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5. Another option is to horizontally adduct the client's arm, and the scapula will begin to abduct. 6. This will make it easier to come into contact with the anterior surface of the scapula. 7. Ask for a breath and wait for a softening. 8. Friction can be used when indicated. 9. Ask for breath when coming out of the release. The Work: Pectoralis Minor Client Position: Supine, with arm at 45 degrees 1. Approach the axilla on the coronal plane and gently make contact with the ribs. 2. Mobilize the ribs to assess for movement. 3. Angle fingers up and over toward the manubrium. 4. When fingers cannot go any further, you are in contact with the pectoralis minor. 5. Ask the client to extend her arm slowly over her head. 6. Occasionally ask for breath into the area of contact. 7. May repeat two to three times. 8. This is a very sensitive area. Enter mindfully. BICEPS AND EXTENSOR COMPARTMENT OF THE FOREARM Image 13 shows the therapist using a broad, soft fist to stretch the bicep. Your ability to move from a broad surface to a smaller surface depends on the tool you are using. Fingertips or knuckles allow you to do some detail work on individual spots of the fascial bag that are stuck. With a slight switch in the position of your hand to fist or elbow, you can take that release into a much broader plane of fascia. This is called organizing the fascia. As with the preceding techniques, keep the client's arm and hand as flat as possible on the table so the technique can be more effective, and use the same type of elbow movement as before. Now it will be a little more challenging for the client to flex her elbow in and out since you are applying more pressure close to the elbow. Once you get below the elbow, place the point of your own elbow on top of the extensor compartment and very slowly move straight down several inches at a time toward the wrist. Image 14 illustrates where your elbow is to be placed. This is a very strong action, because the motion you are asking the client to make is extending the wrist up. In this case, ask the client to focus on pointing her fingertips toward the ceiling. Remember, do not hold this as a static stretch—ask her to relax her hand occasionally. The closer you get with your elbow to the wrist, you need to think about whether you are going to switch tools and use your fingertips and knuckles to go over the retinaculum and carpal bones. In some cases when working with large wrists, you can continue right on over the wrist with your elbow and you need not be afraid to use a lot of pressure. This work is particularly beneficial for any driver in an automobile accident and for the increasing number of repetitive motion injuries that occur in the wrist and the elbow, especially among clients who work at a computer. The Work: Biceps and Extensor Compartment of the Forearm Client Position: Supine 1. Use your fist from deltoid to elbow, moving from a broad surface to a smaller surface when necessary. 2. Once below the client's elbow, use the elbow point on top of the extensor compartment. 3. Move inferiorly down several inches at a time while asking the client to flex and extend her wrist. EXTENSOR RETINACULUM OF THE WRIST AND THE FLEXOR COMPARTMENT OF THE FOREARM These techniques are especially beneficial to those clients who have had repetitive motion injuries to the wrist and forearms. In Image 15, the therapist is pressing down directly on top of the carpal bone with the flat portion of his knuckle. Another option is to use six fingers. The client has her hand lying flat on the table. The elbow is also flat on the table and pronated. 92 m a s s a g e & b o d y w o r k j u l y / a u g u s t 2 0 1 5 13 14