Issue link: https://www.massageandbodyworkdigital.com/i/621015
C h e c k o u t A B M P 's l a t e s t n e w s a n d b l o g p o s t s . Av a i l a b l e a t w w w. a b m p . c o m . 103 middle finger extension and with gripping activities. I've had success treating this tendinopathy using crossfiber frictioning and eccentric strengthening exercises. However, I've had better results when the treatment included articular stretching routines to help calm hyperexcited mechanoreceptors, reduce protective muscle guarding, and remove tension on strained fibers and compressed nerve tunnels. Try incorporating the myoskeletal articular stretching techniques for elbow supination, pronation, and extension shown in Images 3, 4, and 5 prior to assessing and treating soft-tissue lesions. If your state laws allow home retraining advice, teach the radial nerve mobilization stretch shown in Image 6. You may find that many chronic elbow and forearm problems soon disappear as full mobility is restored to motion-restricted joints and associated soft tissues. Notes 1. E. B. Kaplan, "Treatment of Tennis Elbow by Denervation," Journal of Bone and Joint Surgery: American Volume 41, no. A(1) (January 1959): 147–51. 2. J. H. Abbott, C. E. Patla, and R. H. Jensen, "The Initial Effects of an Elbow Mobilization with Movement Technique on Grip Strength in Subjects with Lateral Epicondylalgia," Manual Therapy 6, no. 3 (August 2001): 163–69. 3. V. Arumugam, S. Selvam, and J. C. MacDermid, "Radial Nerve Mobilization Reduces Lateral Elbow Pain and Provides Short-Term Relief in Computer Users," Open Orthopaedics Journal 8 (October 2014): 368–71. Erik Dalton is the executive director of the Freedom from Pain Institute. Educated in massage, osteopathy, and Rolfing, Dalton has maintained a practice in Oklahoma City, Oklahoma, for more than three decades. For more information, visit www.erikdalton.com. 3 4 5 6 With the elbow pinned to the client's side, the forearm is rotated to the first supination barrier. The client gently pronates the arm against resistance to a count of five and relaxes. I supinate to the next restrictive barrier and repeat until full supination is reached. The forearm is rotated to the first pronation barrier and the client gently supinates against resistance to a count of five and relaxes. I rotate to the next restrictive barrier and repeat until full pronation is achieved. The client's elbow is extended to the first restrictive barrier. The client gently flexes the biceps to a count of five and relaxes, and I bring her elbow to the first extension restriction barrier. Repeat until full elbow extension is achieved. The client extends the elbow and curls the fingers around the thumb. She internally rotates the arm, retracts the scapula, and left sidebends her head. To enhance the nerve flossing stretch, she slowly abducts her arm and reaches toward the floor. Repeat daily. Adapted from Dreamstime.