. A manual of therapeutic exercise and massage, designed for the use of physicians, students and masseurs. ses of the radius, moving the soft tissues in smallcircles toward each other and the base, and likewise for theulija. The carpometacarpal joint of the thumb can alsobe reached in that way, while massage of the other partsof the wrist-joint is more or less coincident with that of the MASSAGE OF JOINTS, TENDON SHEATHS, BURSM 111 tendons and tendon sheaths, which is best done by frictionin small circles. On both sides of the tendons of the longcommo* extensor, however, the fingers will reach
. A manual of therapeutic exercise and massage, designed for the use of physicians, students and masseurs. ses of the radius, moving the soft tissues in smallcircles toward each other and the base, and likewise for theulija. The carpometacarpal joint of the thumb can alsobe reached in that way, while massage of the other partsof the wrist-joint is more or less coincident with that of the MASSAGE OF JOINTS, TENDON SHEATHS, BURSM 111 tendons and tendon sheaths, which is best done by frictionin small circles. On both sides of the tendons of the longcommo* extensor, however, the fingers will reach the jointstructures quite well. In simple cases friction can be per-formed for the dorsal and palmar structures of the wristsimultaneously by grasping the joint between the thumband two or three of the fingers, and moving the skin over itin small circles, sidewise, and up and down. The elbow-joint is largely covered with muscles. Thecapsule comes near to the surface only on both sides of theolecranon and a short distance upward on both sides andunderneath the triceps tendon; between the external epi-. FiG. 43.—Part of the outlines within which the elbow-joints can be most easily reached by massage. condyle and the head of the radius as well as around thelatter (Figs. 43 and 44). These are the points wheremassage of the joint structures is most efiective, though acertain effect will also be obtained by friction through andwith the muscles on both sides. Porward from the internalepicondyle the fingers come rather near to the joint, butmassage on the flexor side should be done with special careon account of the large vessels and nerves. Also the posteriorgroove of the internal epicondyle should be handled with careto avoid injuring the ulnar nerve. In fractures and disloca-tions of the elbow I advise m} assistants to be very cautiouswith massage because of the danger of overstimulating thenewly formed callus and the injured periosteum (see p. 189). 112 APPLIED MASSAGE Shoulder-
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