- Hey guys, today we're talking about tennis elbow.
Now, if you've ever had tennis elbow,
you will know exactly how painful it is
and how much it affects your day to day life.
Simple things such as picking up a kettle,
filling it with water and trying to pour it
will cause you pain.
Even picking up something small
and something relatively insignificant like a coffee cup
will cause you pain.
Or if you go to the gym,
it will stop you doing things like lateral raises
where you've got the dumbbell and you're taking it outwards
to try to strengthen your shoulders
that will cause you pain in the forearm.
Now tennis elbow is also known as lateral epicondylitis.
And that's just the medical term,
it just denotes where the pain is
and what's structures are involved
and what's causing the pain.
But we're only gonna talk about it as tennis elbow today.
You may have also heard of golfer's elbow.
That just affects the inside of the elbow here,
but we're only focusing on tennis elbow today.
In today's video,
I'm gonna show you some stretches and some exercises.
But before we do that, I'm just gonna explain
a little bit about what tennis elbow is,
so you understand the problem,
and then you are better equipped to deal with it yourself.
So tennis elbow is a condition that affects the tendons
where they attach in the elbow here.
It's caused by a lot of repetitive movements,
or a lot of strain going through the tendons.
For example, repetitive movements
such as mouse work on a keyboard,
or if you've gone to the gym
and you've been lifting weights,
but you've increased the weights too much too soon,
and it's put a lot of tension through the muscles
and has been pulling on the tendons.
I've had tennis elbow before
on both elbows at the same time.
And this was from massage work
where I was doing a lot of cross directional work
and it's putting a lot of strain
going through the attachment points here.
So any repetitive movement,
anything that causes some sort of irritation to the tendon
is gonna causing inflammation.
And that inflammation is then gonna cause pain,
and it's gonna progressively snowball
and get worse and worse
to the point where you can't really lift things up
as easily.
So tennis elbow, if you look at an arm,
so this is a model of an arm.
So this is a right arm.
So if I was standing up,
you've got your two forearm bones down here,
and then you've got your upper arm bone here.
So on the outside, so on the outside of my elbow here,
is this point just here.
Now you can probably see there's a few red marks.
So these are the attachment points of the tendons.
So the attachment points start here
and then the muscles come down and go into the wrist.
And what these muscles do is they cause wrist extension.
So as I'm doing this with my wrist,
you can probably see
movement going through the forearm here.
So these muscles are coming up and attaching up here.
Now tennis elbow will follow three phases,
much like any other condition.
So the first phase
is where the pain is gonna be quite a lot.
It's gonna be inflamed
and it's gonna be very painful to do most things.
This is not really the phase
where you want to be stretching and strengthening.
What you do want to be doing though,
is trying to get that pain down.
And the best way to do that is gentle massage in the forearm
and around the painful area.
So all you're going to do,
get a little bit oil, a little bit of cream
and work into the muscles of your forearm.
Just gentle massage,
just trying to get blood moving through the muscles.
Use your thumb if you want to,
and find tight and tender points.
When you find those tight and tender points,
just press into the muscle and hold.
So we're not really working the painful area
which is around here.
What we're trying to do
is get the tension through the forearm muscles decreased.
As you decrease the tension in the forearm muscles,
that's gonna take the tension away from the bone.
What you can also do
is gently massage the painful area itself,
that's just gonna help to get circulation,
blood circulating through the problem area
and help to take away some of that inflammation.
Over time, that's gonna help to reduce the pain.
And then you can progress on to the stretching,
which is phase two.
So phase two is where the pain
has generally become a lot less,
maybe it's around three or four out of 10 now.
The muscles will have tightened up
and this is mainly
because you probably haven't been using the muscles as much.
So this is the phase where you want to start stretching.
And then after that, we're gonna go into the phase three,
which is the strengthening.
So you've done your phase two,
increase the flexibility through the muscles.
Hopefully, that's gonna have taken the tension
away from the attachment points.
And then we wanna start strengthening.
