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C h e c k o u t A B M P 's l a t e s t n e w s a n d b l o g p o s t s . Av a i l a b l e a t w w w. a b m p . c o m . 57 Pin Contact When performing a pin and stretch technique, it is possible to use any contact for the pin. Usually, the smaller the point of contact (e.g., a finger pad or thumb pad), the more precise the therapist can be with the technique. However, smaller contacts also tend to be a bit pointed and somewhat uncomfortable for the client. Larger contacts might seem to be more assertive, but as they tend to better spread out the force on the client's body, they are usually more comfortable for the client when the pressure is appropriately modulated. And, because they are larger, they are more powerful and comfortable for the therapist. Images 6A–6F demonstrate the use of various contacts employed when performing a pin and stretch technique on the right piriformis. Sometimes, the contour of the client's body might dictate which contact to use. Images 7A–7B demonstrate pin and stretch for the right pectoralis minor. If the heel of the hand is used, as seen in Image 7A, it might be uncomfortable for the therapist to hold the hand into extension at the wrist joint to avoid contacting the client's breast tissue. For this reason, using finger-pad contact, as seen in Image 7B, might be preferable. AN ADDITION TO YOUR TOOLBOX When working clinically with orthopedic manual therapy, we have so many options for how to treat our clients. The challenge is to find the therapeutic tools that are the most effective at resolving a client's condition. An excellent default method is to combine soft- tissue manipulation with stretching of the target myofascial tissue. And, when stretching is included in the treatment plan, depending on the region of the target myofascial tissue that is to be stretched, pin and stretch technique might be the optimal option toward focusing the stretching force. If you have not yet worked with pin and stretch technique, I recommend you begin to include it in your repertoire of treatment tools today. Pin and stretch to the right pectoralis minor. A: Heel of hand contact. B: Finger pads contact. 7A 7B Joseph E. Muscolino, DC, has been a manual and movement therapy educator for more than 30 years. He is the author of multiple textbooks, including The Muscular System Manual: The Skeletal Muscles of the Human Body (Elsevier, 2017); The Muscle and Bone Palpation Manual with Trigger Points, Referral Patterns, and Stretching (Elsevier, 2016); and Kinesiology: The Skeletal System and Muscle Function (Elsevier, 2017). He is also the author of 12 DVDs on manual and movement therapy and teaches continuing education workshops around the world, including a certification in Clinical Orthopedic Manual Therapy (COMT), and has created Digital COMT, a video streaming subscription service. Visit www.learnmuscles.com for more information or reach him directly at joseph.e.muscolino@gmail.com.