Issue link: https://www.massageandbodyworkdigital.com/i/78617
TABLE LESSONS My literature search revealed that there seems to be a genetic component to trigger thumb when it happens in children. I spoke with the family about a week later to compare notes. The doctor said waiting would not be harmful in any way, but would simply delay the inevitable surgical intervention. My literature search revealed that there seems to be a genetic component to trigger thumb when it happens in children. The mechanics of trigger thumb seem to be the same as in adults, so this information did not alter my treatment protocol, but it did put the outcome slightly in question. After comparing notes, we decided to proceed. Now it was up to me to set the game plan. My experience addressing trigger thumb had taught me that the key to success is short-duration, high-frequency sessions. Trigger thumb (and fi nger) is a form of tenosynovitis, an infl ammation of the sheath around a tendon. The tendon affected in trigger thumb is the fl exor pollicis longus, which originates all the way up the forearm near the pronator teres. While the infl ammation is at the sheath, the whole muscle must be addressed. In fact, hyperaggressive treatment only at the sheath can make things worse, not better. We decided to set a very precise protocol, one in which I would see J. in my offi ce and the parents would also be working on J. at home every day. The home treatments lasted exactly four minutes, with emphasis placed on various aspects of the fl exor pollicis longus. Every detail was scripted, as was the time allotted. His parents took the time to do this every night. At fi rst, they brought J. into my offi ce weekly for me, then they came less frequently. Over time, the improvement in J.'s trigger thumb was obvious. Within the four-month window, the clicking completely disappeared. The family revisited the hand specialist, who admitted that there were no symptoms and no need for further sessions. I was surprised, then, to get a phone call from the family two years later. I assumed that J. had a relapse. "No, this isn't about J.," his mother told me. "This is about A., his little sister. That genetic component of trigger thumb in children seems to hold true. Can we use the protocol we established with J. to help our daughter?" Thus began round two, following almost exactly the same procedure. These amazing parents worked with A. consistently, and the most noticeable improvement began after week six. With A. now beaming and making goofy faces as she fl exed her thumb painlessly, the room erupted in laughter and celebration. Douglas Nelson is the founder and principal instructor for Precision Neuromuscular Therapy Seminars and president of the 16-therapist clinic BodyWork Associates in Champaign, Illinois. His clinic, seminars, and research endeavors explore the science behind this work. Visit www.nmtmidwest.com or email him at doug@nmtmidwest.com. Visit the newly designed ABMP.com. Log in. Explore. Enjoy. 43