Passing Not Passing
Make a fist with your hand. It doesn't have to be too tight. Now curl your first inward toward your elbow as far as possible, as shown. This action stretches the Wrist & Finger Extensors. A Passing Result is when your wrist bends 90 degrees or greater. A Not Passing result is when the wrist bends less than 90 degrees, indicating that there are likely trigger points that need to be treated in the Posterior Forearm.
[Professional Note: When using a goniometer, the standard measurement is the number of degrees of flexion beyond perpendicular. Passing would be documented as -20 degrees in a professional evaluation.]
TEST 2: Wrist Pronation Test (Tests the Supinator Muscle)
Passing Not Passing
As we learned last issue, Supination is the action of the wrist twisting outward. The Supinator Muscle causes this outward twisting to occur. To test how well the Supinator Muscle stretches, however, we do the opposite action - we turn the wrist inward as far as it will go, which you may remember from last issue is called Pronation. So, for this test, hold a ruler or pen in your hand with your elbow at your side. Keeping your forearm parallel to the floor, twist your hand and wrist inward (pronate) as far as you can. A Passing result is if you can reach the point where the ruler is parallel to the floor or beyond. A Not Passing result is if you reach less than parallel, indicating trigger points and myofascial dysfunction in the Supinator Muscle.
Use your fingers or tennis ball or another self-care tool to press into areas of your Posterior Forearm
. The X's mark common areas where trigger points are found in the Wrist & Finger Extensors
and the Supinator
. Check for tenderness and taut bands, as well as any referred pain. Cover the full area, making note of where you find spots that need treatment. [Professional Note: Technically, the 3 smaller x's at the top left are covering the Anconeus Muscle, we know, but part of the Supinator lies beneath this area, so they were included! Also, as we are sure you noticed, the Wrist & Finger Extensors were cut away half way up the forearm to expose the Supinator, as well.]
Simple Self-Care Remedies
Here are simple self-care tips for relieving myofascial pain and dysfunction in your Posterior Forearm:
Step 1: Warming Up with Moist Heat
To relax and warm up the muscle fibers, soak your forearm in a warm bath or wrap it in moist heat such as a Fomentek bag for 10-15 minutes.
Step 2: Compression
Compression can be accomplished very easily with the elbow, as we showed you in our last issue. However, for the Posterior Forearm, leaning into a self-care tool against a wall is especially effective! The Jacknobber works very well on the wall. Follow these instructions:
Stand perpendicular to the wall. Hold the Jacknobber against the wall with the three prongs on the wall and one prong facing you. Press your forearm against the Jacknobber while pressing your torso into your arm, thereby using your body weight to press your Posterior Forearm against the Jacknobber. Maintain this compression with the Jacknobber for two long relaxed breaths. Look for more painful spots throughout the forearm. Also a tennis ball, baseball, golf ball, or rubber ball will do.
If you can't do the above preferred method at the moment, you can always still use your opposite elbow as shown in the picture. As always, when you find a tender spot, press in to tolerance and hold for 10 seconds while completing at least two full breaths in and out. Then continue searching for more tender spots until the entire area is covered.
Step 3: Stretching & Range of Motion
You can stretch your Posterior Forearm very easily by using your opposite hand to apply comfortable pressure while curling your hand and fingers inward. Hold for 20 seconds and repeat three times per day on each side. Afterward, you can roll the wrist around in gentle circles, ten times in each direction.
Congratulations! You now know how to take care of your hands and wrists with simple techniques that have saved many patients from frustrating pain, arthritic changes and even disability. Please pass this information on to others to help them become empowered, as well!