Texting Thumb
Acupressure Solutions for Thenar Tendinitis
By Wolfgang Luckmann
Originally published in Massage & Bodywork magazine, November/December 2010. Copyright 2010. Associated Bodywork and Massage Professionals. All rights reserved.
As cell phones become more comprehensive and easier to use, they also become more indispensable. Text messaging, for many users, has become second nature. Unfortunately, the size and design of today's phones has compelled people to use unfamiliar hand positions and constant motions while texting, which can create repetitive strain injuries. The dependence of consumers on these phones can easily lead to thenar tendinitis, an inflammation of tissues in the thumb. Some opt for surgery to repair or remove "blown out" tendons caused by texting, but from the perspective of traditional Chinese medicine (TCM), acupressure is one noninvasive way this modern-day injury can be addressed.
Since texting thumb, more commonly known as Blackberry thumb, has little research surrounding it, there are no standard treatment protocols at this time. Our training as massage therapists, however, has given us sufficient knowledge to analyze the anatomy and physiology involved in this technology-derived injury, and provide relief for our clients who may suffer from it.
A TCM Perspective
The muscles of the thumb involved in thenar tendinitis are the opponens pollicus, pollicus brevis, adductor pollicus, flexor pollicus brevis, and abductor pollicus brevis. The innervation of these muscles is through the recurrent median nerve. Another group of muscles, namely the abductor pollicus longus and the extensor pollicus longus and brevis, are innervated by the posterior interosseous and radial nerves.
From a TCM perspective, the primary meridians involved in thenar tendinitis are the lung and large intestine. The lung meridian runs ventrally, or medially, along the radial part of the arm and hand, crossing the thenar eminence and ending on the thumb. The large intestine meridian runs dorsally from the radial side of the index finger, over the cleft between thumb and index finger, and then up across the lateral and posterior part of the forearm.
In TCM, pain from repetitive strain is due to qi (vital energy) and blood stagnation. The key concept here is that any stagnation of qi results in imbalance or disease.
Massage therapists trained in Western anatomy and physiology will look for entrapments and impingements of nerves and blood vessels, because Western medical philosophy would say that muscles are contracted due to overuse flexion and adduction movements of mainly the pollicus muscles.
An integrated Western approach that includes the disciplines of physical therapy, occupational therapy, and massage therapy would include: manual therapy like stretching (extending and abducting), ultrasound, microcurrent, galvanic electronic muscle stimulator (EMS) treatment, neuromuscular therapy, myofascial release, or painkillers (opiates). When the pain has substantially subsided, a strengthening program is introduced.
In a TCM approach, acupressure and tui na (a Chinese hands-on therapy) are integrated to address local and distal points. Since tui na is comprehensive in scope, any underlying conditions that predisposed the client to this condition are also addressed. A typical cause of repetitive strain in TCM is the emotional driving force behind the actions and lifestyle of the individual. Some individuals are so highly driven that they become workaholics. Their mental attitude will cause an imbalance in their emotional state because while their egotistical side takes over (yang), their nurturing or caring side (yin) will be deficient. This causes a yin-yang imbalance. Being in the yang mode all the time also depletes viscera and tissues because there is insufficient rest for the tissues to regenerate. In TCM, the client's emotional well-being is the first concern of the therapist, because most issues with the body and viscera arise from an emotional imbalance.
A Qi Problem
Using tui na to address musculoskeletal pain, blood and qi are moved throughout the body. The process is called "dredging the meridians," and in the case of thenar tendinitis, it is done through the meridians of the lung and large intestine. In addition to carrying qi, every meridian also has musculoskeletal branches that feed qi and blood to the muscles and skin of an area. These branches concentrate on the surface of the body under the skin and in the fascia.
If a musculoskeletal injury is left unattended, the stagnant qi will spread back from the surface to the organ itself. Generally, it is through the anatomical and physiological connection of meridians and their branches that various tissues and organs comprise an integrated whole. But that also means that existing conditions in the viscera, like the lung and large intestine, can predispose distal tissues to injury.
On the basis of an organ's function in TCM, we can already determine the location and nature of a pathology or disease. For example, the spleen is, among other things, responsible for the nourishment of muscles. It converts food and drink to qi and transports this energy. When the spleen is healthy, the muscles are well-defined, strong, and flexible. When the spleen is diseased, muscular atrophy occurs, making the whole thenar eminence vulnerable to injury.
The emotional state of the individual is also important when addressing this injury with TCM. In TCM, each organ has an emotional domain. Individuals who are frustrated, angry, and resentful, show an imbalance of the liver and can be predisposed easily to musculotendinous injury. The thenar eminence, for example, would become excessively vulnerable to overwork, because of repetitive strain. Worry and anxiety are the emotional domain of the spleen, according to TCM, while grief and sadness are controlled by the lung. Any one of these emotional imbalances, or a combination thereof, can be the real cause of thenar tendinitis and/or worsen an existing musculotendinous condition.
What about the physical functions of the lungs and large intestine, which have meridians that traverse the area of the thenar eminence? The lung is responsible for the health of the skin and acquiring qi. The large intestine is responsible for elimination. When these organs are diseased, their meridians and acupressure points become tender to the touch.
