Kinesiology THURSDAY – Adrian Belew’s Left Carpal Tunnel

In 2024, Adrian Belew, former lead guitar player for the Talking Heads, went on tour with Steve Vai, Tony Levin and Tool drummer, Danny Carey as the band Beat to perform King Crimson’s 1980’s music. He described his left hand being numb prior to sound check.

“Throughout the BEAT tour my left hand kept going numb and burning like fire. Try playing Three of a Perfect Pair without feeling your fingertips! 😂 It often happened during sound checks but was almost always good by showtime,” he posted on Instagram. (You should click on that link to appreciate what it must be like to play two sets of grueling prog rock every night.)

He was diagnosed with carpal tunnel syndrome and in January 2025 underwent carpal tunnel release by the renowned hand surgeon, Dr. Kobi Azari, the guy who performed the first successful hand transplant.

Carpal tunnel syndrome involves compression of the median nerve as it passes underneath the transverse carpal ligament.

The median nerve shares that postage stamp-sized space with the tendons of flexor digitorum profundus, flexor digitorum superficialis and flexor pollicis longus. Inflammation of the flexor tendons may compromise the space causing compression of the median nerve and resulting pain, numbness or tingling in digits 1-4 of the hand.

Carpal tunnel release involves resecting the transverse carpal ligament, thereby decompressing the median nerve. Problem solved. Or is it? There is more to the story of what contributes to inflammation of the flexor tendons.

If the butt is the hub of lower extremity function, then the scapula is like the butt of the upper extremity. Optimal scapular position provides a stable base for arm and hand function. Malpositioning of the scapula places the smaller distal structures like the common extensor tendon and flexor tendons of the hand/wrist at a disadvantage and prone to overuse injury.

Guitar players often have an elevated left shoulder. The guitar strap sits on this shoulder with most guitars weighing anywhere from 7-11 lbs. And the left hand is the one that requires repetitive finger flexion and constant thumb flexion as it navigates the fret board. Because of this, successful and complete rehabilitation from carpal tunnel release must address thoracic mobility and scapular position.

What Would I Do?

If I had the chance to rehab Adrian Belew, I would make sure to do the following:

Correct pelvic alignment. A rotated pelvis often leads to compensatory rotation of the trunk which will alter scapular position
Perform thoracic sequence to normalize rotation
Check for trigger points in the psoas major and/or quadratus lumborum. These are the two most common muscles that will elevate the pelvis and result in an elevated scapula on the same side
Check for trigger points in the upper trapezius, levator scapula and pec minor. These are the most common trigger points causing scapular elevation and protraction
Release the fascia on the volar forearm
Prescribe exercises that promote thoracic rotation, lower trap activation andscapular retraction

Why does this matter?

Carpal tunnel syndrome involves chronic inflammation of the flexor tendons from overuse. Overuse is more likely to occur when the mechanical advantage of these muscles is decreased and this occurs with proximal postural asymmetry, namely malpositioning of the scapula. Even after carpal tunnel release, it is imperative to normalize scapular position and thoracic rotation to ensure long term success of the procedure.

I may never get to treat Adrian Belew, but I hope this helps a musician out there who may be dealing with hand numbness. Rock on!

Because nobody has time to be in pain.

Until next time…