Massage & Bodywork

May/June 2013

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Page 116 of 140

technique @work | the science of movement | | Energy work | Myofascial techniques Working with the Thenar Eminence By Til Luchau Thank goodness for the thumb. Its unique opposability allows us to grasp, hold, squeeze, and manipulate; its enormous strength gives power to our grip; and its unmatched sensitivity helps us feel the minutest differences in texture, pressure, or size. Thumbs are so good at so many things that they are very commonly overused, causing tissue and joint irritation, pain, and eventual damage. For example, the increasing use of small-device keyboards means thumbs are more active than ever in the awkward, repetitive movement patterns needed to type out emails, texts, and tweets (Image 1). Some in our field have taken this as a business opportunity, catering to their clientele with "Blackberry thumb" massages—hand treatments designed to ease the strain and pain of excessive thumb keyboarding. But manual therapists are themselves vulnerable to thumb overreliance—in our Advanced Myofascial Techniques seminars, we see practitioners in every workshop who are dealing with the effects of thumb overuse, sometimes severe (see A Few Rules of Thumbs on page 116 for a few ways to avoid excessive thumb use). The structure of the thumb lends it special qualities, along with unique vulnerabilities. The thumb's joints are the most mobile of all the digits', 1 114 massage & bodywork may/june 2013 allowing the thumb its distinctive opposability and adaptability. As with the fingers, articular ligaments provide some stability; but because of its highly mobile joints, the thumb gets most of its stability from coordinated active muscular tension. The muscles of the thumb are arrayed in all directions around it, much like guy-wires around a pole or mast (Image 2). And these muscles stay busy—because so much of the thumb's stability comes from the tension of these muscles, most thumb muscles are active during most thumb movements.1 No wonder our thumbs get tired. The origins of the word "thumb" go back to the Old English word th ma, from Indo-European tum, or "swelling" (which also gave us "tumor" and "thigh"). The swelling in the thumb's case is thought to be its round shape, or the thumb's rounded thenar eminence (the muscular portion of the palm at the base of the thumb). It is here that I'll focus our discussion, as the thenar eminence often takes the brunt of thumb overuse and repetitive strain. There are at least two reasons for this: 1. Because the thenar eminence contains the primary muscles of finger-to-thumb gripping, activities or occupations that involve repeated or prolonged use of small instruments or fine tools (dentistry, electronics manufacturing, handwriting, etc.) can be associated with thenareminence fatigue, pain, and overdevelopment. "Blackberry thumb" is another name for the increasingly common thumb or thenar-eminence pain and irritation resulting from excessive use of small keyboards and controls. "Working with the Thenar Eminence" Watch Til Luchau's technique videos and read his past Myofascial Techniques articles in Massage & Bodywork's digital edition. The link is available at, at, and on's Facebook page.

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