The nature of the disease or injury, according to TCM theory, is also important because it determines whether tui na should tonify, strengthen, sedate, or disperse qi in the organs and meridians. For example, if there is liver disease, tui na strokes and manipulations should sedate and disperse the tendon tightness and pain. For spleen disease, tui na strokes should nourish blood and tonify the meridian and tissue.
Acupressure Protocol
What local, adjacent, or distal points should be treated for thenar tendinitis? First, to balance the emotional state of individuals who are driven by frustration, resentment, and anger, choose Liv. 3 (liver). For tonifying qi and blood, LI 4 (large intestine) and Lu 9 (lung) can be used together. If there is severe qi deficiency, the additional point St. 36 (stomach) is used, while Sp. 6 (spleen) is often incorporated into the plan to address blood nourishment.
In the long run, there is an "economy" of sorts when using certain points, or combinations thereof, which can also address multiple issues locally and constitutionally. The therapist can also palpate above the wrist along the large intestine and lung meridians for sensitivity in chronic thenar tendinitis. When there is sensitivity, the whole meridian--from origin to its end--should be treated, and not just local points.
If there is a general constitutional deficiency manifested in constant fatigue, depression, or lack of motivation, the therapist can treat the Back-Shu points on the urinary bladder meridian. These points include UB 14, UB 17, and UB 20 (urinary bladder), which can address the heart and spleen organs directly by infusing them with qi. The result would be increased circulation and more energy throughout the whole body.
On a local level, LI 4 can also eliminate muscular pain, as well as other points in and around the area of the thenar eminence. The therapist just has to rotate his thumb on the point in a counterclockwise direction with very light pressure. The duration of the contact should be about one minute, or until the sensitivity in that area has substantially subsided. There are also Ah Shi points, which translated mean experiential acupressure points that are sore. These are not on any meridian and they don't have a specific name, but when painful, these points can be treated like all acupressure points.
After the treatment, there are self-stretch exercises and acupressure protocols the client can follow to allow the qi to flow plentifully again. This involves the client pressing and rotating all along the lung meridian, from the thenar eminence (Lu 10) to the elbow (Lu 5).
While educating the general population will be a key factor in preventing texting injuries, the TCM protocol for thenar tendinitis goes beyond simple trigger-point issues to include internal medical conditions that can affect the health of muscle and myofascial tissues. This TCM approach for thenar tendinitis aims to include a mind-body-spirit perspective that targets the real cause of the problem and is preventive at the same time.
Wolfgang Luckmann, LMT, is an acupuncture physician and homeopath. For more information, visit www.wolfgangluckmann.com.
As cell phones become more comprehensive and easier to use, they also become more indispensable. Text messaging, for many users, has become second nature. Unfortunately, the size and design of today's phones has compelled people to use unfamiliar hand positions and constant motions while texting, which can create repetitive strain injuries. The dependence of consumers on these phones can easily lead to thenar tendinitis, an inflammation of tissues in the thumb. Some opt for surgery to repair or remove "blown out" tendons caused by texting, but from the perspective of traditional Chinese medicine (TCM), acupressure is one noninvasive way this modern-day injury can be addressed.
Since texting thumb, more commonly known as Blackberry thumb, has little research surrounding it, there are no standard treatment protocols at this time. Our training as massage therapists, however, has given us sufficient knowledge to analyze the anatomy and physiology involved in this technology-derived injury, and provide relief for our clients who may suffer from it.
A TCM Perspective
The muscles of the thumb involved in thenar tendinitis are the opponens pollicus, pollicus brevis, adductor pollicus, flexor pollicus brevis, and abductor pollicus brevis. The innervation of these muscles is through the recurrent median nerve. Another group of muscles, namely the abductor pollicus longus and the extensor pollicus longus and brevis, are innervated by the posterior interosseous and radial nerves.
From a TCM perspective, the primary meridians involved in thenar tendinitis are the lung and large intestine. The lung meridian runs ventrally, or medially, along the radial part of the arm and hand, crossing the thenar eminence and ending on the thumb. The large intestine meridian runs dorsally from the radial side of the index finger, over the cleft between thumb and index finger, and then up across the lateral and posterior part of the forearm.
In TCM, pain from repetitive strain is due to qi (vital energy) and blood stagnation. The key concept here is that any stagnation of qi results in imbalance or disease.
Massage therapists trained in Western anatomy and physiology will look for entrapments and impingements of nerves and blood vessels, because Western medical philosophy would say that muscles are contracted due to overuse flexion and adduction movements of mainly the pollicus muscles.
An integrated Western approach that includes the disciplines of physical therapy, occupational therapy, and massage therapy would include: manual therapy like stretching (extending and abducting), ultrasound, microcurrent, galvanic electronic muscle stimulator (EMS) treatment, neuromuscular therapy, myofascial release, or painkillers (opiates). When the pain has substantially subsided, a strengthening program is introduced.
