Teaching Manuals: A Resource for Body Mapping Educators

Section Three: The Arms

Why Musicians Need Body Mapping

Music serves and enriches our lives socially and personally.
Body Mapping makes it easier to create compelling and artistically satisfying musical performances.
Body Mapping has the potential to save musical careers.
Learning accurate information about the body in movement is the most efficient way to teach any musical skill.
Injury is at epidemic levels among student and professional musicians. This may lead to mental health issues that arise from being in chronic pain.
Body Mapping offers a framework for integrated movement to improve music making and alleviate pain and injury.

Moshe Feldenkrais - “When you know what you are doing, you can do what you want.”

Why We Teach Arms

Arm/hand pain and injuries are prevalent among musicians. See supplement for list of common arm and hand injuries.
Arm/hand injuries are career-threatening.
Quality of arm movement affects facility, tone quality and ease of breathing.
Dynamic balance is affected by use of the arm structure.
Correcting common music pedagogical misconceptions about the design of the arm structure will address injury in current musicians and prevent injury in future generations of musicians.

Learning Objectives for Section Three

An easy neutral for the arm structure, in relationship to the whole body, will be trained.
Spinal support for whole arm structure will be trained.
Easy and free arm movement will be trained by accurately mapping all 4 main arm joints.
Easy and free hand movement will be trained by accurately mapping the thumb and finger joints.
Integration of arms for ease of whole body movement will be trained by mapping the whole arm in relation to the whole body.

Learning Outcomes for Section Three

Teacher Goals

Teaches the whole arm includes a collarbone and shoulder blade
Introduces concept of the four main arm joints
Clearly articulates suspension of the arm structure: relationship of soft tissue to bony structure
Demonstrates neutral for the arms
Mentions how neutral for the arms affects quality of breathing
Stresses importance of and clearly models humeroscapular rhythm
Teaches three main arm rotations (at arm joints #1, #2, #3)
Discusses concept of three main wrist “joints”
Addresses common palm mismappings
Clearly demonstrates three-jointed thumb and its relationship to wrist injuries
Teaches relationship between dynamic balance for torso and freedom for the arms

Participant Goals

Understands the four main arm joints
Finds neutral for arm structure
Experiences humeroscapular rhythm
Discovers three main arm rotations
Understands three main wrist “joints”
Uncovers palm mismappings
Experiences three-jointed thumb
Increases awareness of pinky side of arm for whole arm orientation
Accesses spinal support for the arms for ease of whole arm movement
Searches for integration of arms around torso for ease of whole body movement

Additional information can be found in the Section Three Supplement.
Please individualize your course regarding your own language, movement activities, and research.

Throughout the teaching manuals, text boxes highlight information that may be instrument specific, or may help clarify a concept. The trainee can decide when this information is appropriate for their audience.

Recommendations

Have a life size arm model to use.
Have plumbing pipe insulation tubes cut into 5-6 inch (12-15 cm) lengths.
Have the video “See How They Move” or similar footage of infants and toddlers moving playing throughout Section Three. Choose video footage of musicians who move well to play for your students to model.

List of YouTube Video footage of people moving

Video: Tim Lincecum, baseball pitcher

https://www.youtube.com/watch?v=MVAjxBb6HLY

Video: Whole Arm Movement in Toddlers

https://www.youtube.com/watch?v=Wkxfapvk68A

Refer to Section Three Supplement for Barbara’s comments on “See How They Move” and “Amazing Babies” videos.

Image 3.1a : The Whole Arm

The Whole Arm

A Whole Arm Includes:
A collarbone and shoulder blade (Latin: clavicle and scapula) - an upper arm bone (Latin: humerus)

Two lower arm bones (Latin: ulna and radius)
Wrist and hand bones (Latin: carpal bones and phalanges)

Limitation and injury come to musicians who do not include collarbones and shoulder blades in their map of their arms. Separating this collarbone/shoulder blade unit from the whole arm is like assuming “do re me fa sol la” is a complete acoustic unit and “ti do” is another.
The arm-shoulder distinction doesn’t make anatomical sense even though we make an arm-shoulder distinction in our language. Ask your students to remap their “shoulders” as mobile collarbones, shoulder blades and upper arm bones (or as shoulder girdle, which include the muscles that move their whole arms.)
They must map their collarbones and shoulder blades as a part of their arms just as their hands at the other end of that natural unit are mapped as a part of their arms.
Make sure your students understand that the collarbone and shoulder blade are two separate bones that meet at the acromio-clavicular (AC) joint but behave as one unit. We cannot move the shoulder blade without moving the collar bone. The AC joint provides some movement but not independently from the collarbone or shoulder blade. (You may need to look up the acromio-clavicular joint in an anatomy book for greater clarity. We aren’t labeling it here because it always mobilizes with the sterno-clavicular joint.)

Image 3.1b : Four Main Joints of the Whole Arm

A whole arm has four main joints:

Sternoclavicular Joint
Humeroscapular Joint (or Glenohumeral Joint)
Elbow Joint
Wrist Joint

Image 3.2 : Upper Arm in Context of Whole Body

Image 3.3 : Balanced Neutral for the Arm Structure

Balanced Neutral for the Arm Structure Around the Core

Arms at rest will balance effortlessly around the core as long as there is no unnecessary muscular work interfering.

However, when balance is chronically lost at any of the other places of balance, arm balance will also be lost. Similarly, when balance is lost for the upper arm structure, healthy movement will be compromised in all of the other joints of the arm from the shoulder joint down to the wrist and fingers.

There are four directions in which arms get pulled out of their neutral balance and therefore four phases of restoring arm balance:

Release of chronic pulling humerus into side of body (hugging ribs).
Release of chronic pulling arms down or up.
Release of chronic pulling shoulder blades back or forward.
Release of chronic “round-shoulderedness”.

As you coach your students in finding neutral for the arm structure in these four directions, ask them to be careful not to squeeze the humerus into the side of the torso as they explore. You will need to watch your students carefully through these explorations to help them avoid contracting in this way.

1. Finding Release of Humerus from its Hugging of Upper Ribs

Ask your students to stand up and find their dynamic balance as they did in the Balance Section.

The first arm balance exploration is to teach the “place of no work” for the side-squeezing muscles, latissimus dorsi and pectoralis major.

Exploration

The students should place the pipe-insulation tubes in the underarm region. These act as resilient spacers in the same way people use foam bits to space their toes apart during a pedicure.

