To carry out this method, the thenar eminence, the base of the palm, or the pads of the fingers are used to make slow, gentle and circular movements. The action reaches the subcutaneous and the deep muscular tissues. It relieves pain and is often used after more vigorous treatments. In clinical practice, this method falls into two classes of techniques, one using the fingers and the other the palm (Figs. 1-38, 1-39).
The base of the palm touches the body, while the wrist joint makes a pendulum movement. This method relieves pain and swelling. It is useful as a follow-up to more strenuous
maneuvers and is often used over the lumbar and the lower limbs (Fig. 1-40).
The two palms or the thumbs and index fingers are used to squeeze the affected tissue up. This method is useful in adjusting metacarpal and meta-tarsal joints. It can also be used for the treatment of ganglia (Figs. 1-41, 1-42, 1-43).
Chopping with the palms: The doctor lightly slaps the affected limb with the palms of his hands, moving back and forth. Alternatively the doctor can use the ulnar surface of the thumb and the radial surface of the index finger. This method is used following more vigorous therapies (Fig. 1-44).
Chopping with the fingers:
This method is often used over the head and the limbs. The patient's head can be wrapped in a towel. The doctor uses his wrist as a pivot to produce the chopping movement (Fig. 1-45).
20. Aligning and smoothing
The doctor uses his palm to align and smooth the patient's limbs. The directions of the movements can be from the distal to the proximal part of the limb or vice-versa. This is an adjuvant method of manipulation following strong stimulation (Figs. 1-46, 1-47).