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Lumbricals
Pointer Plus

Pointer Plus

The Pointer Plus is an easy to use trigger point (TP) locator which incorporates a push button stimulation feature to immediately treat Trigger point pain.

 

The Lumbricals are muscles of the hand.

Anatomical Attachments:

  • Origin: There are four lumbricals, all attaching from the tendons of the flexor digitorum profundus. The 1st and 2nd attach from the radial side and the palmar surfaces of the index and middle fingers. The 3rd attaches from the adjacent sides of the tendons of the middle and ring fingers, and the 4th attaches from the adjacent sides of the tendons of the ring and little fingers.
  • Insertion: Attach into the tendinous expansion of the extensor digitorum into the bases of the terminal phalanges of the medial 4 digits.

Action: Flex the fingers at the MP joints and extend the 2 distal phalanges.

 

Click for Muscle Test 

 

Nerve Supply: Median nerve (C6, C7) innervates the two (2) radial fingers; Ulnar nerve (C8) innervates the two (2) ulnar fingers.

Nerve Entrapment: Entrap the digital nerves that cause cutaneous hypoesthesia along side of the finger that is affected.

Vascular supply: The superficial and the deep volar arches artery.

Travell and Simons Trigger Point Pain Referral:  

 

Trigger Point Signs and Symptoms: Pain or stiffness of the fingers, impairment of hand motion and tenderness of the joints.

Trigger Point Activating and Perpetuating Factors: Repetitive pincer grasp; knitting, coloring, drawing or writing for long periods of time.

Differential Diagnosis: (Segmental, Subluxation, Somatic dysfunction) C6 radiculopathy, Ulnar neuropathy, C8 or T1 radiculopathy, Thoracic Outlet Syndrome, Articular Dysfunction, Carpal tunnel syndrome, De Quervain’s stenosing tenosynovitis, Carpometacarpal dysfunction, Osteoarthritis, Paronychia (Ingrown fingernail), Bone cancer, Bone fracture, Strain/Sprain, Rheumatoid Arthritis, Dupuytren’s Contracture, Ganglion cyst, Mixed Connective Tissue Disease, Raynaud’s Phenomenon, Frostbite, Diabetic Neuropathy, Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

 

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