Ask your students to purposely squeeze their arms into their sides and sense in which muscle areas they feel that work happening. Then ask them to slowly release and monitor the diminishing work in those muscles until the place of no work is reached.

Doing this before teaching the other “places of no work” will improve the effectiveness of these later explorations because when students take their arms up, down, back or forward, they also sometimes unnecessarily squeeze the arms into the side of the body.

2. Finding Release of Chronic Pulling Arms Down or Up

Use your segments of plumbing pipe-insulation tubes/pool noodles for the following explorations.

The foamy pipe-insulation tubes are placed snugly up in the underarm region. The tubes act as resilient spacers -in the same way foam strips are used to space the toes apart during a pedicure. Reinforce this point if you see students trying to keep the tubes in place by squeezing them into the torso with the upper arm.

Once the tubes are in place, ask your students to bring their collarbones and shoulder blades up all the way, noticing where they feel the muscular work. Most report they sense work happening in superficial upper torso muscles (i.e. trapezius) but once it’s pointed out to them, they will also begin to discern that there is muscular support coming from deep within the underarm region (i.e. serratus anterior).

Next ask them to lower the collarbones and shoulder blades slowly, looking for a place where the upper torso muscular work has stopped but some of the deep underarm muscles are still providing upwards support. These deep support muscles are often underworked and will need encouragement to do more just as the upper torso muscles will need encouragement to do less.

Now ask them to do the same exercise, but this time taking their collarbones and shoulder blades through the range of motion down toward the ribs and then to ease back up to the place of no work. Ask them to only move in a range that is comfortable.

Many students have their collarbones and shoulder blades mapped as moving up and releasing to neutral, but they do not have them mapped as moving down toward the ribs and releasing back up to balance. They have neutral for the collarbone and shoulder blade mapped as resting on the ribs and therefore their collarbones and shoulder blades are chronically pulled too low.

Being mapped too low is every bit as dangerous as the habit of holding the collarbones and shoulder blades too high, because holding the collarbones down puts pressure on the nerves and blood vessels that lie between the collarbones and the ribs, creating a situation of poor nerve transmission and poor blood flow to the arms and hands.

This is a common cause of numbness in the hands if the pressure is severe. However numbness can also be caused by pressure on the nerves when the neck is scrunched, pressure on the nerves when the upper arm bone is pulled in very tight to the upper ribs, or pressure anywhere along the length of the nerves between the neck and the hand. Sometimes a student comes along whose forearm and hand numbness comes from all three problems: collarbones too low, scrunched neck, and humerus held in close to the ribs.

Image 3.4 : Nerves and Blood Vessels that Run Under the Collarbone

3. Release of Chronic Pulling Shoulder Blades Back or Forward

In a similar fashion, instruct your students to pull their shoulder blades back through their range (pulling the shoulder blades together) and then ease them forward again to balance at their sides. Students who have been told to “get the shoulders back” or “sit up straight” will need patient coaching in order to find neutral in this direction. Ask the students to do the same thing forward, pulling the shoulder blades and collarbones forward and then releasing back to balance.

Very few musicians have collarbones mismapped as moving straight forward- usually it’s a combination of down and forward rotation (“round-shouldered”).

4. Releasing out of Slumping and Round Shoulderedness

When a musician goes into a slump, the head, neck and upper torso get pulled forward and rounded, and alignment through the entire body is compromised. Many activities can contribute to this common problem, including playing an instrument, driving, desk work and texting.

Often, the collarbone participates in the slumping pattern by rotating forward at the S.C. joint. In the back, the shoulder blade may be chronically pulled up and over the top of the ribs. Finding ways to release periodically out of the forward and downward pull of slumping can be helpful. See the following movement explorations and videos for exploring release.

Collarbone at Neutral

Collarbone Rotated Forward and Down

Image 3.5a : Neutral Vs. Round Shouldered: Front View

Image 3.5b : Playing from Balanced Shoulder Blades

These musicians have moved from a neutral dynamic balance into healthy playing movement.

The shoulder blades have remained flush with the ribs as they glide around the torso into movement because, in part, the serratus anterior muscle is doing its job of keeping the scapula from protruding. Note the steep diagonal angle of the ridge of the shoulder blades as shown by the arrows.

Image 3.5c : Violinist Playing from Round-Shouldered Mismapping

This musician has moved from the round-shouldered mismapping into an unhealthy playing movement.

Movement Explorations

Video: Jennifer Johnson demonstrating Finding Rotational Neutral for Collarbone and Shoulder Blade

https://www.youtube.com/watch?v=d9FEls6ZzxU

Refer to Section Three Supplement for a more detailed description of this exploration.

After watching Jennifer’s video, you can also do this movement exploration submitted by Bonnie Draina. Lying supine with a bolster under the shoulder blades or the spine, or with the arms resting above the head, can encourage release of tight pectoral muscles while allowing muscles in the back of the torso to rest.

Video: Animation of movements of collarbone including rotation at the S.C. joint.

(Begin at minute 1:10) https://www.youtube.com/watch?v=wDilE1UJUp8

Refer to Section Three Supplement for more details on the importance of the serratus anterior.

Image 3.6 : Arm Balance Around the Core

Use this image to refresh the context for everything you’re saying about the arm structure, and to remind students that the arm structure balances over and around the core of their bodies.

Questions for Review

What part of the arm is most frequently left out of a musician’s map of the arm?
What mismappings did you have about your arm balance? How will you correct this? What might a mismapping of arm balance look like?
What symptoms may result from the arms being mapped too low?
What other bony structures will be negatively affected by arms being mapped as too low?

Image 3.7 : Suspension of Arm Structure Over and Around the Ribs

Suspension of the Arms by Connective Tissue

We have a significant amount of connective tissue. If we stood our connective tissue alone, it would have our shape. If we weighed it, we would find its weight a significant proportion of our body weight. Connective tissue shows up again and again in the course in one way or another so it’s important to be clear about it. It is literally what holds us together and it needs to be mapped, preferably as a system, like the muscular system, or the nervous system.