In a TCM approach, acupressure and tui na (a Chinese hands-on therapy) are integrated to address local and distal points. Since tui na is comprehensive in scope, any underlying conditions that predisposed the client to this condition are also addressed. A typical cause of repetitive strain in TCM is the emotional driving force behind the actions and lifestyle of the individual. Some individuals are so highly driven that they become workaholics. Their mental attitude will cause an imbalance in their emotional state because while their egotistical side takes over (yang), their nurturing or caring side (yin) will be deficient. This causes a yin-yang imbalance. Being in the yang mode all the time also depletes viscera and tissues because there is insufficient rest for the tissues to regenerate. In TCM, the client's emotional well-being is the first concern of the therapist, because most issues with the body and viscera arise from an emotional imbalance.
A Qi Problem
Using tui na to address musculoskeletal pain, blood and qi are moved throughout the body. The process is called "dredging the meridians," and in the case of thenar tendinitis, it is done through the meridians of the lung and large intestine. In addition to carrying qi, every meridian also has musculoskeletal branches that feed qi and blood to the muscles and skin of an area. These branches concentrate on the surface of the body under the skin and in the fascia.
If a musculoskeletal injury is left unattended, the stagnant qi will spread back from the surface to the organ itself. Generally, it is through the anatomical and physiological connection of meridians and their branches that various tissues and organs comprise an integrated whole. But that also means that existing conditions in the viscera, like the lung and large intestine, can predispose distal tissues to injury.
On the basis of an organ's function in TCM, we can already determine the location and nature of a pathology or disease. For example, the spleen is, among other things, responsible for the nourishment of muscles. It converts food and drink to qi and transports this energy. When the spleen is healthy, the muscles are well-defined, strong, and flexible. When the spleen is diseased, muscular atrophy occurs, making the whole thenar eminence vulnerable to injury.
The emotional state of the individual is also important when addressing this injury with TCM. In TCM, each organ has an emotional domain. Individuals who are frustrated, angry, and resentful, show an imbalance of the liver and can be predisposed easily to musculotendinous injury. The thenar eminence, for example, would become excessively vulnerable to overwork, because of repetitive strain. Worry and anxiety are the emotional domain of the spleen, according to TCM, while grief and sadness are controlled by the lung. Any one of these emotional imbalances, or a combination thereof, can be the real cause of thenar tendinitis and/or worsen an existing musculotendinous condition.
What about the physical functions of the lungs and large intestine, which have meridians that traverse the area of the thenar eminence? The lung is responsible for the health of the skin and acquiring qi. The large intestine is responsible for elimination. When these organs are diseased, their meridians and acupressure points become tender to the touch.
The nature of the disease or injury, according to TCM theory, is also important because it determines whether tui na should tonify, strengthen, sedate, or disperse qi in the organs and meridians. For example, if there is liver disease, tui na strokes and manipulations should sedate and disperse the tendon tightness and pain. For spleen disease, tui na strokes should nourish blood and tonify the meridian and tissue.
Acupressure Protocol
What local, adjacent, or distal points should be treated for thenar tendinitis? First, to balance the emotional state of individuals who are driven by frustration, resentment, and anger, choose Liv. 3 (liver). For tonifying qi and blood, LI 4 (large intestine) and Lu 9 (lung) can be used together. If there is severe qi deficiency, the additional point St. 36 (stomach) is used, while Sp. 6 (spleen) is often incorporated into the plan to address blood nourishment.
In the long run, there is an "economy" of sorts when using certain points, or combinations thereof, which can also address multiple issues locally and constitutionally. The therapist can also palpate above the wrist along the large intestine and lung meridians for sensitivity in chronic thenar tendinitis. When there is sensitivity, the whole meridian--from origin to its end--should be treated, and not just local points.
If there is a general constitutional deficiency manifested in constant fatigue, depression, or lack of motivation, the therapist can treat the Back-Shu points on the urinary bladder meridian. These points include UB 14, UB 17, and UB 20 (urinary bladder), which can address the heart and spleen organs directly by infusing them with qi. The result would be increased circulation and more energy throughout the whole body.
On a local level, LI 4 can also eliminate muscular pain, as well as other points in and around the area of the thenar eminence. The therapist just has to rotate his thumb on the point in a counterclockwise direction with very light pressure. The duration of the contact should be about one minute, or until the sensitivity in that area has substantially subsided. There are also Ah Shi points, which translated mean experiential acupressure points that are sore. These are not on any meridian and they don't have a specific name, but when painful, these points can be treated like all acupressure points.
After the treatment, there are self-stretch exercises and acupressure protocols the client can follow to allow the qi to flow plentifully again. This involves the client pressing and rotating all along the lung meridian, from the thenar eminence (Lu 10) to the elbow (Lu 5).
While educating the general population will be a key factor in preventing texting injuries, the TCM protocol for thenar tendinitis goes beyond simple trigger-point issues to include internal medical conditions that can affect the health of muscle and myofascial tissues. This TCM approach for thenar tendinitis aims to include a mind-body-spirit perspective that targets the real cause of the problem and is preventive at the same time.
Wolfgang Luckmann, LMT, is an acupuncture physician and homeopath. For more information, visit www.wolfgangluckmann.com.
