This video describes the importance of a Light Touch.
Okay. I wanted to talk to you today about a really important subject, and that is palpation and the grip when you are needling, particularly in a pincer grip. I want to show you how I can grab hold of the upper trapezius and then the biceps, but use very light pressure, but still get great contact and be able to move it away from a caution point, such as the apex of the lung or in the case of the biceps, the neurovascular bundle.
So, let’s have a look at how we do that. It’s really important because when we’re grabbing this upper trapezius, what you’ll often see therapists do is they’ll grab really hard like this, and they’ll get in like that and they start doing this and all this random movement. That’s just going to overstimulate the area. You’re going to create pain and make your patient less likely to relax and allow you to do the needling technique safely and comfortably, which is, after all, what you’re trying to achieve. What you’re actually really trying to achieve at the end is that they say to you, “Wow. I didn’t even feel that. That was great. I felt the twitches. I felt the aching, the heaviness, but I didn’t feel your grip,” which was actually worse than the needling technique itself.
What you want to do is be very light with your touch, so that when you’re grabbing hold of that upper trapezius, that’s going to be the least contact and the least discomfort for them when you palpate onto the upper trap.
So, what does that look like? So, when you’re coming to here, you’re coming with straight fingers here, straight there, meet the clavicle and then very light connect like this. So, we’re going to go ulnar deviation. So, here contact the clavicle. Here. Then we fold over and here. That’s all there is. That is all we need. I’m in exactly the right position right there. So, that is my position. I find my … When I’m now finding my spot, again, this is … So, the classic thing is, we come in like this, and we start doing this. We don’t do that. We come in like this, ulnar deviate. Connect with the AC joint, fold over, and now we’ve got exactly the right thing, right contact, right here. There’s my bent thumb. We’ve got a perfect position right on top. If we get a bird’s eye view straight down there, you will not be able to see my fingers at all, and that’s because I’ve been able to grab a good portion of that upper trapezius and I’ve got a lot of contact there. There’s a lot of contact with my thumb here. There’s a lot of contact underneath with my fingers, and it’s all very light.
The next part is we don’t want to do this. This. That is not going to be great. When we’ve got this position, all we need to do is come down, feel very lightly. We don’t have to hit … That’s the spot there. Come up back to here, and here we are. Very light. That’s going to give you great confidence because the patient’s going to think well, “Wow. This is calm. This is very nice.”
In everything that you do, approach the muscle very slowly. Approach everything that you do very calmly. That’s going to reduce anxiety for your patient and allow you to do the technique really effectively without causing pain to the patient.
Let’s have a look at what that looks like in the biceps. I’ll get you to lie on your side for me. So, I take this pillow. Put that up here. Just come back towards me. Perfect. Okay. So, biceps, again, here. Look. We’re going to … There’s your biceps, right? We’re going to … And rather than come in like this and randomly feel for the muscle, we’re going to come up like this. Look. We’ve just got the neurovascular bundle here. Come away from that very gently. Here’s my spot. Yes. There. Now, when I’ve got my spot that I want, I’m going to come down, cross. There we go. And we can start needling in here.
So, all that is nice contact here, very gentle. Don’t grab the thing and don’t pull it away like this. As soon as you do that, the key thing is that you’ve got much less contact now, much less. This is lot less contact than this. Broad contact is really important. Here’s broad contact. There’s my spot right there. Come down, across, squeeze, pull away. There’s my spot. We can start needling in here, right? I’m going to show you this as if I was a left-hander, of course. Doesn’t really matter, but it’s better for our camera angle, but this is the contact that you need. Nice, broad … See how much of that bicep is in contact with my hand here? That’s really important. The minute that you see a lot contact, a lot of your hand in touch with them, that’s going to give you great feeling and great palpation and great confidence for your patient because everything like this is going to feel a lot more comfortable than you trying to do this. They’re going to go, “What’s happening next?” They’re not sure what’s going to be. There’s a lot going on here. Then especially if you start doing this. You’re not really sure what you’re doing, randomly looking for something.
All this actually really, in the end, all of this all boils down to great palpation because great palpation comes from lighter touch. It’s actually the opposite. The paradox of what you think. Oh, we’re going to feel really hard and feel really deep in there to really make sure that we’re on that trigger point or that sore bit. That’s not the way it works. The way it works is the lighter your touch, the more you’ll be able to feel. So, have a look at that next time you’re looking at any area, not just the upper traps or biceps, any area that you’re just feeling or even range of motion. The lighter your touch, the more you’ll feel. The more receptive, the more input that you’re going to have, comes from lighter touch.
So, the key points here, light touch, gentle approach and a slow approach giving you greater contact with the target muscle. Hope that helps.
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