Connective tissue is the elastic, stretchy, collagen-based material that makes up tendon, ligament, fascia, cartilage, and disk. Each of these has a different purpose and therefore a different texture. Tendons link muscles to bone usually, though the central tendon of the diaphragm links muscle to muscle (heart). Ligament holds bone to bone. Fascia, in general, adheres muscle to muscle and either skin to muscle or skin to bone. It also secures organs, and it is protective — as are the disks of the spine, for instance. Some connective tissue limits extraneous movement. It binds the entire body and helps to suspend the arm structure over and around the ribs.

See Gil Hedley’s website for more information on fascia:

http://www.gilhedley.com/

Refer to Section 3 Supplement for more of Dr. Richard Nichols’ comments regarding the role of muscles and fascia in the suspension of the arms. You will also find here Barbara Conable’s definitions of Suspension, Suspensible, Suspensive, and Suspensory.

Definition of Biotensegrity:

Different researchers in different parts of the world have demonstrated evidence that the entire fascial network is interconnected so that a continuous tension network is known to exist within the body. We also know that at least some of the body’s structures, like the shoulder girdle, transmit their loads through the tension of the soft tissue and not the compression of the bones.

Common Mismappings of Arm Joint #1

That the top of the arm starts at the glenohumeral joint. Related myth is that “the shoulders shouldn’t move” or “shoulders should stay down.”
That the top of the rib structure is square, rather than beehive-shaped.
That the collarbone rests on the ribs.
That the humerus is attached to a fantasy “shoulder socket” that is unrelated to the shoulder blade.
That the shoulder blade is directly attached to ribs.
That the entire shoulder blade is on the back of the body.

Image 3.8 : Arm Joints #1 and #2

Since it is the sternoclavicular joint that is so often left out of a musician’s inner list of arm joints, it

makes sense to use an image that highlights that joint, but which also clearly shows the location of arm joint number two, which is also frequently mismapped.

Run your laser pointer along the inner edge of the shoulder blade in the back and then point to the proximal end of the collarbone to remind your students about the inclusion of the collarbone and the shoulder blade in the map of the arm.
Emphasize to your students that the sternoclavicular joint is the only joint that the arm structure forms with the skeletal structure of the torso.

Image 3.9 : The Whole Arm

The wrist and the elbow were left out of Image 3.8 to emphasize the first two arm joints. Use Image 3.9 to put Arm Joints #1 and #2 back into the context of the whole arm by just pointing to all the arm joints.

Specific Movements at Arm Joints #1, #2, #3, and #4

Having discussed the general overview of the whole arm, now is the time to cover all of the specific movements that are possible at each of the four main joints of the arm. As in all movement explorations, carefully watch your students. If a student is currently injured, his or her participation in these explorations should be carefully monitored.

Image 3.10 : Arm Joint #1 - The Sternoclavicular Joint

When musicians do not map this joint, they suffer. The easiest way for someone to know if it is mapped is to ask if he or she would have included it in a list of joints if they were asked to make such a list. If they are clarinetists, they will suffer limitation to some degree in their breathing and in the dexterity of their fingers. If they are violinists or trombone players or flute players, they will suffer pain and injury because these instruments require significant movement of the collarbone and shoulder blade, as do some other instruments.

Some students will have the area mapped as actively or aggressively immobile. They say, “I really didn’t think anything there moved” or, worse, “I thought you weren’t supposed to move there,” or, “I thought you were supposed to hold that still.”

Those who have the structure mapped may nevertheless not have the function fully mapped. They will say, “Well, yes, I think the collarbone goes up and down at that joint.” This incomplete mapping of its function will not hurt a clarinetist much, but it will limit a trombone player as much as mapping the joint with no mobility, for the trombone player needs the collarbone to move forward.

A flute player needs the movement forward on the left side, as the collarbone and shoulder blade must move to full range forward in order to reach the flute. If movement is not permitted there because it is not provided for in the body map, then there will be compensations in the upper back that are dangerous and limiting.

Image 3.11 : Shoulder Blade Movements

Ask the students to put their collarbones and shoulder blades through their full range of motion. (If a student is currently injured, their participation in these explorations should be carefully monitored, or they should just be encouraged to observe others.)

These images above show protraction, depression, retraction and neutral. In addition, there is elevation and rotation. You’ll want to make sure your students are aware of all of these potential movements.

Students can do these motions twice, once palpating the sternoclavicular joint, another time palpating the shoulder blade. Repeat on the other side. Some Body Mapping Educators will pair students up to do these explorations by placing their hands on each other’s shoulder blades. When pairing students up have them ask permission to use their hands. It is best to demonstrate movement at this joint without movement at any other, just rolling the collarbones and shoulder blades in circles, as a jazz-era dancer does. If the other bones are participating, their movement may distract or confuse the students.

Watch them carefully as they do this and look out for the following movement errors:

Some will jump immediately to the humeroscapular joint and simply substitute movement there instead of finding full movement from the S.C. joint. Coach them patiently until they are making at least some of the movement you are teaching them.
Some will move from the S.C. joints, but only in one direction. Make sure they find movement up/down, forward/back and in rotation.

See Section Three Supplement for video demonstrating rotations at glenohumeral and sternoclavicular joints.

Some will have some movement in all three directions but will have not found their full range. Observe that they are taking the whole arm safely through their range of motion

Shoulder blades move at the sternoclavicular joints. Musicians sometimes have their shoulder blades mapped as fixed to the ribs and they are always astonished to discover that they are designed to move as part of the arm. These pictures will help these students, but it’s also useful for them to put their hands on someone else’s shoulder blades to feel the range of movement.

Questions

What are some movement activities you would include for exploration of the first arm joint?
How will you demonstrate rotation at the first arm joint?

Image 3.12 : Collarbone and Shoulder Blades Balance Over Ribs

This image is a reminder, and it sets the stage for teaching about the humeroscapular joint. Students need to see that the collarbone and shoulder blade form a unit.

You will need to point out that this unit is curved and when at neutral it is released wide so that the socket is available at the side of the body for the ball of the humerus to meet it without strain.

A very serious and common mismapping is the inner conception that the collarbones and shoulder blades rest on the ribs, rather than being suspended and supported by connective tissue over and around the ribs. The collarbones and shoulder blades will always be carried too low as a result of this mismapping, and upper body tension will always result. This is as serious a mismapping for singers as it is for instrumentalists, because it limits upper rib movement and the lengthening of the spine on exhalation.

Image 3.13 : The Whole Arm

The image of the whole arm can be re-introduced at the beginning of discussion about each new arm joint and can be used to shift attention from the previous arm joint to the new one in the same way the Balance Mascot is used in Section Two.

