Palmar kneading

Palmar kneading applies pressure to the tissues through the palmar surface of the hands and fingers, and moves the superficial tissues over the deep tissues.

The hands work in a circular motion, applying pressure on the upward part of the circle. This ensures that the pressure is applied in the direction of venous return to the heart and lymphatic drainage to the lymph nodes.

Figure 5.1

Palmar kneading (a) single-handed kneading (b) alternate palmar kneading.

A variety of methods of palmar kneading may be used - selection depends on the area being treated.

® Single-handed kneading: one hand performs the kneading while the other supports the tissues on the other side. This is useful on smaller muscles such as triceps and biceps in the arm.

© Alternate palmar kneading: one hand works slightly before the other, resulting in alternate upward pressure. The hands are placed on either side of a limb (e.g. one on the abductors and one on the adductors of the leg) or they may be placed on the right and left side of the spine if kneading the back from the nape of the neck to the sacrum. One hand starts, then after half a circle the other hand begins producing alternate pressure upwards. This produces excellent mobilisation of the tissues.

© Reinforced palmar kneading: one hand lies directly on top of the other, reinforcing its movement. This produces very deep pressure, which is useful on large muscle groups such as the quadriceps, hamstrings, posterior tibials, and also on areas of dense adipose tissue over the hips, waist and sides of the trunk.

® Double-handed kneading: the hands work side by side, moving the tissues in a large circle with the pressure upwards. This is useful when covering large areas, e.g. from one side of the back to the other. It is also used over the quadriceps and hamstrings on very large thighs.

Although these manipulations have different names according to the way the hands work, they are all methods of palmar kneading and the basic technique is the same for all.

Stand in walk or stride standing, depending on the direction of work.

The hands must be warm, relaxed and supple -they must mould to the contours of the body.

The pressure must be directed upwards through the palms and fingers in the direction of venous return to the heart and the lymphatic drainage.

The pressure is applied upwards on each half circle and then released slightly to complete the circle.

The pressure must be firm enough to prevent skin rubbing. The flesh should move under the hands.

The heel of the hand must not dig into the part.

The movements must be smooth, rhythmical and with continuous flow.


Figure 5.2 Palmar kneading

(a) reinforced palmar kneading (b) double-handed kneading.

Figure 5.2 Palmar kneading

(a) reinforced palmar kneading (b) double-handed kneading.

The hands may work upwards and downwards in continuous sequence, or they may work in one direction and slide back, maintaining contact.

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  • saradas
    What is double handed palmar kneading?
    7 months ago

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