Carpal Tunnel Syndrome and Golfer's Elbow Relief: Palmaris Longus Release
This module teaches the release of the palmar flexor system, which can contribute to both medial epicondylitis and carpal tunnel symptoms.
Modality 21 · Releases: Carpal tunnel syndrome · Hand numbness and tingling · Golfer's elbow (medial epicondylitis) · Wrist pain · Grip weakness · Median nerve compression · Athletic and keyboard overuse injuries
Step 1
Understanding the Problem
Carpal tunnel syndrome and golfer's elbow are one muscle. The palmaris longus originates at the medial epicondyle on the inside of the elbow, runs down the front of the forearm and inserts onto the bases of three metacarpal bones in the palm. When it fatigues into spasm from gripping, typing, tools, racquets or instruments, it pulls at the medial epicondyle, producing golfer's elbow, and it pulls the distal carpal ridge down into the ventral plane of the wrist, crunching everything inside the carpal tunnel and shutting down the median nerve completely. In our experience every case of carpal tunnel syndrome is a palmaris longus in spasm. It does not need to be cut; it needs to be released. When it lets go, the carpal bones lift back out of the tunnel, the wrist usually gives a series of cracks like a chiropractic adjustment, and the numbness clears.
What this release relieves
- Carpal tunnel syndrome: numbness and tingling in the hand. The palmaris longus in spasm pulls the distal carpal ridge into the wrist and crushes the median nerve in the tunnel. Release the muscle, the ridge lifts, the tunnel opens and the nerve comes back. In our experience this is the cause every time.
- Golfer's elbow (medial epicondylitis). The same muscle pulling on its origin at the inside of the elbow. Release the pull and the inflammation has no reason to continue.
- Wrist pain and palm tension. The palmaris longus tightens the palm and holds the wrist compressed; releasing it frees both, often with an audible crack, crack, crack as the carpal bones move back into place.
- Hand weakness and pain with gripping. A shut-down median nerve loses signal and a spasmed flexor loses range. Grip and sensation return as the nerve is freed.
- Overuse injuries from keyboard, tools, racquet or instrument. Repetitive gripping and typing fatigue the palmaris longus first; the release is the same, and the modality teaches a self-release for maintenance.
Medial epicondylitis and carpal tunnel syndrome are often treated as separate conditions.
In practice, they frequently share a common muscular source: the palmaris longus and its associated flexor tension pattern.
The palmaris longus runs from the medial epicondyle down into the palm through a long central tendon.
When it enters spasm, it can create:
• pulling at the medial elbow
• tension through the flexor forearm
• compression into the palm and wrist
This is why a client may present with both:
• medial elbow pain
• numbness or tingling into the hand
The symptoms appear to be separate.
The cause is often one continuous line of tension.
Frequently asked questions
I was told I need carpal tunnel surgery. Can this help first?
Surgery cuts the ligament over the tunnel to make room. In our experience the room is missing because the palmaris longus in spasm has pulled the carpal ridge down into the tunnel. Release the muscle and the room comes back without cutting anything. Persistent numbness with muscle wasting in the hand should still be evaluated by a physician.
Why does my wrist crack when it is released?
Because the palmaris longus had pulled the distal carpal bones down into the ventral plane of the wrist. When the muscle releases, the bones move back to where they belong, and that movement is the crack. It is the tunnel reopening.
What about the pronator muscles? I read they compress the median nerve too.
They do. The pronator teres and pronator quadratus (Modality 23) compress the median nerve enough to cause discomfort, and they are released when they are involved. But they do not produce the full carpal tunnel syndrome. That takes the palmaris longus.
Is this tennis elbow?
Tennis elbow is the opposite side of the elbow, the extensor group at the lateral epicondyle, released in Modality 20. Golfer's elbow and carpal tunnel belong here, with the palmaris longus.
Read more: Carpal Tunnel Syndrome Without Surgery: Why the Palmaris Longus Is the Muscle to Release
Step 2
The Clinical Problem
Step 1: Understanding the Problem
Medial epicondylitis and carpal tunnel syndrome are often treated as separate conditions. In practice, they are the same fundamental problem. The palmaris longus and its associated carpal flexors are in spasm
The palmaris longus runs from the medial epicondyle down into the palm through a long central tendon. When it enters spasm, it can create:
• pulling at the medial elbow
• tension through the flexor forearm
• pulling on the flexor retinaculum, pulling it up the forearm like pulling on a sock
• entrapment of the median nerve where they entertwine on their path under the flexor retinacuolum. the palmaris longus has a tendon sheath that runs along with and next to the median nerve and where they cross under the retinaculum
• the palmaris longus teminates as three tendons that attach to the base of the metacarpal bones. These bones are directly connected, via mc joints to the carpal bones. When these muscles spasm, they pull the carpal bones forward and can collapse the carpal ridge like a bridge with too much weight in the middle. For this reason, these joints can automatically reset and make popping sounds when this muscle is released.
The symptoms of carpal tunnel syndrome and golfer's elbow (medial epicondylitis) are thought of as different problems, but they are truly different symptoms of a muscle spasm. Now, hopefully you know which muscle that is.
Wrist pain and Golfer's Elbow are caused by the same muscle spasm - the palmaris longs
Step 3
Why This Happens
The palmaris longus is a long tensile structure. When it enters spasm, it creates constant pull from the medial epicondyle into the palmar fascia.
At the elbow, this produces:
• traction at the medial epicondyle
• the pattern commonly called golfer’s elbow or medial epicondylitis
At the wrist and hand, it contributes to:
• increased tension in the palmar tissues
• reduced space and glide for neural structures
• compression patterns consistent with carpal tunnel syndrome
This is why both ends of the line must be understood together.
The logic is:
👉 palmaris longus in spasm
👉 medial pull at the elbow
👉 distal tension across the median nerve under the carpal flexor ligament
👉 median nerve irritation (carpal tunnel syndrome) and wrist compression
👉reduced nerve signalling across the impingement
When the muscle releases, both proximal and distal symptoms will be released and relieved.