Image 3.14 : Arm Joint #2, The Humeroscapular (Glenohumeral) Joint

Mapping the Humeroscapular Joint (Sometimes Called the “Glenohumeral Joint”)

This is where the ball of the humerus meets the small thumbprint socket at the side of the scapula (the glenoid fossa.)

Many musicians have incorrectly mapped the socket as something separate from the shoulder blade and/or they conceive of the socket as larger than it is. These players will often feel that the shoulder blade belongs on the back of the body and that the socket is something separate at the side of the body. In a student with this mismapping, the entire shoulder region may be bunched and curled.

Image 3.15 : Bunched and Curled vs. a Healthy Humeroscapular Rhythm

The bunching and the curling may be for mismapping reasons, or it may be a musical issue tied to performance anxiety. (See Barbara Conables’ article: https://www.bodymap.org/performance-anxiety) As you are working with students who are retraining habits, use patience and compassion.

Sample question to ask students who are bunching and curling: “What does an upper arm bone meet at the shoulder joint?”

Carefully watch your students’ gestures as they answer this question.

Ask them to point to their socket and they may end up gesturing by cupping their entire humeroscapular region in their hand. Make sure you have clarified what the structure actually is.

Map the following with the student by using models:

Show that the socket is contained within the structure of the shoulder blade.
Show that the socket is actually small; have a quarter to show the comparison.
Have a model of a humerus and show how large it is relative to the socket.
Show that the ball of the humeroscapular joint can be palpated from the underarm region. The two bones

meet deep in the underarm region. Some musicians have the joint mismapped as being located at the top of the humerus.

Watch for any expressions of surprise as they remap. Inquire how this remapping will change their movement patterns.

Image 3.16 : Scapular Socket, Curves

This image will be adjunct to the model of the shoulder blade, collarbone, and upper arm bone that you are using. It is a good picture for explaining the small socket.

Exploration

Demonstrate to your students how to palpate the ball of the humerus.
With one arm raised straight up in the air, ask them to feel around with the fingers of the other hand in the underarm region- right where they put their underarm deodorant. Show them on the anatomical model how the rounded part of the ball, that articulates with its socket when the arm is at the side of the body, is now what they can feel under their fingers with their arms raised.
Next ask them to locate the back rim of the socket as you display an image of the back of a shoulder blade
Have them walk their fingers up the outside edge of the opposite arm’s shoulder blade starting down at the tip and walking up towards the back of the underarm region.
Tell them they are looking for evidence of a bony protrusion under many layers of muscle. It may be tender under their palpating fingertips. This is the back rim of the shoulder blade’s socket.

You may notice we have chosen to use the term underarm region. Some may use the term armpit. The term armpit could cause a mismapping depending on how someone translates the term. The anatomical term for this region is the axilla. The Axilla is an area that lies under the glenohumeral joint through which vessels and nerves enter and leave the upper arm.

The term humeroscapular rhythm was the one Barbara Conable created rather than the traditional kinesiology term “scapulohumeral” or “glenohumeral” because she wished to be clear that in most movements for musicians, the humerus moves first and leads the scapula and clavicle into any direction that the humerus is travelling. In kinesiology terminology, “scapulohumeral rhythm” refers only to movement in the frontal plane.

If you have not done so already, this is as good a place as any to talk about humeroscapular rhythm, which is that built-in tendency for the shoulder blade to move (really at the sternoclavicular joint, remember) in a particular sequence with the upper arm bone (the humerus). The upper arm bone moves a certain distance, and the collarbone and shoulder blade fit right in and begin to move, too, in the same direction. This is true of humeral movement in any direction, including rotation. The humerus rotates a certain distance and then the shoulder blade rotates up over the ribs in rhythm and in sequence. Many people will have preserved the integrity of that sequence in a swimming motion, so ask them to make swimming motions and watch them to see if humeroscapular rhythm is clearly there in a natural, fluid way. If it is not moving in a natural way, it will be important to help the student find neutral for the upper arm structure as a starting point before taking it into humeroscapular rhythm.

Failure of humeroscapular rhythm is a big problem for musicians and accounts for most rotator cuff injury in musicians. Get out your anatomy books and explore the rotator cuff, which is the group of small muscles that snuggle into the grooves of the shoulder blade. Their function is to stabilize the relationship of the humerus to the scapula, especially to prevent the humerus from dislocating from its socket. After the movement upward of the humerus to its natural comfortable limit,* if you are raising your arm, the movement will sweep to the sternoclavicular joint, and the collarbone and shoulder blade will come up. If the sternoclavicular joint isn’t mapped, humeroscapular rhythm is guaranteed to be distorted, and injury may result. Tell your students to be on the watch in their playing for any failure of humeroscapular rhythm and to immediately restore it!

*“Natural comfortable limit”for the humerus is roughly 30-45 degrees away from the side of the torso--definitely long before the arm approaches a 90 degree angle to the torso.

The 3 Rules of Humeroscapular Rhythm

The scapula (i.e. collarbone-scapula unit moving from the S.C. joint) must follow the humerus in whatever direction the humerus travels
The scapula must begin moving soon enough (when humerus is no more than 30-45 degrees away from torso)
The scapula must go far enough for the task at hand

See following video links for studying humeroscapular rhythm

https://www.physio-pedia.com/Scapulohumeral_Rhythm
https://www.youtube.com/watch?v=rpzBGlOEW4E (Note: the rib movement in this video clip is inaccurate and is a result of

a fault in the animation program.)
Humeroscapular Rhythm from MWAI : https://www.youtube.com/watch?v=AbmpDzD8YIs
Humeroscapular Rhythm from RIE- (Note: share visuals with students with audio off): https://www.youtube.com/watch?v=JljBhZPNOPM

Questions

What have you discovered about the state of your humeroscapular rhythm? What mismappings have you discovered that are restricting an easy humeroscapular rhythm?
Where would you include the segment on humeroscapular rhythm in your presentation?
What movement activities will you use to help musicians remap their humeroscapular rhythm?
Document the changes you hear in your sound when you allow your own humeroscapular rhythm.

