Massage For Tennis Elbow

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Misty L. Trepke

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Good Morning!

 

Massage Techniques for Lateral Epicondylitis

 

The proper medical term for tennis elbow is lateral epicondylitis.

The lateral epicondyle is the distal outer boney protuberance of the

upper arm bone called the humerus. The wrist extensor muscles insert

into the lateral epicondyle and this is the area which gets inflamed

when one has tennis elbow. The forearm muscle most commonly affected

is the extensor carpi radialus brevis. Most simply put, tennis elbow

is a strain of the lateral forearm muscles and tendons.

 

Lateral epicondylitis (tennis elbow) is a repetitive overuse injury

of proximal forearm muscles in the body. Repetitive overuse injuries

occur from prolonged loads on muscles and tendons. Excessive use of

a hammer is just one example of an activity which can lead to tennis

elbow. Tennis elbow can also emerge from faulty body mechanics while

sitting at a computer with a keyboard that is positioned too high

for the elbow and wrist. Proper posture is an important element to

prevent tennis elbow. While sitting at a computer, one should keep a

90 angle at the elbows, knees and hips to minimize the chance of

overloading the forearm muscles. Playing tennis with poor techniques

can also result in tennis elbow, the origin of the generic injury

name.

 

Excessive activity that overloads the wrist extensor (outer forearm)

muscles may bring on an annoying burning sensation along the outer

part of the elbow that just doesn't want to quit. In mild cases of

injury, the irritated muscle will respond to the basic procedures of

rest and ice. However, a severely aggravated muscle will most likely

require a trip to your medical doctor. Anti-inflammatory medications

and physical therapy are often prescribed by doctors.

After a physical therapy evaluation for tennis elbow, a physical

therapist will teach home exercise programs for stretching and

strengthening the forearm. A physical therapist might use special

modality equipment such as electrical stimulation, ice packs, or

ultrasound to help reduce pain and enhance the healing process. Many

treatment techniques are employed to resolve the pain and

dysfunction of tennis elbow. Friction massage treatment effectively

strengthens the musculotendon junction.

 

A strong tendon insertion from the muscle into the bone will

increase one's tolerance for excessive force on the forearm

musculotendon region. Faulty elbow joint mechanics are corrected by

the therapist with specific joint mobilization techniques. Sport-

specific training may rectify improper backhand swing techniques one

uses during tennis. Neoprene elbow supports with special pressure

pads are sometimes used to provide compression and can help one

manage daily life activities and work with less pain. For complete

recovery, physical therapy treatment may also include the correction

of movement system imbalances of the body.

 

One should realize that other regions in the body especially the

neck, upper back, and shoulder can be a contributing cause of

lateral elbow pain. The pain sometimes isn't from the lateral elbow

muscle or tendon at all. The lateral elbow pain might be from a disc

problem in the neck, shoulder impingement, or entrapped distal

peripheral nerves of the upper extremity. One should also not

confuse the pain along the inner medial elbow/forearm region, that

is often medial epicondylitis (a.k.a. golfer's elbow), with the

lateral elbow/forearm pain of tennis elbow. Trauma, such as falls,

may result in elbow fractures and can give rise to lateral elbow

pain as well. So, although this injury appears generally straight

forward, it is always best to seek a medical professional for proper

evaluation and treatment. Reach out and be pain free of tennis elbow.

 

Massage Techniques for Lateral Epicondylitis

 

Massage has two goals. The first applied directly to the tendon

attachment itself will help reduce adhesions between the tendon and

the tendon sheath and assist healing by stimulating the bodies

natural healing mechanisms.

 

The second benefit is by applying massage to the surrounding muscles

to improve the condition and flexibility of the muscles themselves

and so taking some of the strain off the tendon.

 

Massage must not be performed during the acute stage of this injury -

 

usually 48 hours after injury. For grade two and three strains,

massage may not be suitable for over a week.

 

Cross frictions to the tendon

 

If the injury is recent or it is the first time the athlete has

suffered from tennis elbow then it may be wise to avoid massage to

the tendon attachment itself. In more chronic cases where

conservative treatment has not produced the desired results then

friction massage may help.

 

Goal - to gradually apply firmer frictions to reduce adhesions and

assist healing. With a finger, apply frictions backwards and

forwards across the tendon when it is in a stretched position. Start

gently and slightly away from the tendon attachment, gradually

working towards the attachment and getting deeper as the athlete

becomes accustomed to massage. Apply frictions to the tendon for 5

to 10 minutes. Ice may be applied before and after to ease pain and

reduce inflammation.

 

Stripping the muscle and Circular frictions

 

Goal - to apply sustained pressure to the muscle, smoothing out any

lumps, bumps and knots.

 

With the thumb of the left hand (for the left arm), apply deep

sustained pressure along the full length of the muscle. This

technique should be slow and deliberate to 'feel' the muscle

underneath. Repeat this 3 to 5 times in a row, alternating with

petrissage for 5 to 10 minutes.

 

 

If the therapist comes across any tight, tender knots in the muscle

(usually at the point of strain or rupture), these can be worked out

with deep circular frictions to the sore spot.

Massage should be deep but not so deep that the client ends up with

pain.

 

 

Trigger points

 

A trigger point is a highly sensitive localized point in the muscle.

If the therapist finds any lumps and bumps or particularly sensitive

spots then apply deep, sustained pressure to these points using the

thumbs. Increase the pressure on the spot until it ranks 7/10 on the

pain scale (10 being painful). Hold this pressure until it eases off

to 4/10 on the pain scale (usually about 5 seconds). Without easing

off with the pressure, increase again until it reaches 7/10 on the

pain scale once more. Hold until it eases, repeat once more.

This technique is very hard on the thumbs. It is important to keep

the thumb slightly bent (flexed) when applying pressure to avoid

damaging the joints.

 

 

Ending Technique

 

The therapist can finish off with more petrissage techniques and

then finally effleurage again. The whole process should not last

more than half an hour. Massage therapy can be applied every day if

it is performed lightly however deeper techniques may result in a

days recovery period to allow tissues to 'recover'. For

rehabilitation of muscle strains, massage is very important in

softening / preventing scar tissue forming at the site of injury and

re-aligning the new healing fibres in the direction of the muscle

fibres. This will help prevent re-injury.

 

 

Andrew Pacholyk, MS, L.Ac.

Peacefulmind.com

Therapies for healing

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