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MYOFASCIAL TECHNIQUES of carpal bones. The side-to-side "royal wave" of radial and ulnar deviation occurs mainly at the radiocarpal joint, and during these movements, you can feel a healthy carpus moving as an integrated unit. Check all these motions and their combinations, feeling for and releasing any soft-tissue restrictions that seem to be inhibiting the desired concave shape of the hand. We've focused our discussion on bones and boney relationships. There are, of course, many factors in wrist issues and carpal tunnel syndrome, but together, the two techniques we've described here can help you get even better results with hand, wrist, and carpal tunnel issues. Don't put off receiving them yourself. The Transverse Arch Technique uses a ball to maintain the concave shape of your client's hand, while you encourage lateral opening of the dorsal intercarpal joints with your thumb tips or fingers. Work in the direction of the arrows, but feel for ligament release, rather than simply sliding over the surface. Trainings.com Inc., which offers continuing education DVDs and seminars throughout the United States and abroad. He is a Certified Advanced Rolfer and a Rolf Institute faculty member. Contact him at info@advanced- trainings.com. NOTES 1. Even clients with hypermobile patterns will often have local areas of hypomobility. With these clients, you can help the overall balance of the wrist by applying these techniques to the areas where there is less motion. Referring to an orthopedist, physical therapist, occupational therapist, or other medical professional who specializes in hand issues is of course indicated for recent or unresolved injuries, or when your clients has symptoms you think might be related to overly-mobile wrist joints. 2. There are many good sources for more about carpal tunnel issues, diagnostic tests, and neurovascular compression symptoms. Two of our recommendations are: René Cailliet, Soft Tissue Pain and Disability, 3rd edition (Philadelphia: F.A. Davis, 1996), 310–29; René Cailliet, Hand Pain and Impairment, 4th Edition (Philadelphia: F.A. Davis, 1994), 176–86. 3. Thanks to Judith Aston and Siana Goodwin for their influences seen in the "ball" technique. With the ball still in your client's hand, add passive wrist movement to the Transverse Arch Technique. This will help you make sure that the back of the wrist can stay wide in various positions. Check wrist flexion/extension (pictured), side-to-side deviation, and their combinations. Til Luchau is a lead instructor at Advanced- visit massageandbodywork.com to access your digital magazine 129