Rotation and Humeroscapular Rhythm at Joint #2

Emphasize that part of the movement of the upper arm bone in relationship to the shoulder blade is rotation. This rotation can be internal or external, and can happen in all planes of motion. There are musicians injured, because over years of playing, they did not allow the proper rotation at the humeroscapular joint. This loss is the direct result of an inadequacy in the body map with regard to function. Rotation isn’t mapped, therefore rotation doesn’t occur. These musicians are usually string players, and they will also have been handicapped in their playing near the tip of the bow, because it is the rotation at the humeroscapular joint (combined with humeroscapular rhythm) that gives the bow a secure connection on the string at the end of the bow stroke, allowing the friction to continue in the same degree right to the tip, making a lovely, consistent sound. Those without rotation who nevertheless have a consistent sound to the tip have learned to achieve it with pressure from an unnecessary pushing with the hand. They will be very happy to give up that compensation, which may itself have hurt them if there is tension in their hands.

Activity

Rotation at Arm Joint #2

See video : https://www.youtube.com/watch?v=0orsNjXYEBg

Looking at your palm, bend your right arm at the elbow so your right fingers are pointing straight to the ceiling.
Then keeping the elbow bent, move the elbow away from the torso so the fingers point to your left. This is one way to learn what rotation at Arm Joint #2 (humeroscapular joint) feels and looks like.
Take the rotation to its extreme ranges by sending the elbow away and up as fingers point down more toward the floor and notice that in addition to rotation at Arm Joint #2, there will also be a forward rotational movement at the sternoclavicular joint (humeroscapular rhythm).
Use the fingers of your opposite hand to monitor the other arm’s rotation while you are doing this exploration.

Questions

What are the common mismappings at Arm Joint #2’s “ball and socket” joint?
Did you have an Arm Joint #2 socket mismapping? If so, what movement explorations are you doing to

remap this?
How will you demonstrate rotation at Arm Joint #2?

Image 3.17 : The Whole Arm

Ask if there are any questions about arm joint number two as they see it in context. In every instance, insofar as it is possible, we want to keep returning to the part within the whole.

Common Mismappings of Arm Joint #2

That there is a fantasy socket at the side of the body completely unrelated to the shoulder blade which belongs on the back.
That the socket is big enough to enclose the ball like the gesture people make when demonstrating a ball and socket joint with one fist enclosed in the palm of the other hand.
That the joint is located at the rounded part at the top of the humerus.

Image 3.18a : Bending/Unbending happens at Humeroulnar Joint

Image 3.18b : Pronating/Supinating happens at Humeroradial Joint

There are only two movements at the elbow: bending/unbending, and pronating/supinating (turning palm down and palm up). These images illustrate those two movements.

Ask your students to make these movements so they feel clearly what is being talked about.

It is common for students to mismap pronation and supination as occurring at the wrist. It may be necessary to restate that pronation and supination occur at the elbow.

These students may have severe wrist problems and may look very confused when you teach this. Be compassionate and kind as you take the time to inquire and respond. Sample questions are:

May I know what your expression means?

What are you learning?
What surprises you about this?

Some Body Mapping teachers like to teach rotation at the elbow joint with the upper arm at rest against the torso so the humerus does not get involved. Others teach it with the forearm resting on a table (as shown above in Image 3.18b) to ensure that neither the ulna nor the humerus substitute for the rotation work of the radius.

Activity with a Partner

Part One

Place your forearm palm-up on a piece of paper on a table and draw one line on the paper up the radius side and one line up the ulna side. In order to witness unhealthy rotation at the elbow joint and feel how chronic ulnar deviation results when the ulna becomes involved in pronation, move your hand palm-down, but do not allow your forearm to leave the space between the two lines. This is what it feels like when the radius is doing 50% of the rotation (instead of 100%) and the ulna is trying, against its design, to do the other 50% of the rotation. Ask your partner to place his hand on your bicep and notice the unnecessary tension in these muscles. Notice also the strain across the back of the wrist as well as the tendency of the hand to get tilted so that the thumb begins to align with the radial side of the forearm. This is called ulnar deviation.

Very Important: Please note that ulnar deviation is a very useful and important movement for many musicians and will not lead to injury unless it is chronic ulnar deviation caused by the ulna being involved in rotation. If the ulnar deviation is chronic for any reason, it will become a habit in the musician’s everyday activities such as shaking hands or turning a faucet. It will also become chronic in the musician’s music-making and might cause strain and injury such as tendinitis or carpal tunnel syndrome.

Part Two

Once again, place your forearm palm-up on your piece of paper between the two lines you drew in Part One of this activity. However, this time you will leave your ulna on its line on the paper and move the hand palm-down (pronate), allowing the radius to leave its first line in order to cross over the ulna. The radius is now doing 100% of the rotation as it is designed to do. Ask your partner to notice that there is no strain in the forearm muscles, across the wrist bones or unnecessary work in the bicep. There will also be no ulnar deviation caused by the interference of the ulna- the hand will be at neutral (until you decide you need the hand to deviate from neutral for a specific task and then return it to neutral!). Draw a third line now along the radius to highlight its new location on the page.

Image 3.19 : Stationary Ulna and Rotating Radius

In every course you teach, you will have at least one person who has mismapped pronating and supinating as occurring around the radius, rather than around the ulna, as it actually does. There is an ongoing discussion among Licensed Body Mapping Educators about how to best address this issue of the ulna, since it is one of the most important that we confront.

You need to know exactly what it looks like when it’s wrong, and exactly what it looks like when it’s right. You need to be able to clearly explain the true nature of the movement and you need to be able to spell out the consequences of its mismapping. You need to be able to recognize the following visual clues or red flags which point to a student’s mismapping of the radius as stationary:

Red Flags to Watch For

Muscular tension in the forearm that results from trying to stabilize the radius at the very moment when it is moving. The muscles that pronate and supinate are close to the bone and quite small, so when you see muscular work in superficial muscles as a person pronates and supinates, you know the person has the function mismapped.
Chronic ulnar deviation (when hand is habitually tilted out of neutral at the wrist and the thumb appears to be aligned with the radius side of forearm)
Pulling of the thumb toward the index finger as if to make it one of the fingers
The little finger is left on its own as if it were the opposable digit instead of the thumb
The arm always looks organized around the thumb side rather than around the little finger side
Complaint of a weak little finger
Compression of the wrist bones

Activity

Use three small stickers or erasable markers to map forearm rotation. With the palm facing up, the student puts a sticker or mark on the upper radius (where it forms a joint with the humerus). At the same time, put one on yourself and one on the forearm model.
Then ask the students to go about halfway down the radius and place the second sticker there.
Ask them to put their third sticker at the wrist-end of the radius, which is easy to palpate because you can

hook your fingers right over the top of the radius.
Then have them hold their forearm parallel to the floor and in supine (palm-up) position. They can just see their three stickers on the radial edge of their arms, more or less in a straight line.
Ask the students to slowly pronate. They will watch the stickers near their wrists go around 180 degrees and they will see the stickers in the middle of their forearms go 90 degrees, over the place where the two bones are crossed. They will see that the sticker at their elbow joint remains stationary.

