Issue link: https://www.massageandbodyworkdigital.com/i/121374
The Thenar Eminence Technique. Slowly and patiently work into the structures of the thenar eminence. Add active client thumb and finger movements in order to separate tissue layers. Keep a small amount of flexion in each joint of your own thumbs. Image 5 courtesy Advanced-Trainings. com. Used by permission. A Few Rules of Thumbs Here are some principles of sustainable thumb use: • he best way to save your thumbs T is to use something else instead. The most sustainable thumb alternatives are boney projections such as your forearm, soft fist (Image 7), or knuckle. With practice and creative positioning, any of these tools can be as sensitive and specific as your thumb. • void hyperextension at any A of your thumb joints (Image 6). Hyperextension may feel stable, but this stability relies on stretching your articular ligaments and joint capsules to their maximum length, which will cause them to slacken over time. This leads to less stability and eventual pain. Hyperextension of any of the thumb's joints can strain articular ligaments, eventually reducing joint stability. • eutral joint position is good; N even better is to keep a small amount of flexion at each thumb joint. Engaging the powerful flexor muscles of your palm will support your thumb joints and ligaments. If this positioning isn't familiar, you may need to practice it gradually as you develop the necessary flexor strength. You don't actually need much strength, but you do need a little, and if you're not accustomed to working with slightly flexed thumb joints, the muscles involved may be quite weak. •P ain or discomfort is a sign that something is wrong. If your thumb or hand hurts when doing a technique, do it a different way. This sounds obvious, but many of us forget about our own comfort when we're focused on that of our clients. • ome practitioners S have found handheld tools or thumb splints useful. I haven't, but you might. When using 6 116 massage & bodywork The first variation of the Thenar Eminence Technique (Image 5) uses the practitioner's thumbs to feel into and release the various layers of the palm. Be sure to use your own thumbs in a way that is comfortable and sustainable for you. Especially avoid any hyperextension by maintaining a little bit of flexion in each of your thumb joints. Work from the center of the palm outward, starting superficially with the palmar fascia, then working deeper, layer by layer, until you're deep within the thenar eminence. Although there is some sliding involved, we suggest not using oil or lotion as the friction will actually lend therapeutic stretching to the palmar and muscular fascias; it should not be uncomfortable if you work slowly enough. As always, be sure your pressure isn't too painful for your client. If he or she is gripping or contracting elsewhere in the body as a result of your pressure or speed, you're working against yourself. Slow down and let the layers melt away. The thumb figures large may/june 2013 a handheld tool, be sure you're acutely attuned to your client's verbal and nonverbal signals since you have less direct tactile feedback with a tool. • ave your thumbs for the few S places where they excel and are truly irreplaceable. After several thumb injuries unrelated to bodywork, and after 30 years of manual therapy practice, I still use my thumbs quite comfortably (knock on wood) in a few areas. In addition to the Thenar Eminence Technique, I use my thumbs for working the iliolumbar ligaments, knee (meniscal ligaments, infrapatellar fat pad, and patellar tendon), and sacrotuberous ligaments ("Working with Sacrotuberous Ligaments," Massage & Bodywork, September/ October 2012, page 114), but hardly anywhere else—that's the way I've found to make them last.