Step 2
The Clinical Problem

A client arrives complaining of stiffness in the fingers or pain between the finger bones. They may also notice that the fingers do not bend or straighten smoothly and that gripping objects feels awkward or weak.

In some cases the fingers appear to lock into unusual positions or resist normal movement. Despite stretching or treatment of the forearm muscles, the symptoms often persist.

The source frequently lies in the intrinsic muscles of the hand, particularly the interossei and lumbrical muscles, which control fine movement of the fingers.

The interossei muscles lie between the metacarpal bones of the hand — the very location reflected in their name. These muscles help stabilize the fingers and guide the direction of movement at the finger joints.

The lumbrical muscles originate from the flexor tendons of the fingers and insert into the extensor expansion on the back of the fingers. Because of this unique attachment pattern, they play an important role in coordinating the balance between finger flexion and extension.

Together these muscles normally allow the fingers to move with remarkable precision.

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However, when the interossei and lumbricals become fatigued and enter spasm, their combined action can create abnormal tension within the finger joints.

When both groups contract excessively at the same time, the fingers may be pulled into hyperextension, causing the joints to lock in an extended position.

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This imbalance disrupts the normal tracking of the finger joints and can make flexion difficult or uncomfortable.

Clients may experience:

• stiffness in the fingers
• difficulty bending the fingers
• pain between the finger bones 
• fingers locking in extended positions

Because these muscles lie deep in the hand, their involvement is often overlooked when treating finger pain.

The tendons of these muscles become most accessible near the base of the fingers between the proximal phalanges, where they pass into the finger structures.

By positioning the finger to take slack out of the tendon — flexing the finger for the dorsal interossei, or extending it for the palmar interossei and lumbricals — their tendons can be easily palpated in the web of skin between the fingers, crossing at an angle into the side of the finger bone (phalange). Hold their remaining fingers relatively straight with one hand while articulating their fingers while palpating these tendons between your index, or middle finger, and thumb. Go ahead and stretch the target finger, while holding the hand and other fingers steady and begin to pinch in to the web between the fingers to find these tendons. Once found, hold the stretch, become more focused with the pinching hand (which could be the hand that is holding the other fingers steady or the hand that is articulating the target finger). This is where you begin the "Yang-Yin Pulse." 

Begin to intensify compression of the target tendon while increasing the stretch slightly at the end of the range of motion for the target finger. and while holding the hand and fingers straight. From this position, increase pressure very slightly, but even more for about 15 seconds, and then transition your compression, so even though it is subtle, make it feel like slightly and subtly you are backing pressure off, but still maintain compression. Make both of these sensations at the same time, and yin flow begins.

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Once you feel the muscle begin to relax, don't just let go. While there is still remaining tension, stay balanced on the point while you are making it feel like you are backing away and its fibers will continue to melt until the texture has changed from very solid to very liquid. You will also feel a wave of relaxation travel through your body to the ground. This "energy" (electromagnetic) flow takes a moment to feel like it has settled. Let this wave come to rest before moving on to the next release. Also, test the mobility of their fingers after this release by flexing and extending them to see if they feel looser.  This is how the Yang-Yin pulse should feel. If it doesn't, like a dark theatre, at first you cannot see, but after a few minutes, your eyes, and in this case your hands, suddenly become able to perceive everything. So, give yourself more time and practice, but it will become obvious with practice.

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As these tendons relax, the pressure between the finger bones is relieved and the normal tracking of the finger joints can return.

Releasing the interossei and lumbricals often restores freedom of movement within the fingers and eliminates pain between the bones of the hand.