Palpation Master Lab

Palpation is an assessment skill, not magic fingers. Use anatomy, position and movement to test whether the structure under your hand is the one you think it is.

The 6-step palpation method

Orient: place the client safely and expose only the region needed.
Find bone first: reliable bony landmarks create your map.
Predict: state where the target should lie relative to those landmarks.
Ask for a gentle action: contract or move the target when appropriate.
Confirm: feel whether the tissue changes in the expected place/direction.
Relax and reassess: distinguish the muscle from tendon, bone and neighboring structures.

High-yield landmarks

Landmark	What it helps you find	Caution
Spine of scapula / acromion	Trapezius, deltoid, supraspinatus/infraspinatus regions	Do not confuse bone with “tight tissue.”
Medial scapular border	Rhomboid region, serratus relationship, scapular motion	Do not force beneath scapula.
Inferior angle scapula	Scapular orientation; latissimus/teres relationships	Position changes scapular location.
ASIS	Sartorius, TFL region, pelvic orientation	Communicate before palpating near anterior hip.
Greater trochanter	Gluteal and deep lateral-rotator region	Direct bone pressure may be uncomfortable.
Ischial tuberosity	Proximal hamstrings	Sensitive region. Draping and consent matter.
Patella / tibial tuberosity	Quadriceps tendon/patellar ligament and knee orientation	Do not aggressively compress symptomatic knee structures.
Fibular head	Biceps femoris insertion; lateral leg orientation	Common fibular nerve is vulnerable nearby.
Medial/lateral malleoli	Ankle tendon orientation	Tarsal-tunnel structures lie posterior to medial malleolus.

Confirmation examples

Deltoid: locate acromion, then ask for gentle shoulder abduction. Biceps: elbow flexion plus supination helps distinguish it from brachialis. SCM: gentle contralateral head rotation makes the ipsilateral SCM easier to identify, but avoid indiscriminate anterior-neck pressure. Tibialis anterior: dorsiflexion with inversion confirms the muscle lateral to the tibial crest. Fibularis longus/brevis: eversion helps identify the lateral compartment. Hamstrings: gentle knee flexion can clarify posterior-thigh tendons while you protect the popliteal fossa.

Texture and tenderness

Palpation can describe qualities such as temperature, tissue resistance, tenderness, swelling or movement. Those observations do not automatically establish a medical diagnosis, “adhesion,” toxin accumulation, nerve entrapment or structural lesion. Document what you actually observed and what the client reported.

Practical test

For each assigned muscle, the student should identify a bony landmark, locate the target, demonstrate one confirming action, name its major action and innervation, and identify the closest relevant endangerment site.