And it's the strengthening
that's gonna help to rebuild the tendons
and that's gonna take it from
this kind of muddled up, jumbled up sort of knotted
structure.
And as you start to strengthen,
it encourages those tendons to reform
back into their normal alignment.
So what we're gonna do now
is I'm gonna show you the stretches that you can do at home.
So to stretch your forearm here,
what you're gonna do is find a surface
that's around thigh height.
So with your affected side, turn your hand upside down,
so the top of your hand is facing towards the surface.
Get your arm straight,
and then gradually, just gently just push your wrist
down to flatten it against the surface.
Now that is probably gonna cause you some discomfort.
If you want to increase that stretch,
then you do the same thing to start,
but instead of having your fingers pointing towards you,
you're gonna now turn your fingers
so they're pointing outwards.
So, hand down, turn your fingers outwards as much as you can
and straighten your elbow.
And then from here, just gently push your wrist
down towards the desk or surface or bed
or whatever it is you're stretching against.
And just go into with the point
where it's about a three or four out of pain and hold.
So you don't wanna be,
you don't wanna be creating too much pain
because too much pain is just gonna make things worse.
So this should be bearable.
If you want you can bend your elbow like so
and then straighten it out to increase that stretch.
So you can bend and straighten.
So in addition to stretching the muscles,
it's also a really good thing to use one of these.
This is a lacrosse ball.
Any massage ball would be fine.
Personally, I prefer the smooth ones over the spiky ones.
And I like lacrosse balls because they are rubbery,
so they grip the skin and they grip the surface really well,
so they're not gonna keep slipping out.
But what you're gonna do with this
is use the ball to try and break down those tight muscles.
So get the ball on the table.
And I would put my other hand on top of my forearm
just to create some pressure downwards.
And what you're gonna do is move your arm around
over the top of that ball until you can find a tender point.
So let's say I've got one here,
and I'm gonna press in and hold, and I hold for 30 seconds.
And then after 30 seconds,
then I can move to another point in my arm,
and then find a tender point and hold.
Now you will see a lot of people recommending exercises,
or using the ball like this,
where they roll it up and down on the muscles,
or they do cross fiber like this,
and they're just rolling up and down.
Personally, I don't think that a great idea
because every time you do that,
one, you're stimulating pain,
so every time you move the ball,
you're stimulating those pain receptors.
And two,
it's gonna cause more inflammation.
So I like to just press and hold,
and just let that pain go down
because eventually the pain receptors will start to ignore
the amount of pain going through that muscle
and it will help to relax the muscle
without stimulating more inflammation and more pain.
So find those tender points, press and hold,
and then move somewhere else.
You can do this up against a wall, if you find that easier.
I know it's not a great angle,
but something like this where you just press into a wall
and move it around like so.
It's the same principle, but just a different angle.
If you don't have a ball,
you can use something simple as a rolling pin.
Doesn't matter what it is, as long as it's hard,
and it will get into those muscles
and allow those muscles to compress.
And that eventually will allow the muscle to relax.
Now when it comes to using the ball,
or using the rolling pin
and you're trying to break down these muscles,
I would suggest you do this
every other day or every two days.
This will make you quite sore.
So if you're doing this every day,
your muscles are not gonna have a chance to recover.
So all you gonna end up doing if you do this too much
is you're gonna make yourself more and more sore.
You could do this up to about five minutes
where you're rolling and pressing,
move to another point rolling press rolling and press,
you don't wanna be doing it for too long
because again, that's gonna make you quite sore.
So little amount is actually probably better
than overdoing it.
Okay guys, so now we're gonna go into the phase three,
which is the strengthening phase.
This can take up to a few months to get to this point,
so don't rush it.
Once you've gone through phase one
of getting that pain down.
Then you've gone through phase two
of trying to reestablish
some of that flexibility in the muscles,
only then do you go into phase three,
which is the strengthening.
So to start off with,
I like to introduce towels to my patients.
And what we do with the towels is a couple of things.
First of all, we can start to roll the towels up,
so with a towel like so,
you're gonna bring that towel into this position,
and then reset, bring it up,
and you're just trying to roll the towel up,
take your time very, very slow,
and then just regroup
and then bring it up.
