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Wrist pain can be a frustrating and debilitating problem for both sufferer and therapist. Repetitive jobs, computer-based work postures, and poor workplace ergonomics are leading to an ever-increasing incidence of RSI and occupational overuse syndrome (see Chapter 2 for the proper work set-up). Symptoms may include recurring pain (myalgia) or soreness in the neck, shoulders, upper back, wrists, or hands; tingling, numbness, coldness, or loss of sensation; loss of grip strength; lack of endurance; and weakness. It is important to view the hand and wrist in context. Chronic poor posture and problems in the head, neck, and shoulder should all be taken into account. There are often many trigger points to be found in the wrist flexors and extensors, all of which will need to be documented and addressed.

STEP 1 Study the anatomy and direction of the muscle fibers.


STEP 2 Sitting ICT to:

Scalenes group (STP)

 Upper trapezius


  Slow sliding massage downward onto rhomboids, pausing on trigger points.


STEP 3 Massage area generously.

STEP 4 Infraspinatus, wrist flexors, wrist flexor common origin (sustained), wrist extensors, common wrist extensor origin (sustained), palmaris longus (may be absent), interosseous membrane of radius and ulna, and small muscles of hand.

STEP 5 Apply gentle and thorough massage from elbows to hands.