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- Welcome, my friends, to the "Bob and Brad" podcast.
My name is Mike Kenitz and I'm a PT assistant.
Today, I'm interviewing Rick Olderman,
who is a physical therapist.
And I'm gonna ask him
different shoulder and arm pain questions
that you, our audience, had for him,
things like rotator cuff or forearm injuries,
even upper trap issues.
So without further ado, here is Rick.
Last question, this is about forearm pain.
So, "I have awful pain in my right forearm
on top from the joint down to my wrist."
I'm guessing they mean elbow joint. They didn't specify.
"It's not muscle pain.
When I grasp anything, it's painful.
When I try to lift anything, it's excruciating.
Even when I go move my arm at night,
when I'm turning over in bed, it's painful.
Any idea what could be wrong with my arm?"
- Yeah, so this is a great question.
So in the forearm, we have deep rotators,
pronator teres and a pronator quadratus,
and then we have a supinator muscle too.
And what these muscles do is they control the hand moving,
you know, palm down to palm up.
And so what I have found is that,
and you'll notice that when this hand is moving,
say, to palm down,
you see how this bone is rotating at the elbow joint,
and then when I go palm up, it rotates like that.
So this radius is rotating kind of over the ulna.
And this is where the problem occurs
for most people with elbow pain
is that the rotation,
there's a ligament that's holding that radius in place.
Is it the conoid ligament?
Excuse me, I can't remember the exact name of the ligament,
if it's not the conoid.
- Radial annular ligament.
- That may be it, that may be it.
The annular ligament, that's what it is.
- Otherwise, ulnar collateral ligament or those-
- No, I'm pretty sure it's the annular ligament.
But anyway, if that ligament is damaged for any reason,
then the radial head is not tracking correctly,
so that would be one thing to determine if that's happening.
The second thing is, I mentioned this
is because these rotator muscles often become tight
especially if we do a lot of palms down work.
What happens is these, this is called pronation,
the pronator muscles then become excessively tight.
And what happens is they don't do well to unlock again
to allow supination.
So I have found that stretching the pronator muscles
into supination often solves a lot
of tennis elbow, golfer's elbow,
and other types of strange elbow and forearm pain
because now the whole system can move more
how it's designed to move, okay?
Now if we go up the chain a little bit,
let's say, what if the arm bone
is rotated in too much already?
And that's setting the elbow up to fail.
Well, why would the arm bone be rotated in too much?
Perhaps a tight chest muscle,
tight latissimus dorsi muscle that attaches from behind.
Both of those are big, powerful internal rotators.
And so those being stretched out
would allow more freedom in the upper arm bone
to then rotate more freely
which then establishes a better environment
for the elbow bones to work more freely.
So those would be things I would look at.
So the other thing is a lot of people work with a mouse.
And what I have found is if that mouse is further away
or out to the side from you,
then you're activating these upper forearm bones
and your neck muscles,
and your shoulder muscles to control that mouse.
So if you work with a mouse, try this little experiment.
bring the mouse into your body
and actually scoot your keyboard over a little bit
to put the mouse more in the center
so you're not reaching forward at all
and your arm is completely relaxed while you're using it.
I once saw the guy's 20 years of neck pain
by simply moving his mouse closer to his body
and his neck was no longer holding his arm up
to do this mouse work.
Gone in like a couple days.
And this is how the body reacts
when you find the right solution.
The body reacts very rapidly. It heals very, very quickly.
Then the last thing I would say
is, ergonomically, a lot of chairs at work
don't fit our bodies.
The elbow, when we're working,
the elbow should be at the seam of our shirt on the side.
And it should be supported so it's resting,
perhaps maybe 1/4 to 1/2 higher
than what we think it should be.
And where my hand is right now
is where my keyboard or mouse should be.
If my keyboard is not here or my mouse is not here,
then I've gotta make changes to my ergonomics setup
so that they are here.
'Cause the moment I start to move my arm forward,
I've lost all the support of the arm of my chair
and I'm now using forearm extensors, shoulder muscles,
neck muscles to hold this whole system up.
What's the best way?
Most chairs, even the best ergonomic chairs,
can't be situated correctly for everyone.
So what I ask a lot of people to do
is bring pillows in from home, fold them in half,
and stuff 'em between your body and the arm of the chair.
Now you've got a big broad surface to rest your elbow on
and it usually is a little bit higher
than the arm of your chair already.
And a lot of people aren't even using arms on their chairs.
Well, first of all, get an arm on your chair
and then stuff that pillow in there and start using it
'cause that could be the stressor
that's stressing this whole system for you.
- All right, well, thank you for joining us again.
Where can people find more information about you at?
- If they go to rickolderman.com,
I have lots of free stuff there,
I have some blogs, I have all my home programs,
my practitioner training program,
and there's a contact form there, of course, for me
that you can use to reach out, if you like.
- Okay, perfect. Well, thank you for joining us.
- My pleasure, Mike. Thanks for having me.
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