Position

The patient is sitting or lying, with the semiflexed arm supported, if convenient. The operator sits at the side.

I. Stroking with one hand on the outside of the arm, from the wrist to the trapezius. The other hand should support around the wrist, but care should be taken that no pressure be used over the radial artery, as that checks circulation considerably.

3. Stroking with the other hand upon the inside of the arm, from wrist to shoulder-joint, the thumb going out toward the pectoral muscles. Support is given in a similar manner as described in I.

3. Friction with the thumb upon the extensors of the hand and fingers with repeated strokings of the same part.

4. Friction with the thumb of the other hand upon the flexors of the hand and fingers, with repeated strokings upon the same part.

5. Friction with the hand upon the arm proper.

6. Stroking of the whole arm, as described in 1 and 2.

7. Kneading with the two thumbs or both hands upon different muscles, special attention being paid to reach the extensors and flexors in the forearm, the biceps, triceps, deltoid, supraspinatus, and infraspinatus.

8. Hacking over the whole arm.

The most common mistakes in treating the arm are:

1. Too tight grasp around the wrist with the supporting hand.

2. The arm is kept too rigid, preventing the proper and necessary relaxation of the muscles.

3. The muscles of the upper part of the arm and shoulder are too often neglected.

4. Inefficient kneading.