Massage & Bodywork

November/December 2013

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Page 105 of 141

Want more treatment options? Visit the Online Education Center at to see Whitney Lowe's webinars, where he explores specific treatment approaches for common pathologies. 2 Poor thumb mechanics. Note multiple bends in the thumb, which will stress the joint structures. I operate the pressure tool with one hand and place a fingertip or thumb of the other hand next to the pressure tool contact surface, which allows me to palpate the tissue's response with a fingertip or thumb pad while delivering effective treatment pressure. Accurate placement of the tool, appropriate pressure, and attention to tissue/client response is critical for preventing client injury. FOREARM/WRIST INJURY Massage treatment involves significant upperextremity muscular effort, and it is no surprise that practitioners experience overuse injuries of the forearm and wrist. The most common conditions involve chronic muscle-tendon overload leading to tendinosis. This condition is most common in the wrist flexor and extensor tendons at their proximal attachment sites. Tendinosis involves collagen degeneration from extensive and repetitive overload on the tendon. Unlike tendinitis, which is actually quite rare, tendinosis is not an inflammatory condition and does not respond to traditional anti-inflammatory overuse treatment strategies. It does, however, respond quite well to massage treatment. The most effective way to avoid developing tendinosis is through conditioning. This does not necessarily mean you have to regularly do high-intensity weight training. However, putting a regular degree of appropriately designed biomechanical stress on a muscle-tendon unit makes it stronger and more resistant to the degenerative changes that lead to tendinosis. Simple conditioning exercises for the wrist flexor and extensor muscles can be performed by taking a broom in one hand and drawing figure-eight designs in the air. The level of resistance for the muscles is determined by how close the hand is to the end of the broom. Experiment with placing your hand in different locations along the broom handle to determine a good level of resistance for doing about 10 repetitions of this movement at a time. If you have already developed tendinosis, massage performed on those affected tendons will be very helpful.2 Pressure and movement applied consistently to the tendon help encourage fibroblast proliferation, which then encourages a faster recovery from the collagen degeneration. The more frequently this treatment The Shemala Finger Press Massager is applied, the is an effective pressure tool. faster the healing process and the greater likelihood of getting back to good functional activity. The challenge in treating yourself is that you have to engage the affected muscles once again to apply the treatment. However, there are some alternative methods to apply massage to your own forearms without extensively using your wrists. Pressure tools can be effectively applied to the forearms as well. The backside of a hand or a rolling pin (or a foam roller or other rolling device) can also be used as a massage tool to work the opposite extremity's flexor and extensor muscles without muscle overuse. 3 See what benefits await you. 103

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