UpClose & Personal - Ralph Stephens

Thumbs are probably the most important tool a massage therapist has. The pad of the thumb is one of the most highly innervated external areas of the body. Considering it's position there is no logical reason for it having such extraordinary sensitivity. Why does it need more sensitivity than the individual fingertips? Could it be that the thumb was intended to be an incredibly sensitive palpatory tool for use in therapy and healing of the human body? Sounds good to me. Even if it wasn't, the fact is that we use it for exactly that. We use it and use it. Some forms of massage use it almost exclusively. For hours a day we use our thumbs and then "put them away" until we go back to work the next day.

It is no wonder that so many massage therapists are suffering from sore thumbs. It is a sad fact that many therapists must limit or give up the work they love to do because of thumb pain and/or injury.

Sometimes we must go through periods of discomfort as we condition the thumb. It must develop strength just like any other muscular area. Your abdominals will be "sore" if you do sit-ups for the first time in awhile. However, there is a difference between the pain of training and the pain of injury. Too many people jump in and over exert themselves, injuring the thumb muscles and tendons by doing too much activity, in this case massage. This commonly happens to students in school. It also happens to therapists who have taken some time off or who suddenly get busy. Because of the need to continue with school or work, these people never allow the area to recover and heal. They just keep using it and go from acute to chronic pain. Eventually they cannot work with the thumb(s) at all, greatly limiting their ability to palpate and treat tissues.

There are some simple things anyone can do to prevent thumb injuries when doing massage. The most important is to work in good biomechanical positions. The skeletal structure should support the weight or pressure applied through the thumb. Be sure the bones are "stacked" in a straight line from the thumb through the wrist. If you hold your arm out straight in front of you and look down the arm, the thumb should continue as a straight line from the radius bone. This is the best working position for the thumb. It puts the least strain on the tendons and muscles. The fingers may be open or closed. Closing the fingers helps support the thumbs better than open hands. If you are experiencing discomfort while doing therapy, look down your arm, if your thumbs are not aligned straight with your forearm, change immediately.

Thumbs, like every part of the body, require maintenance. Therapists should do a regular stretching routine which includes stretches specifically for the thumb. The best system of stretching for the thumb is Active Isolated Stretching© by Aaron Mattes. (NOTE: Books and videos showing AIS© stretches and explaining how to properly do them are available from Golden Ratio.com.) Even if you do Yoga or workout regularly, very few routines include thumb specific exercises or stretches. Stretch your thumbs before and after doing massage. The five to ten minutes it takes will return to you in many years of pain free service from your thumbs.

The thumbs may need to be strengthened to support the increased workload demanded of them. While the efforts of just doing massage will develop the flexor and opponens muscles, this leaves the abductor and extensor muscles weak and soon the joint becomes unbalanced. Pain often results. A simple, inexpensive tool to strengthen your thumbs in all directions is a rubber band. Start with a medium sized rubber band and work up to large ones. Work gradually up to three sets of ten repetitions per day for every movement of the thumb. Just like with stretching, the investment in the time to develop balanced strength in your thumbs will pay huge, ongoing dividends. Stretching, strengthening and massaging our own thumbs can enable us to better help others through touch and prevent pain and possible career ending injury.

Take a few minutes to check out the thumb musculature and movements in an anatomy book. Gaining an understanding of the anatomy and movement of the thumb will not only help you maintain your own thumbs better but may enable you to become the "expert" all the other therapists in town with sore thumbs come too.

Click here: Seminar Calendar for more information on live seminars.

Visit Ralph's website: www.ralphstephens.com

Email Ralph: Ralphing1@aol.com