deviation. If no symptoms arise, the therapist may then pronate the forearm while bringing the arm into extension. A nerve impingement of the radial nerve will cause pain of the arm or shoulder. The therapist should massage the entire anterior shoulder, arm and radial side of the forearm Upper limb tension test 4 Tests for a nerve impingement of the ulna nerve as a cause of upper limb or shoulder pain. The client should be supine on the table with their affected arm near the edge of the table. The massage therapist applies an inferiorly directed compression to the affected shoulder then abducts the arm to 90 degrees. The therapist then flexes the client’s elbow while supinating the client’s forearm to the end of its ROM. The therapist then extends the client’s fingers while bringing Golfer’s elbow test Tests for medial epicondylitis of the humerus. The client may be seated or standing and should flex their elbow to 90 degrees with their palm face up. Their fingers should be flexed into a fist. The massage therapist palpates the medial epicondyle with one hand while maintaining a grip Tennis elbow test Tests for lateral epicondylitis of the humerus. The client may be seated or standing and should flex their elbow to 90 degrees with their palm face down. Their fingers should be flexed into a fist. The massage therapist palpates the lateral epicondyle with one hand while maintaining a grip Pinch-grip test Tests for a compression or dysfunction of the anterior interosseous nerve. The client may be seated or standing and asked to pinch their thumb and index finger together. Flick test Tests for carpal tunnel syndrome. This simple test involves the massage therapist asking the client what they do when they feel carpal tunnel syndrome symptoms (i.e. tingling, numbness, burning and/or pain in the palm, thumb, index and/or middle fingers). If the client flicks their wrist, this Phalen’s test Tests for carpal tunnel syndrome. With their arms in front of them, the client is asked to place the back of their hands together and, keeping them together, raise their elbows
of the affected side. Note that further nerve impingement should be avoided, so the therapist should communicate with the client about burning, tingling or numbing sensations during the massage.
the wrist into extension. A nerve impingement of the ulna nerve will cause pain of the arm or shoulder. Similar to the previous test, the therapist should massage the entire anterior shoulder, arm and ulnar side of the forearm of the affected side. Again, further nerve impingement should be avoided, so the therapist should communicate with the client about burning, tingling or numbing sensations.
on the client’s wrist with the other hand. The therapist then supinates the client’s forearm while extending the elbow and wrist. A positive result is indicated by pain or discomfort in the area of the medial epicondyle.
on the back of the client’s hand. The therapist first resists the client’s attempt to place their wrist in extension and second, the client moving their wrist into radial deviation. A positive result is indicated by pain or discomfort in the area of the lateral epicondyle.
A lack of strength or an inability to do so may indicate hypertonic forearm flexor muscles.
is considered a positive indicator of the pathology. The therapist should start with light myofascial release of the entire flexor retinaculum of the wrist before addressing hypertonicity in the forearm.
to 90 degrees. Carpal tunnel syndrome is indicated if symptoms emerge as the client maintains this position.
ORTHOPEDIC TESTS FOR THE SPINE AND TRUNK
Functional vs. structural scoliosis test Tests for whether the cause of scoliosis is functional/ muscular or structural/skeletal in nature. The client stands with their shirt removed. The therapist stands behind the client and observes the client’s spine and its curvature. The client bends their trunk into lateral flexion on the convex (curving laterally) side of their spine, then returns to the neutral position. Then the client flexes their trunk forward. Functional scoliosis is indicated if the spinal curvature Scoliosis short leg test Tests for uneven leg length that may be causing functional scoliosis. The client is standing. The massage therapist is in front of the client noting the position of the bilateral hips and shoulders to see if there is any tilting due to scoliosis. The therapist places a thin book under the foot of the Kemp’s test aka lumbar quadrant test Tests for nerve root compression due to a disc herniation in the lumbar region. The client is standing and extends their back then laterally flexes their trunk to the affected side before returning to the neutral position. The client may also
corrects itself when the client laterally flexes their trunk or if the curvature reverses when the client flexes their trunk forward. Structural scoliosis is indicated if the curvature does not correct itself during either action. In either case, the massage therapist can massage hypertonic muscles, but the client’s long-term relief can only be expected if the client’s scoliosis is functional in nature. It is outside a therapist’s scope-of-practice to attempt structural corrections. suspected shorter leg which itself may be indicated by either an inferiorly situated hip or shoulder. A positive result is indicated if the curvature disappears after the book is placed under the shorter leg’s foot. Hypertonic muscles of the lower back and hips should be addressed. go into lateral flexion toward the affected side then rotate their trunk toward the affected side. A positive result is indicated by pain, numbness or tingling down the leg of the affected side. Avoid traction of the neck and lower limbs.
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Book Code: MNJ0524
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