Consider the Palm:
Broad, strong, and underutilized in massage therapy
Dr Joe Muscolino
Key Points
• The palm is a contact point that is strong, flexible, yet soft and somatically intuitive.
• When we angle the palm by supinating or pronating the forearm, we can diminish the size of the palm contact, making it much more specific without being‘ pokey’ the way thumb and finger pads can be.
• The palm’ s strength and stability are matched by its comfort because of the surrounding myofascial tissue.
The following article is reprinted with the kind permission of the author. It first appeared in Massage and Bodywork.
There are many contact points to use when performing massage therapy, ranging from thumb pads and finger pads as smaller contacts to the larger contacts offered by the elbow and forearm( Figure 1). The advantage of using larger contacts with clients is that the joints are larger and therefore stronger and less vulnerable to injury; larger contacts also cover more surface area of the client’ s body. However, larger contacts have less sensitivity, and some— like the olecranon process of the elbow and the medial shaft of the ulna— are hard and bony and can be uncomfortable for the client, especially when used in areas where bone is close to skin.
better at reaching deeper into tissue. It is for these reasons that I would like us to consider the palm as a strong, flexible, smaller contact point to use with clients during massage therapy.
Motor Out and Sensory In
There is an old adage in the world of massage that no massage stroke should ever end the way it was originally intended when it began. This means we need to be constantly assessing the response of the client’ s tissues as we work so we modify the depth and direction of our stroke. This requires not just motor output to create the stroke, but also reception of sensory input as we work— motor out and sensory in. The ability to integrate and balance these two aspects of a massage stroke is greatly dependent on the contact we choose to employ.
A
B
Variations of Using the Palm
Many therapists already use the palm, but I believe there are variations with its use that are not always fully appreciated. And these variations render the palm, in my opinion, perhaps the best contact in massage, and the contact I use the most when working on clients.
Why is the palm such a good contact? It is broad and strong, somewhat like the elbow or forearm, but it’ s much softer and comfortable for the client due to the cushioning of the myofascial tissue of the thenar and hypothenar eminences. And when we angle the palm by supinating or pronating the forearm, we can diminish the size of the palm contact, making it much more specific without being pokey the way thumb and finger pads can be.
C
D
While smaller contact points can also feel pokey to the client when not applied appropriately, and are more prone to injury when used repetitively, the advantage of using these smaller points of contact is that they are the most sensitive and best at assessing the client’ s tissue texture and tone. They are also
Figure 1. Small and large contacts for massage therapy –( A) Thumb pad,( B) Finger pads,( C) Olecranon process of elbow,( D) Ulna of flat forearm
150 | vol31 | no3 | JATMS