By Nancy Dail, LMT
Often in a practice we run across individuals with similar problems in a series that can sometimes be blamed on the season or weather. Certainly clients with back issues come to us after playing sports or during gardening season. For whatever reason, however, lately, I am seeing several clients with short upper arm structures and resulting issues from their genetic frame. Normally, if you measure the arm or humerus in our upper extremity it expands from the glenoid fossa of the scapula superiorly to the distal end (olecranon process of the ulna) inferiorly to the waist and iliac crest. Individuals with short upper arms have humeral bones that do not measure down to the iliac crest.
Usually they have no idea why they have leaned forward their entire lives or why they may not have been able to reach something on a top shelf when someone the same size can. Often these folks will have more trouble with work stations and are likely to develop carpal tunnel-like symptoms.
A medical history and a visual observation will reveal clients with short upper arms present with over-pronated forearms; very hypertonic pronator teres and resulting numbness and tingling to wrist and fingers.
The structure itself lends to abducted scapulae with prominent medial humeral rotation, more so on the dominant upper extremity. Add repetitive actions and non-ergonomic work areas and you have a laundry list of muscles to unravel and release entrapments and a recipe for carpal tunnel syndrome, pronator teres syndrome and possibly double crush syndrome.
A Dimensional Massage approach begins the sequence in a supine position with techniques to release hypertonic trapezius, SCM, posterior cervical muscles and pectoralis minor and major muscles. Active engagements techniques help to pin and stretch pectoralis minor and subscapularis. Both muscles are usually very tight on these types of frames. Moving on to the upper arm, release and stretch arm muscles with elliptical movement and dual-distraction moves. Release the elbow joint with movement and techniques. Elliptically move the forearm muscles and release the pronator teres. Sidelying is next with serratus anterior as a star target. Position the client prone lastly to release the soft tissue of the back. Exercises are suggested.
There are a wide variety of techniques massage therapy uses on clients with all kinds of structural issues. The above is my approach for short upper arms and clinical issues that often present themselves to this target group. Other considerations could be referred back pain, hip and pelvic positions, gait, and lower extremity factors. One fact remains apparent that the structure we have contributes to a reaction to our repetitive activities. A wise massage therapist will see beyond the repetitive action!
Nancy W. Dail, BA, LMT, NCTMB has been a practicing professional massage therapist since 1974. She is the founder of Downeast School of Massage in Waldoboro, Maine (USA) (1980). Nancy presents workshops internationally, is certified in Orthopedic and Sports Massage, and has developed the philosophy and practice of Dimensional Massage Therapy as lead author in Kinesiology for Manual Therapies published by McGraw-Hill.