Digits in Distress

Many of our ADLs (activities of daily living), contribute to the pain that we feel in our bodies.  Allow me to explain and be the bearer of bad news.  We ALL perform the following activities on a daily basis: 




·         holding your cell phone

·         reaching for a carton of milk
·         handing money / charge card to clerk
·         clearing plates from table
·         Pulling leggings /exercise pants on
·         holding steering wheel
·         opening a jar

Some of us also do the following: 

·         work with weights (gripping them)
·         carrying bundles and babies
·         work at a computer keyboard

I recently felt some aches in the base of my thumbs and knew I had to figure this out.  I did not think it was arthritis since it was both thumbs and my thoughts went to what I was doing lately that would cause the distress.  Well, I was using my biceps a lot doing upper body work so that was definitely a contributing factor.  The movements that contributed to this would be the ones listed in the second grouping (above).  I hear this thumb / finger / hand / wrist / forearm complaint from lots of clients and students and I needed to do some research on it. 

While there are many reasons for pain in this region, we should start by exploring the role of referred pain from trigger points in the brachialis muscle and methods for treating it with self-massage.

Anatomy: The brachialis muscle lies deep to the biceps brachii muscle. It attaches above the elbow on the lower half of the anterior surface of the humerus.

The photo indicates the location of trigger points (X) and red areas indicate the common referred pain zones. The trigger points in the brachialis muscle refer pain to the dorsal side of the base of the thumb and the adjacent web space between the thumb and first finger.  Trigger points in the region of the brachialis produce referred pain that is felt in the base of the thumb at rest and often with the use of the thumb.

Perpetuating Factors: Trigger points can form and remain in the brachialis muscle due to elbow flexion movements that overstress the muscle and/or require the muscle to remain in a flexed position for an extended period of time.  Some examples include holding a child, lifting heavy tools, carrying groceries or boxes, and playing an instrument such as a violin or guitar.

Treatment

If you were in my recent class, “Fascia Pilates:  Release & Restore w/ Massage Balls”  you did this release with me.  We were standing with the affected arm hanging as limp as possible with the muscle relaxed.  We took the knuckles of the opposite hand and pressed and scraped deeply from top to bottom on the medial side of the brachialis muscle and we kept repeating that movement over and over.  To be more specific, the part that we are targeting is the internal side of the arm near your ribs.  As you are continuing to press into the muscle, you will feel the tension and muscular tightness leave the thumb / hand area.  It will begin to feel free, loose and pain-free.  The movement can also be done with a small spikey ball or a spikey ball roller stick if your knuckles get tired.

Trigger-point charts help educate you about referred pain patterns. Some charts show which muscles refer pain to specific regions of the body, like the base of the thumb in this case.  Where you are feeling the pain is not necessarily the source.  That’s why it’s important to get to the root of the problem so that you will be on the road to eliminating the pain with an effective treatment plan.