What is tennis elbow? Lateral epicondylitis is the medical term for tennis elbow. Tendons (thick structures that attach muscle to bone) attached to the lateral epicondyle (a bone on the outside of your elbow- next to the elbow bone) develop microtears and inflammation often from overuse of the forearm muscles. These are the forearm muscles that assist in extending the wrist (bending your wrist backward from the palm). They develop pain and swelling often due to overuse.
Tightness which can increase the stress on those muscles is:
1. A lack of internal rotation of the shoulder. For example, with a backhand tennis swing, if you lack internal rotation of the shoulder, you will place additional stress on the forearm muscles. This motion must occur somewhere and if the shoulder cannot provide it, the forearm takes the additional stress.
(Shoulder Internal Rotation)
2. A lack of pronation and or supination at the forearm. With your elbows at your side and your forearms level if you turn your palm facing up - that is supination. Palm facing down is pronation. You should be able to get the wrists in a horizontal position (use a ruler). Again, the motion must occur somewhere and if your forearms cannot rotate the muscles will take the brunt.
First, we will have you massage the muscles and tendons. Then we will show you stretches to decrease the likelihood of pain reoccurring.
A. Cross-fiber friction massage to the lateral epicondyle tendon. Use two fingertips side by side or one atop of another. The forearm should be supported by a table or pillow. Find the tender spot over the tendon and massage across the fibers deeply and vigorously. Try 30 to 60 seconds and if too tender try exercise B instead.
B. Place continuous pressure on the tendon with your fingertips or thumb and simultaneously extend the wrist 10x. It is ok to experience some pain, but the pain should not continue after you are done. If it does perform the massage under C and return to this massage in the future. If it feels ok, continue 4x per day (10 reps).
C. Massage the muscles of the forearm avoiding the tender spots.
D. Use of massage gun for cross-fiber massage and forearm massage.
Stretches to restore shoulder internal rotation and forearm pronation/supination.
WARNING: Do not perform these if you have brittle bones (osteoporosis) or shoulders that tend to be loose joints or dislocate.
Shoulder Internal Rotation:
A. Using a belt or stretch strap, place a loop around the wrist of the painful arm. Put the painful arm behind your back and drape the other end of the belt over your opposite shoulder and grab it with the opposite hand. The opposite hand should pull on the belt and slide the painful arm up the back. Do not increase the pain but just bump into it. Repeat 10x. Do throughout the day 4-6x.
B. Using a Booyah stick, place the painful arm behind your back palm facing out. Place the stick behind your back with your opposite arm palm facing forward. Use the opposite arm to slide the painful arm hand up the back. As pain allows - bump into pain. (10 repetitions) If acceptable may also add in some extension by pulling the opposite arm forward. Maintain good body posture while doing this. Again, should be virtually pain-free - if not stop. Repeat 10x if pain-free, 4-6x per day.
A. Bend your painful forearm to your chest. Use your opposite hand to stretch the forearm into pronation and then supination. (10x)
B. Standing position. Place your painful arm hand flat on a table with the fingers facing toward you and the wrist bent and stretching. Take the opposite hand and place the web between your thumb and first finger just below the inner bump by your elbow. Using the web push the forearm out to the side 10x all the while keeping the elbow as straight as possible. Both exercises can be done 4-6x per day.
This video is part of a series of videos on how to treat your pain with self-massage. Check the full series of videos along with the downloadable guide sheets for each video on our website here: https://www.bobandbrad.com/massage/
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