Feb 7 2012

Palmar Fascia Soft Tissue Work

by cliftongreen • Miscellaneous 0

Written on February 1, 2012 at 7:45 am, by Eric Cressey

Anyone who has ever broken or burned a finger will tell you that you just don’t appreciate how much you use your hands until you don’t have access to one for a bit.  Obviously, you partially lose your ability to do things – but what many folks might not appreciate is that you also lose some of your ability to sense things, as the hands contain a tremendously amount of sensory receptors relative to the rest of the body.  In fact, the tiny folds in our skin on the fingertips that comprise the fingertip are there because they increase the surface area of the hands – which allows us to get more sensory receptors where we need them.  Cool stuff, huh?

Why then, do we not give the hands any love when it comes to soft tissue work?  We’ll foam roll our hip flexors, lats, and other large muscle groups (which are certainly valuable), but we’ll ignore one of the most sensory-rich parts of our body – and one that is constantly active (and overused, in some cases) throughout the day.  We grip, type, and flip people the bird – but we never really pay attention to soft tissue quality in this region…until today, that is.

If you look at the structure of the hand, you’ll see that it has a large fascial, the palmar aponeurosis (we’ll call it the palmar fascia to keep things simple).  This structure has an intimate relationship with the muscles/tendons and ligaments of the hand, and serves as a link between the forearm and fingers.

Based on the size alone, you can see that it has plantar-fascia-caliber importance even if it isn’t weight bearing.  You see, of the five muscles that attach via the common flexor tendon on the medial epicondyle at the elbow, four cross the wrist joint and palmar fascia on the way to the hand, where they work to flex and abduct or adduct the wrist, and flex the fingers.

Loads of people have tendinopathies going on up on the medial elbow (Golfer’s Elbow), but they only work on this spot (called a zone of convergence).  Meanwhile, the soft tissue quality might be just as bad further down at the wrist and hand, adding tension on an already over-burdended common flexor tendon.  Think about it this way: if you had a pulled hamstring up by your glutes, would you only work to improve tissue quality at that spot, or would you work all the way down to the posterior knee to make sure that you’d improved some of the poor tissue quality further down as well?

Below, massage therapist and Cressey Performance coach Chris Howard talks you through two different ways to work out the kinks in the palmar fascia and surrounding regions, but keep in mind that it’ll always be more effective to have a qualified manual therapist do the job – and that’s certainly someone you should see if you have any symptoms whatsoever.

We’ve found that quite a few of our pitchers comment on how the ball seems to come out of their hand easier after this work.  Usually, they’re the guys who have the most stiffness along the forearm, particularly into wrist extension and supination.

Give it a shot at your desk at work and see how it feels.