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Monday, October 19, 2026
The Hack
The five-shape hand sequence that glides nine tendons through your carpal tunnel
It takes no equipment and works sitting, standing, or lying down
Your carpal tunnel holds the median nerve alongside every flexor tendon of the fingers and thumb. When those tendons swell or stiffen, the nerve gets compressed. The AAOS includes a glide sequence in its carpal tunnel exercise program.
Gelberman et al. threaded a catheter into the carpal tunnel in 1981 and measured 2.5 mmHg of pressure with the wrist neutral, then 31 mmHg when the wrist bent forward 90 degrees. Carpal tunnel syndrome affects an estimated 2.7 to 5.8 percent of adults, according to a 2011 review in American Family Physician. The five-shape sequence works by sliding each tendon independently through the tunnel, which may relieve crowding on the nerve.
Kim’s 2015 systematic review of four randomized controlled trials found symptom severity decreased and functional status improved when gliding exercises were added to conventional treatment. Abdolrazaghi’s 80-patient trial (2023, mild carpal tunnel syndrome only) found the sequence did not beat a wrist splint alone. The sequence is a low-risk addition to care, not a standalone treatment.
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2.5 mmHg
tunnel pressure, wrist neutral
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31 mmHg
tunnel pressure, wrist bent
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3 sec
per hand shape
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The real reason coffee keeps you awake (and what it says about your sleep)
Here's something most coffee lovers never think about.
Caffeine doesn't really give you energy.
It works by blocking a natural compound in your brain called adenosine.
From the moment you wake up, adenosine slowly builds up in your brain. The longer you stay awake, the more of it there is, and the sleepier you feel.
Scientists call this "sleep pressure."
By bedtime, that pressure is supposed to be strong enough to carry you into deep sleep and keep you there.
Caffeine simply hides the signal for a few hours.
But plenty of everyday things can weaken that pressure or override it. A late-afternoon latte. A long nap on the couch. A stressful day that keeps your mind buzzing long after the lights go out.
And you feel it: tossing and turning, waking up at odd hours, dragging yourself through the next morning.
If you've been waiting for the night when you finally sleep straight through, this is a good place to start:
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Monday, October 19, 2026
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✅ The 5-Shape Sequence
Do one round now. Hold your hand up, wrist straight. Move through five shapes, holding each three seconds. (1) Straight hand, all fingers extended. (2) Hook fist: bend the two outer finger joints while keeping the big knuckles straight. (3) Tabletop: bend at the big knuckles to 90 degrees, keep fingers straight. (4) Straight fist: curl knuckles and middle joints down, fingertips near the palm. (5) Full fist: close all joints gently, thumb outside. Return to straight. That is one cycle. Do five cycles, then switch hands. Run the sequence two to three times today.
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Join today’s streak
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More Hand Wins
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Warm up first. The AAOS carpal tunnel protocol includes about 15 minutes of warmth before hand exercises. Soak your hands in warm water or hold a warm towel on them before your first set today.
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Flatten your wrist at the keyboard. Tunnel pressure climbs sharply with any wrist bend. If your wrists angle up or down while you type, adjust your keyboard height until forearm and hand run in a straight line.
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Ice after, not before. The same AAOS protocol calls for up to 20 minutes of cold after hand exercises to prevent inflammation. Wrap ice in a towel and place it on your wrist after your last set today.
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Quick Vote
When do your hands feel worst?
From the Mailbag
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“My fingers go numb at night and wake me up. Is the sequence enough or do I need a splint too?”
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Nighttime numbness is a classic early sign of carpal tunnel syndrome. The wrist flexes during sleep, which raises pressure inside the tunnel. The daytime sequence may help keep tendons mobile, but it does not hold the wrist neutral overnight. A wrist splint that keeps the joint near neutral during sleep is the standard first step for nighttime symptoms. Mayo Clinic guidance says to see a clinician if symptoms interfere with sleep, because untreated carpal tunnel syndrome can lead to lasting nerve and muscle damage. Start the glide sequence during the day and ask a clinician about a night splint this week.
Got an ache question? I read every one.
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Keep moving,
The Ache Report
P.S. On your next phone call, hold the phone at face height instead of looking down at the screen. One fewer tilt position each day means fewer hours of extra load on the neck.
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