Figure 8: Pressing Petrissage upon Brachialis
Move along the biceps brachii laterally with straight fingers, then firmly plant fingers deeply toward the distal end of the humerus bone (see Figure 8). The thick mass of muscle felt on the bone is the brachialis muscle. Slow, nongliding movements are enough to stimulate these fibers. Moving superior–inferior will allow for longitudinal strokes; moving medial–lateral will perform cross-fiber strokes. Healthcare Consideration: Cross-fiber strokes are
designed to break up adhesions and tear muscle tissue. Ideally, these are employed only to aid muscle tissue growth and clear adhesions felt in tissue.
Figures 9
Figure 10
Midline Knuckles on Brachium Three basic steps:
1. Place the PIP (proximal interphalangeal joints) of both hands together at the center of the biceps brachii muscle (see Figure 9). Press with firm to medium pressure into the muscle. 2. Slowly ulnar deviate (abducts) your wrist with both hands, creating a slow, gliding force in opposing directions (see Figure 10). 3. Continue this slow, gliding force in straight lines toward the table with both hands. Continue this stroke until both sets of your knuckles strike the table.
Figure 11: Peeling at Olecranon
Use straight fingers to begin the stroke at the superior aspects of the olecranon process, then tissue in a proximal direction (See Figure 11). Repeat several times.
Freeing the medial epicondyle Figure 12: Knuckle Scooping Inferiorly
Use the distal interphalangeal (DIP) joints of index and middle digits to create a scooping motion away from the medial epicondyle landmark (see Figure 12). Each scooping motion may be 1 to 2 inches. Moving in a proximal direction from this landmark addresses the triceps brachii muscle. Moving in a distal direction from this landmark addresses the common “flexors tendon” at which many anterior antebrachial muscles converge. Repeat the scooping motion several times, creating space around this key landmark.
Figure 13: Thumb Friction
Use the radial side of the thumb to accomplish the same goal of creating space as in the prior technique, knuckle scooping (see Figure 13). Each scooping motion may be 1 to 2 inches.
Figure 14: Elbow Scooping Inferiorly
First, guide the olecranon process at the distal end of client’s medial epicondyle with the client’s arm upon the table with your palm forward and your hand near client’s head (see Figure 14). A small towel bolster may help the client achieve this position if there is any discomfort. Second, begin this sequence of movement: Glide the elbow approximately 0.5 inch distally upon forearm as you elevate your hand, then press deeply with pressure when lowering your hand toward the client’s forearm. Repeat this motion several times until you have glided distally enough to contact the flexor tendons (thereby being off muscle belly).
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