The neutral relationship will feel all wrong to those who have mismapped pronating and supinating as happening around the radius. They will feel that the “natural” way to align their hands with their forearms is with their thumb lined up with their radius. This puts the poor little finger off on its own, rather than the thumb, which is supposed to be off on its own to a certain degree, being opposable. The mismapped will initially complain about the wrist braces that put them back to a really natural neutral, and they will not understand why the wrist braces help them feel better, as they generally do. You will also see in these folks a narrowing of the back of the hand, so that the hand bones will not spread as they should. There will also be a loss of range in the pronating and supinating which will be particularly apparent when a person pronates and supinates with their forearms supported on a table or desk.

Refer to Section 3 Supplement for further observations by Tom Mark and Susan Riggs.

Image 3.20 : Bending at the Elbow Joint

Questions

What two movements happen at the elbow joint?
What mismappings have you corrected regarding the elbow joints?
What is the most common and harmful mismapping that musicians suffer from at the elbow joint?

Common Mismappings of Arm Joint #3

That the elbow is only a hinge joint, bending and unbending but not rotating from here.
That the elbow is the meeting of one upper arm bone and one lower arm bone.
That both forearm bones participate in rotating the forearm to take the hand from palm-up to palm-down
That the ulna is the rotating bone to take the hand from palm-up to palm-down.
That the skin crease on the top of the forearm is where elbow bending happens.

Image 3.21 : The Whole Arm

Image 3.22 : Neutral Relationship of Hand, Wrist and Forearm

The neutral relationship of the hand, wrist and forearm is in the mid range of possible wrist movement side to side (ulnar or radial deviation). This is the place of least work for muscles and tendons of the forearm and hand.

Watch your students carefully as they address ulnar deviation to ensure they do not overcorrect and mistakenly map radial deviation instead of a neutral relationship.

Image 3.23a : Arm Joint #4 - The Wrist Joints

An updated document with detailed information about the wrist can be found here.

Arm Joint #4 is actually comprised of eight bones which create multiple joints at the wrist.

Most wrist injury is the direct result of mismapping the forearm in its rotation. The reason is this: when the thumb is chronically lined up with the radius, the wrist bones are chronically jammed. The bones go out of right relationship with each other, and many of the symptoms of distress in this area begin to appear: numbness, inflammation, swelling, reduced nerve transmission, reduced blood flow, stiffness.

The connective tissue over time can become so warped and distorted that the hand can’t come back to neutral until and unless careful work is done to free the area and restore the resilience of the connective tissue. This is particularly true around the natural gap between the forearm bone (ulna) and the wrist bone on the little finger side that “closes” in ulnar deviation (the movement of the hand to the outside).

However, some wrist injury comes from the mismapping of the wrist itself; especially the simple failure to map a wrist at all, assuming that a hand merely meets an arm at this location. Another serious mismapping that always results in injury in this area is mistakenly mapping the supinating and pronating of the hand as occurring at the wrist rather than the elbow.

The wrist is comprised of eight bones, in roughly two offset, curving rows of four, creating a series of three major joints: arm and wrist; hand and wrist; and intercarpal, where one set of four moves in relation to another set of four.

Image 3.23b : The wrist bones in ulnar and radial deviation

Image 3.24 : Three-Jointed Wrist

Free movement of the wrist is sequential across the three joints. The joints where the bones of the wrist meet the bones of the hand (the carpometacarpal joints) need special attention because they are both the location of wrist movement and of finger movement. The bones in the hand move apart and together at this location as well as at the large knuckles. Free movement at this carpometacarpal joint is crucial for pianists when playing octaves and for moving to big chords with guitarist. A common mismapping is that the fingers open from the webbing of skin above the large knuckle.

There may be a student with an otherwise correct wrist mapping who has mapped the wrist as flat. They do not have a carpal tunnel in their body map, so they do not have a carpal arch. What is a tunnel on the palm side is an arch on the back side, or top side. There is a chronic muscular strain that has the effect of flattening the wrist to some extent, to justify the map, to create a feeling congruent with the map.

There are three mismappings of the wrist that cause compression of the wrist bones and carpal tunnel:

Twisting (ulnar deviation).
Dropping the wrist.
Mapping the wrist as a flat structure.

Activity

Explore movement from the radiocarpal joint only- like a hinge.
Move from the carpometacarpal joints, opening your fingers like a fan.
Move through the midcarpal joints, sequencing all wrist joints doing the “hula”.

Questions

Make a list of your own personal wrist mismappings that you have discovered.
If a student has wrist pain, what other joint should you help them remap?

Common Mismappings of Arm Joint #4

That rotation happens at the wrist.
That the wrist is the two bumps at the end of the forearm bones. That the wrist is flat.
That the wrist is a hinge joint.
That the wrist joint only exists where the skin creases are.

Image 3.25 : The Whole Arm
Finish your discussion of the wrist by showing it within the context of the whole arm.

Image 3.26 : The Hand

Image 3.27a : Muscles on the inside of the forearm bending wrist and fingers

Image 3.27b : Muscles on the outside of the forearm straightening the fingers and creating wrist extension*

*Extension at the wrist brings the back of the hand toward the forearm.

A majority of the finger movements that musicians use are accomplished by muscles in the forearm. These forearm muscles are connected to the fingers by tendons. Musicians who map the forearm, wrist and hand accurately are able to more efficiently access these muscles. Musicians with chronic ulnar deviation or musicians who habitually lock their wrists interfere with the natural connections of forearm muscles to the hands.

Image 3.28 : Intrinsic Hand Muscles

There are some intrinsic hand muscles that help us with fine motor control. Not all finger movements come from the forearm muscles and tendons. The intrinsic hand muscles spread the fingers and bring them back together, and assist with flexion. As Image 3.28 shows, there are no muscles in the fingers beyond the palm.

