. And the rate is increasing.

So yes, the hand pain and numbness from horseback riding can be the onset of carpal tunnel. But it can also be tired hands or wrist tendonitis. The two latter conditions are much easier to treat (usually with just a few days rest) than carpal tunnel.

If you actually have carpal tunnel, horseback riding probably brought it on. Unfortunately, there is no “cure” for carpal tunnel syndrome. The most you can do is manage the condition. 

It’s like asking, “What’s the cure for diabetes?” There is no cure. However, you can manage diabetes (with insulin) quite well.

The same goes for carpal tunnel syndrome. There's no cure but there are many carpal tunnel treatments that are so effective that pain or numbness will never bother you again.

The most successful way equestrians (or anybody else) can eliminate carpal tunnel syndrome is to use the “B.R.E.M.” combination. That stands for Brace, Rest, Exercise, Massage.

Brace your hand while you sleep. NEVER wear a wrist brace during the day if you have carpal tunnel syndrome. Doing so only makes your hand subconsciously fight the brace in addition to doing its regular work. That makes the problem worse.

And make sure your night brace doesn't have a palmar spine. If you unconsciously bend your hand backward while sleeping, a palmar spine will push into your carpal tunnel, making matters worse.

Rest is nature's remedy for just about anything. Indeed, we rest because pain is how nature tells us to stop doing what's causing the problem.



Therefore, rest your hands as often as you can. Also, never maintain a constant grip on ropes or a rein. Be especially careful to avoid a lot of grip-and-release activities without resting your hands in between. During your rest periods, add stretching exercises to the rest period (see below).

If you have hand numbness or pain from carpal tunnel, horseback riding is probably the reason for the problem. But one of the key ways to solve the problem is with stretching exercises which are dedicated to flexor tendon health.

Exercise and stretch your fingers as often as you can. Targeted carpal tunnel exercises stretch your fingers, hand and forearm. That means the entire length of the flexor tendons. Regular stretching exercises are perhaps the best way to avoid having hand pain when you stress your hands.

Massage is an ancient therapy. But it's effects on the body can be miraculous. Using massage for carpal tunnel is no different.

Massage your wrist and forearm as frequently as you can. Dig your thumb into your forearm, just below your wrist crease. Then, make circular motions for a few minutes. This promotes fluid drainage and blood flow. In fact, the best massage is called myofascial release. But you can't easily do it on yourself because you need two thumbs for best results.

Carpal tunnel, horseback riding, and hand pain go, well, "hand in hand". They're practically inseparable. But you can enjoy your horse without the pain, numbness or other symptoms of carpal tunnel syndrome. A regimen incorporating braces, rest, exercise and massage will help you avoid these problems. And in most cases they can even reverse the condition.