Issue link: https://www.massageandbodyworkdigital.com/i/1488451
L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 49 3A: Palm brace. 3B: Thumb-web brace. 3C: Thumb-web brace incorrectly placed. 4A: Exaggeration of base-of-the-palm contact for full-flat palm. 4B: Exaggeration of thumb-web support of base- of-the-palm contact for full-flat palm. 4C: Relaxed posture of hands with thumb-web brace for full-flat palm. Bracing/Supporting the Palm There are two easy ways to brace a full-f lat palm. Image 3A shows what is likely the most common brace used: that is, to use the palm of the other hand. This brace works very well when the palm is fully f lat. However, it is not as versatile a brace for when we want to orient away from the full-f lat palm and angle it to use more of the hypothenar eminence or the thenar eminence. For full versatility of the palm, I recommend using the thumb-web brace shown in Image 3B. For the thumb-web brace to be used effectively, the actual web of the thumb needs to be placed directly over the carpal region at the base of the palm where the pressure of the contact hand is contacting the client. Often, therapists will err and instead brace the contact hand/ forearm as seen in Image 3C, with the ulnar side of the support hand on the dorsum of the contact hand, and the thumb web up high on the distal forearm. This leaves no support to the actual contact region at the base of the palm that meets the client's body. One way to learn how to effectively employ the thumb-web brace for the full- f lat palm is to first place the palm as a contact on the client but exaggerate the ability to see the contact by extending the hand at the wrist joint (Image 4A). Then place the thumb-web support directly over the base-of-the-palm contact but exaggerate the position of the support upper extremity by pronating the forearm (Image 4B) so that we can better visualize where the thumb web supports the contact hand. This positioning shown in Images 4A and 4B is not comfortable or relaxed for the therapist; it is just done to help us better understand the positioning of our hands. So, now let both hands relax as seen in Image 4C. Comparing this thumb-web brace with the opposite-side palm brace (Image 3A), you can see that the disadvantage of the thumb- web brace is that the elbow of the brace-side upper extremity is out a bit, which means the brace-side glenohumeral joint is slightly in medial/internal rotation, which is not the ideal posture for the shoulder joint. However, where the thumb-web brace really shines is how it allows for the versatility of the orientation of the palm as a contact. Full-flat palm contact with brace 3A 4A 3B 4B 3C 4C