Activities

Releasing the four muscles that comprise the thenar eminence of the thumb to avoid crowding of all the hand bones. Massage or use a small ball rolled over this muscle group.
Opening or fanning of the hand from metacarpophalangeal (FJ1) and the carpometacarpal (CMJ) joints.
Palpating muscles and fascia between hand bones from back of hand.

Image 3.29 : Joint Numbering System (from WEV)

Note: Many LBME’s choose to use vernacular language when talking about the hand bones in particular. Musicians often respond more quickly to the information if they do not need to sort through the Latin medical terminology. One labelling possibility is to borrow the finger bone and finger joint numbering system found in WEV (see Image 3.29). This numbering system includes what are traditionally called “hand bones” as finger bones #1 (FB1) in order to encourage musicians to map them as bones providing movement as important to making music as the other finger bones that are traditionally thought of exclusively as “the fingers.”

However, if you want to learn the technical names and use them in your teaching, refer to image 3.29. How much Latin to use when teaching the course is one of the personal choices all Trainees need to make.

Mapping the Hand from the Back Vs. the Palm

See Video : https://www.youtube.com/watch?v=r4_mt3O50Vg

It is more accurate to map the joints of the hand from the back of the hand, rather than from the palm side. Take particular note of the location of the large knuckle joints on the back side compared to the palm side. There are nineteen joints in a hand, and you can palpate each of them. The hand opens from both the large knuckle joints and the joints where the finger bones meet the wrist bones. Feel the space between the long finger bones as you open your hand like a fan from both of these joints.

The following movement explorations will make this apparent:
Use a hand-out of a full page view of Image 3.26. Point out that it is a picture of the right hand as seen from the palm-side and the back-side. Ask your students to label the finger bones and joints on their hand image from either the numbering system or the Latin short-forms as shown in Image 3.29. It can be their choice which to use, though the numbering system is used in the explorations below.

Dispelling the Palm Myth: Finger Side

Hold your hand in front of you, palm up.
Study your fingers.
Notice that the upper set of finger joints (FJ4), near the tips of the fingers, is at creases. So are the next

ones down. Go ahead and locate these joints- FJ4 and FJ3 on Image 3.29.
However, the next set of creases down is not at joints, though the people who have mapped the hand as a solid palm (as basically a palm with fingers off one side, a thumb off another side, and a wrist at the bottom) will try to move their fingers at those creases because they will have them mapped as a set of joints.
This causes hand tension and a narrowing of the back of the hand which you can learn to recognize as indicative of this mismapping.
Turn your hand over so that you can see it from the back. You will now be able to locate the actual set of joints - FJ2- and then find where they lie in the palm. You’ll see the FJ2 joints lie quite far down into the palm, at the major crease in the palm closest to the fingers.

Dispelling the Palm Myth: Thumb Side

Next look to the thumb side of the palm. A common mismapping is that the thumb is comprised of only two bones and therefore has only two joints.
Notice the skin webbing does make it appear this way, especially from the palm side. It looks like a two-jointed thumb comes off that side of the palm in the way that some musicians imagine three-jointed fingers sprout off from the top of the palm.
People who have mismapped the thumb this way will display a prominent second knuckle and an immobile first joint, down at the wrist. These people will never move the thumb from that first joint because moving from there folds the palm and their mismapping doesn’t permit that folding.
Indeed, many of these people have the palm mapped as one flat bone, like a shoulder blade. In that case, of course, the palm couldn’t fold.
This mismapping is especially unfortunate for clarinet and oboe players. They try to support their instruments on two-jointed thumbs and they are inevitably in pain. Once they remap their thumbs as three-jointed (i.e. with three bones, not just two), the pain begins to subside.

Dispelling the Palm Myth: Wrist Side

Next turn your attention to the wrist side of the palm.
To palm-mapped people, the wrist is merely the crease at the bottom of the palm.
Musicians with this mismapping will always display a hingy kind of movement at the wrist.
Turn your hand to the back again to find the joints where the hand bones meet the wrist bones (FJ1).
If you again explore where those same joints lie in the palm, you will find that the FJ1’s are about as far up into the palm as the FJ2’s are down into the palm, once again dispelling the myth of the palm.
Palm-mapped people have no discernible movement at the joints of the hand bones with the wrist (FJ1’s) even in coming to an octave on the piano or a large chord on guitar, so it is a serious limitation.
There will also be a shortening of the wrist as well as the hingy look already mentioned.
You will need to help these students find the entire wrist lying within the base of the palm because it will not occur to them to go looking for the possibility of movement there.
When a musician has his or her hand mapped accurately, the fingers will spread open, close up and also drop using both the large knuckle joint (FJ2) and the joint where the finger bones meet the wrist bones (FJ1).
The thumb has more movement at its TJ1 than the fingers. This wider range of thumb movement is more easily accessed when the thumb is clearly mapped as having 3 joints.

Dispelling the Palm Myth: Pinky Side

Turn your attention now to the little finger side.
A common mismapping here is that the palm should stay more or less flat as the little finger moves- this can be devastating to the left hand of a string player.
Musicians who hold that little finger hand bone back at FJ1, will be preventing it from moving forward easily to depress a string or a key. This overuses the pinky’s FJ2 and causes a muscular strain that always results in a sharp pain between the little finger hand bone and the ring finger hand bone. There is a characteristic gesture seen frequently among these musicians--rubbing between those bones.
To help them remap, ask them to make a left hand fist. In making a fist the little finger hand bone will move quite significantly forward in relation to the ring finger bone.
Ask them to bring their fist to their instrument and slowly open out of the fist and notice that it’s possible to allow the pinky hand bone (FB1) to stay forward and closer to the string or key.
The mismapped student will be tempted by his inaccurate map and may let it pop back to flat, so you will have to watch closely.

This exploration will aid students in dismantling the myth of the palm and remapping to the truth of the hand’s structure and function.

Image 3.30 : Drawing in the Bones (from MWAI)

Activity

• Draw the bones of the wrist and fingers on the palm side of your hand.

