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MuscleForearm & handsuperficialBeyond Cert IVDraft

Palmaris longusMusculus palmaris longus

Small, slender forearm muscle with a long tendon that tightens the fascia of the palm and weakly bends the wrist; missing in some people.

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LatinMusculus palmaris longus
Origin
  • Medial epicondyle of the humerus (common flexor tendon)
Insertion
  • Central part of the flexor retinaculum
  • Palmar aponeurosis (the tough fascia of the palm)
Action
  • Weakly flexes the wrist
  • Tenses the palmar aponeurosis
  • May assist thumb abduction
NerveMedian nerve (C7–C8)
GroupWrist flexors
NameLatin palma, 'palm', and longus, 'long' — the long muscle of the palm.

Palpation

  1. Client seated or supine with the forearm palm up.
  2. Ask the client to touch the pad of the thumb to the pad of the little finger and bend the wrist slightly.
  3. Look and feel for a thin, taut tendon in the midline of the front of the wrist.
  4. Follow it up the forearm; the short belly blends into the flexor mass towards the medial epicondyle.
  5. If no tendon appears, the muscle may be absent. This is a normal variation.

Landmarks: Medial epicondyle of humerus

Palmaris longus is the middle tendon of the three you can usually see at the front of the wrist, between Flexor carpi radialis and the finger flexor tendons. It is missing on one or both sides in roughly 10–20% of people (Wikipedia). Its absence does not reduce grip strength, so do not be alarmed if you cannot find it.

The median nerve lies just under its tendon at the wrist. Keep pressure light in the middle of the front of the wrist, and work the belly in the upper forearm instead. It is part of the Wrist flexors and starts from the Medial epicondyle of humerus.

Sources disagree on root levels: Kenhub gives C7–C8, while Gray’s (1918) says the supply comes “primarily from the sixth cervical nerve”. This note uses C7–C8.

Techniques

  • Petrissage — Kneading strokes that compress, lift and squeeze the muscle away from the bone, working the tissue between the hands.
  • Stripping — A slow, deep, narrow glide along the length of a single muscle with the thumb, knuckle or elbow, pausing over tight bands on the way.
  • Circular friction — Small circles made with the finger or thumb pads that move the skin over the deeper tissue without sliding, to work a specific spot.
  • Passive stretching — The therapist gently moves a relaxed limb to lengthen a muscle to a point of mild stretch and holds it there, with no effort from the client.

Works with

  • Flexor carpi radialis — Superficial forearm muscle that runs from the medial epicondyle to the index and middle finger metacarpals, bending the wrist and tilting it towards the thumb.
  • Flexor carpi ulnaris — Superficial muscle along the inner (little-finger) border of the forearm that bends the wrist and tilts it towards the little finger.

Opposes

  • Extensor carpi radialis longus — Outer forearm muscle running from above the lateral epicondyle to the index finger metacarpal, extending the wrist and tilting it towards the thumb.
  • Extensor carpi radialis brevis — Wrist extensor lying just under its longer partner, running from the lateral epicondyle to the middle finger metacarpal and lifting the back of the hand.
  • Extensor carpi ulnaris — Long muscle on the back of the forearm next to the ulna that extends the wrist and tilts it towards the little finger.

Same group

  • Flexor carpi radialis — Superficial forearm muscle that runs from the medial epicondyle to the index and middle finger metacarpals, bending the wrist and tilting it towards the thumb.
  • Flexor carpi ulnaris — Superficial muscle along the inner (little-finger) border of the forearm that bends the wrist and tilts it towards the little finger.
  • Flexor digitorum profundus — Deep forearm muscle lying on the ulna that bends the fingertips and is the only muscle able to flex the end joints of the four fingers.
  • Flexor digitorum superficialis — Large middle-layer forearm muscle that bends the four fingers at their middle joints and helps bend the knuckles and wrist.

Sources

  1. Wikipedia: Palmaris longus muscle
  2. Kenhub: Palmaris longus muscle (Used for nerve root levels (C7–C8), which the Wikipedia article does not give.)
  3. Gray's Anatomy of the Human Body (1918), Myology 7e: The Muscles and Fasciae of the Forearm (Public domain. Gives the sixth cervical nerve as the main root.)