As the towel starts to roll up
and it becomes thicker and thicker,
that changes the grip,
and that will put different stresses through those tendons
and it will work those muscles slightly differently.
Then from there, what I also like to do,
is to roll the towel up slightly
and then you can start to introduce basic movements.
So here I've got the towel slightly rolled up,
I'm gripping it,
you can bring your elbow in, and then you can curl it up,
pause,
and then down slow.
If it's too painful,
then you can assist yourself on the way up
with the other hand,
and lower the towel down really slow.
Over time, you can then roll the towel up more,
so your grip is a lot wider,
so it puts a different strain on those tendons.
So grip the towel and do the same thing,
lift it up if you need to, and slowly down.
You can change the angle of your hand as well.
So you could have this kind of upright position here.
Or you can turn it so your palm is facing down.
Both are very good
and both will work those muscles slightly differently.
So I encourage you to do both.
What I would say is do about five to 10 reps maximum,
and only start with one set.
Over time, so maybe you've done this on a Monday,
give Tuesday off and then on Wednesday, you can return.
If you're no worse than you were on Monday,
then you could add in a few more reps
only to a maximum of 10.
Or you can add in a second set or a third set.
Once you've done this with a towel for a while,
then you can start introducing weights.
So here I've got a dumbbell.
You don't have to use dumbbell,
you can use household objects
and I'll show you how in a second.
But the same thing applies, you grip the dumbbell.
You can start with this thumbs up position.
Slowly lower the weight.
When you get to the bottom,
then you can assist yourself back up
and slowly lower the weight.
What you must avoid doing is fast movements like this
because that's just gonna irritate the tendons.
So keep it slow and keep it steady.
So you've got this thumbs up position.
And you can also add in this palm down position.
Again, really slow on the way down.
Pause at the bottom, assist it back up, and repeat.
As you start to get stronger and stronger,
you can then start to come up unassisted.
So you can come down slow, get to the bottom,
and then come up really slow.
Now quite often, you may see
people doing this,
which is fine,
but in my opinion it's often done too fast.
And it puts too much repetition
through those tendons and through those muscles.
You can do them but if you aren't gonna do them
just keep it really slow and only do a maximum of 10.
Now if you want to use a household object,
you could start to do things like a kettle for example.
And a kettle is great,
because you can control how much weight goes through it.
So here I've got empty kettle.
So you could start off doing exactly the same movements
as you've just done.
Start at the top and lower it slowly down.
And over time, you can increase the amount of weight
by putting water in there.
And if you want, you can then start to replicate
other movements as well.
So if you want to replicate pouring,
you could just turn it to the side
and start adding a bit of rotation through your wrists.
Start off with minimal amount of weight.
And just do this really slow,
pause,
and then come back.
Really slow, pause,
and then come back.
And again, just start off with 10 repetitions as a maximum,
just one set.
And then over time, you could add in a second set
and then a third set.
Once you've done these exercises,
give it a day rest in between,
and then do it the following day.
If you're doing this too much or too often
or if you're doing it more than once a day,
the chances are it will actually delay your recovery.
So only do it a maximum of once a day.
Keep it really slow, keep the quality really good.
And then just do it a few times per week.
Be patient guys, it's gonna take time.
So anyway, I hope that's given you some ideas
of what you can do at home.
You've got the massage ball
to try and break down those muscles in phase two
so that stretching phase, you've got the stretches,
and you've got the massage ball.
That could take a couple of months,
two, three, four months at most.
Once the pain starts to go down
and you feel like you can go through those ranges of motion,
then you start to go into phase three,
which is the strengthening phase.
Take your time build it up slow,
10 reps maximum, few times a week.
I hope that video has helped you.
Please let me know if it does,
let me know in the comment section below
what exercise you find the most helpful.
And if I've missed anything let me know,
let me know in the comment section below
because I love to hear your experiences
and what works for you.
So guys, I hope that helps
and I will see you in the next video.
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