Image 3.31 : Finger Facing Thumb

This information should be in the first lesson on every instrument that requires the movement of the opposable thumb in relationship to the fingers. How is it possible that a thumb can come opposite the fingers with a flute in between, a clarinet in between, the neck of a guitar in between, or something bigger, a cello in between, a string bass, a bassoon? Because of its nature. It is by nature opposable. Ask your students to tap the thumb and the index finger together, then the thumb to the little finger. If tapping the little finger is more difficult than tapping the index, it will be because they are trying to move the thumb from the second joint instead of from its joint at the wrist. Watch to see if chronic ulnar deviation is in evidence. Make sure they are allowing the little finger to move toward the thumb from its joint with the wrist. Some pianists use the opposable nature of the thumb very little in their technique and some use it a lot, depending on how much they rely on what they call cross over, the fingers coming over the thumb, a.k.a., cross under.

Help your students who are having opposable thumb problems by asking them to contemplate what happens when movement of the thumb in the other direction is required, as in harp playing. A clarinetist moves from neutral toward opposed with the hand, but a harp player never does that and often moves from neutral to more “open,” as do massage therapists and visual artists who must smooth fabric over a flat surface. Movement in the “open” direction is as difficult and uncomfortable and potentially dangerous for the mis- mapped as is the opposed direction, and it can be instructive to go there and see how dependent both movements are on accuracy in the body map and freedom from tension.

Refer to Section 3 Supplement for additional information regarding the interosseous and lumbrical muscles of the hand.

Questions

How many joints are in the hand?
Name the most common mismapping of the thumb. How can you identify this mismapping?
Why is it important to map the joints of the hand from the back rather than the palm?

Common Mismappings of The Hand

That the thumb only has two joints.
That the fingers only have three joints.
That the skin creases on the palm side always occur where the joints occur.
That the palm is solid or flat.

Image 3.32 : The Whole Arm

It’s important to let people know that they are not done with their remapping work until there is no trace or shadow or residue of the old map left. The image of the whole arm and then the reality of the whole arm and then the kinesthetic experience of the whole arm must be completely absorbed into the body map so that the person will never again move a part of an arm in relationship to a fictional shoulder, never again fix the shoulder blade or fail to let the shoulder blade move soon enough or far enough in activity. The new accurate, adequate map needs to have the same integrity and integration that the map of a person who has always mapped the area correctly has. Emphasize this to your students: “Don’t stop the mapping work until it’s done.”

Image 3.33 : The Whole Body

The best body awareness is that in which the entire body is in awareness, as a whole, not as a collection of parts. Awareness of the whole means perceiving the whole body as being articulated at joints and organized around the spine, with the head and the limbs in relationship to the spine and supported and coordinated by the spine.

Our arms as we play, sing, and conduct need to be integrated with the whole and supported by the whole. The support and coordination of the arms come from the spine.

View the following clip to see limbs in coordination with spine.

https://www.youtube.com/watch?v=_oEA18Y8gM0

Arms without the support and coordination of the spine are “arms in isolation” and will always compromise the work and the sound. This skeletal image offers an opportunity to work with your students on giving the arms the support and integration they need.

Singers and wind and brass players cannot support their arms with the lengthening of their spines except as the lengthening supports the breath, and that is what we see in the very free players. The arms piggyback the breath, taking advantage of the lengthening that is occurring for the benefit of the breath.

When the collarbones and shoulder blades are mismapped as part of the torso instead of part of the whole arm, they behave as emergency brakes, severely limiting the movement of the ribs, the lengthening spine and therefore the freedom of the breath.

All other players, those who don’t use air to make the sounds, are free to coordinate the arms directly with the lengthening. In general, string players often access the lengthening of the spine as the arms move into the extremes of their range of motion, but there is much variation.

Pianists who have that lengthening and gathering available to them use it when they need it and it becomes an important element in the interpretation. The spine is always available to support the arms and moves to wherever in space it needs to be to achieve this function. Ease and freedom of the arms integrate with the ease and freedom of the whole body. If the arms are in motion, there should be at least micromovement (tiny motion, or not locked) in the hip joints, knee joints and ankle joints. This is a good time to review the integration of the arms with a dynamically poised torso over the pelvis and legs, and freedom and ease in the A-O joint.

Questions

How does the spine support the arms?
What other structures support the arms?
How do the spine and the arms coordinate for movement?

Barbara Conable on Consulting Doctors

It is in this hour of the course that I always make my pitch for getting a medical evaluation in all cases
of pain. The first thing that should be done is to consult a medical professional because the diseases that cause pain in musicians often need to be treated yesterday. In all my years of teaching, only one occurrence of numbness in forearms turned out to be a brain tumor, but one is enough in a lifetime to justify ruling it out in every case. Likewise, anomaly. There is nothing you can do from a movement point of view to help someone with two tendons where there should be one.

Never assume a problem is use related even when the use is not good. You have someone’s life in your hands here. Be sure that disease and anomaly are ruled out even as you and your students commit to pursuing a remedy in movement. It can sometimes be very challenging to get to the right medical professional and to get the right diagnostic procedures. Nonetheless, it must be done.

Refer to Section 3 Supplement regarding more details on the consultation of medical professionals.

Common Mismappings of the Arms

Arm Joint #1

That the top of the arm starts at the glenohumeral joint. Related myth is that “the shoulders shouldn’t move” or “shoulders should stay down.”
That the top of the torso is square rather than beehive-shaped.
That the collarbone rests on the ribs.
That the shoulder blades belong on the back. Related myths are “Get your shoulders back” and “Stand up

straight.”

Arm Joint #2

That there is a fantasy socket at the side of the body completely unrelated to the shoulder blade which belongs on the back.
That the socket is big enough to enclose the ball like the gesture people make when demonstrating a ball and socket joint with one fist enclosed in the palm of the other hand.
That the joint is located at the rounded part at the top of the humerus.

Arm Joint #3

That the elbow is only a hinge joint, bending and unbending but not rotating from here. That the elbow is the meeting of one upper arm bone and one lower arm bone.
That both forearm bones participate in rotating the forearm to take the hand from palm-up to palm-down.
That the ulna is the rotating bone to take the hand from palm-up to palm-down.
That the skin crease on the thumb-side of the forearm is where elbow bending happens.

Arm Joint #4

That rotation happens at the wrist.
That the wrist is the two bumps at the end of the forearm bones.
That the wrist is flat.
That the wrist is a hinge joint.
That the wrist joint only exists where the skin creases are.

Hands

That the thumb only has two joints.
That the fingers only have three joints.
That the skin creases on the palm side always occur where the joints occur.
That the palm is solid or flat.