Massage & Bodywork

JANUARY | FEBRUARY 2023

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Angle of Our Forearms When working with the thumb-web brace for a palm contact (whether it is the full-f lat palm or a hypothenar- oriented or thenar-oriented palm), the force for the pressure can be generated from either-side upper extremity, or both upper extremities. In other words, the brace-side hand can contribute to the force of the stroke. The degree of contribution can vary from adding perhaps 10–20 percent of the force, to being 50 percent of the force, to even being the majority, or even all, of the force of the stroke. This is important because it allows for us to change the angle of our forearms, which in turn changes the angle of our wrist joints. For example, if we have the contact-side hand generate all the force, then if we want to meet the contour of the client's body perpendicularly (which allows for maximal pressure with minimal effort), then the angle of the forearms would need to be vertical, which would then require the posture of our wrist joint to be in full or near-full extension (Image 8A). This could be injurious to therapists' wrists. If instead, we share the force of the stroke 50/50 between the contact and brace hands, then we can change the angle of our forearms to be less vertical, allowing our wrist joints to be in less extension (Image 8B). But the resultant force is still vertically downward and perpendicular to the contour of the client's body. We maximize the efficiency of our force, and with a healthier posture to our wrist joints. Of course, we do not want to angle our forearms too horizontally, or we lose the ability to transfer force from our core into the client (Image 8C). QUANTITY OF STRENGTH, QUALITY OF FEEL There are many choices for contact when performing manual therapy. Each contact has advantages and disadvantages. When deciding between smaller and larger contacts, I hope you consider the palm as perhaps the ideal middle-sized contact because of the advantages that it shares with both smaller and larger contacts. And beyond the consideration of the size of the palm contact, there is also the quality of the feel of the palm as a contact. Its strength and stability are matched by its comfort because of the surrounding myofascial tissue. And when you learn how to change the orientation of the palm to focus toward the hypothenar eminence and its pisiform, or the thenar eminence with its trapezium/ scaphoid tubercles, the specificity and efficiency of our work increases multifold. So, consider the palm for its quantity of strength and its quality of feel. Dr. Joe Muscolino has been a manual and movement therapy educator for more than 35 years. He has created several online streaming subscription platforms for manual therapy continuing education, including LearnMuscles Continuing Education (LMCE) with more than 3,000 video lessons and more than 300 hours of NCBTMB credit. He has also created Muscle Anatomy Master Class (MAMC), Bone and Joint Anatomy Master Class (BAJAMC), Visceral Anatomy Master Class (VMC), and Kinesiology Master Class (KMC). He is the author of multiple textbooks with Elsevier and has authored more than 90 articles. For more information on any of Dr. Joe's content, visit learnmuscles.com. To contact Dr. Joe directly, you can reach him at joseph.e.muscolino@gmail.com. L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 53 8A: Wrist joint in full extension. 8B: Forearms angle so that the wrist joints are in less extension. 8C: Excessive change in angle of the forearms. Light green arrows represent the force transmitted through the forearm. Dark green arrows represent the resultant force into the client. 8A 8B 8C

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