Issue link: https://www.massageandbodyworkdigital.com/i/296580
52 m a s s a g e & b o d y w o r k m a y / j u n e 2 0 1 4 Palpating the Palmaris Longus Positioning: client supine with forearm supinated. 1. Passively flex the elbow and the wrist to slacken tissue. 2. Locate the medial epicondyle and flexor tendon with the thumb. 3. Move distally and medially onto the muscle belly of the palmaris longus. 4. Resist at the base of the fingers and thumb as the client strongly cups the palm and flexes the wrist to ensure proper location. FUNCTIONAL ANATOMY Dysfunction of the palmaris longus takes many forms. One such dysfunction is fibrosis of the palmar aponeurosis (Dupuytren's contracture), which limits mobility when opening the hand and extending the fingers, particularly the fourth and fifth digits. Trigger points in this muscle present as a superficial, prickling sensation in the palm, sometimes extending to the base of the thumb, but not into the fingers. Clients may also report tenderness on the palm and lack of grip strength. Activities that involve grasping implements or applying pressure to the palm (such as walking with a cane) exacerbate these symptoms. Maintaining proper range of motion, tone, and circulation in the palmaris longus and minimizing adhesions in the palmar fascia and aponeurosis may prevent or relieve these issues. Christy Cael is a licensed massage therapist and certified strength and conditioning specialist. Her private practice focuses on injury treatment, biomechanical analysis, craniosacral therapy, and massage for clients with neurological issues. She is the author of Functional Anatomy: Musculoskeletal Anatomy, Kinesiology, and Palpation for Manual Therapists (Lippincott Williams & Wilkins, 2009). Contact her at functionalbook@hotmail.com. Client Homework: Wrist Flexor Stretch 1. Sit or stand with your arm out in front of you, palm up. 2. Keeping your elbow slightly bent, use your other hand to pull your hand and fingers down until you feel a slight stretch in your wrist and arm. 3. Increase the stretch by gradually straightening your elbow. 4. Hold until you feel a release in the arm, wrist, and hand. CAEL: Functional Anatomy: A Guide of Musculoskeletal Anatomy for Profs Lippincott Williams & Wilkins Figure #05.26 Dragonfly Media Group 11/12/08 01/29/09 Editor's note: The Client Homework element in Functional Anatomy is intended as a take-home resource for clients experiencing issues with the profiled muscle. The stretches identified in Functional Anatomy should not be performed within massage sessions or progressed by massage therapists, in order to comply with state laws and maintain scope of practice.