Massage & Bodywork

January/February 2012

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EDUCATION BODY AWARENESS Maintain Strength with a Neutral Wrist Position By Barb Frye Often we hear or read: "Whenever possible, keep the wrist joint in a neutral position." But why is this easier said than done? The reason is the movements of the wrist joint, which include ulnar deviation (adduction), radial deviation (abduction), flexion, and extension, are used constantly—both separately and in combination—when performing manual therapy. It is not uncommon for a massage therapist to use wrist joint deviations throughout a massage treatment for up to an hour or more. Deviations occur at almost every point during a treatment (e.g., with gliding, gripping, and friction manipulations). Therefore, it is crucial to understand that when in deviation, the movement at the wrist joint is restricted and your hand strength diminished: with ulnar deviation, you have approximately 30 degrees of movement, and your hand strength is reduced about 25 percent (Image 1); with radial deviation, you have approximately 15 degrees of movement and up to a 20 percent reduction in hand strength (Image 2). Think about what this means if you were to use these deviations throughout several treatments during a long workday. The strength of your hand would be severely compromised and the muscles of the forearm stressed. This leads us back to: "Whenever possible, keep the wrist joint in a neutral position." Yes, it is a challenge, but it will help maintain the strength of your hand and prevent injury. Here's a smart practice tip: when performing a gliding stroke, avoid initiating the stroke using deviation (Image 3); instead, begin the stroke using a neutral wrist joint, following through with an aligned joint (Image 4). Celebrate ABMP's 25th anniversary and you may win a refund on your membership. ABMP.com. 43

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