♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- Hi folks I'm Bob Schrupp, Physical Therapist.
- Brad Heineck, Physical Therapist.
- Together we are the most famous physical therapists
on the internet.
- In our own opinion, of course, Bob.
- Not only our opinion but only our opinion. (laughs)
I was just going to say that.
- Yeah, I think that's the way it is.
- Five best tennis elbow treatments to stop pain.
That's what we're gonna talk about today.
- Yep.
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(Bob laughs) Bob, why Bob?
- Why Bob?
All right.
Brad, you're gonna take the control of the reins here.
- [Brad] By the hand, by the shoulder.
- Yeah.
- We're going to talk about the tennis elbow.
First we should talk a little bit about the anatomy,
where the tissues are that are irritated, causing the pain.
- 'Cause this will help you treat it.
By understanding the anatomy.
- Right, right, and I'm wearing some things
on my elbows, too.
We're gonna explain those in a little bit,
but if you look at Sam,
the muscle groups that are on the backside of the elbow
to the wrist, and they make your wrist extend, okay?
So if you look, I've got a piece of Kinesio tape
that flexes with it, so it hopefully gives you some idea.
The black lines represent the fibers of the muscles.
And that's important for two of the treatments
that we're going to do with it.
But right up here is where you get that tennis elbow,
and it's where these muscles that connect to the wrist
connect to the bone here.
- [Bob] They're attached at that point, right.
- And that's the point where you get
these microtears and it becomes very painful.
And a lotta times, you just touch that or tap it like that,
it's very, very painful.
It's just irritating, something you wanna get rid of.
- [Bob] I thought you were gonna do your,
you say bad things when that happens.
- Well, Bob. (Bob laughs)
I'm trying to get away from that.
But yeah, I have said bad things,
so there's just a number of things
that can stress those muscles.
From bending your elbow to extending the wrist--
- [Bob] If you're extending the wrist a lot
and that's why it's called golfer's elbow.
Or tennis elbow. - Tennis elbow.
- [Bob] Yeah, golfer's elbow the other side.
- Yeah.
- [Bob] 'Cause you're gripping so much --
- Right. - With tennis elbow.
- Yeah, but you could get it without playing tennis.
As a matter of fact, most people do I think.
- [Bob] Right.
- At least, most of my patients.
- I had it in both arms and I don't play any tennis.
- You do a lot of using the hand-tools.
- Oh, right.
- And trimming. - Right.
- And that would all bring it on.
- You bet. - So, the first thing,
if you got that pain, I'm gonna move this down,
so they can show it.
You'll feel it right on that bone.
And oftentimes, let's say you've had a hard day.
You've worked it, you've irritated it, it's very sore.
The first thing you wanna do is get a cold pack on it,
at a point where you can sit down and rest and relax.
And that's what I have this on for.
There's a couple ways to use a cold pack.
You can use a gel cold pack like this.
Don't put it directly on your skin.
That's why I have a thin towel over it.
And I got a Velcro strap I actually use for ankle weights.
But you can hold it with your hand
or, if you can strap it on, it works better.
Leave it on for 20 minutes
and relax and just let that hand and arm settle down.
- That helps knock the pain down.
- Right. - Quite significantly.
- If you wanna get more direct, you can take a cup like this
and fill it up almost to the top with water,
put it in your freezer overnight let it freeze solid.
And then, you can see I tore, these don't have water in them
but you'll understand it.
You tear the edges away.
It's just a styrofoam that easily tears easily away
when you have the solid ice in there.
And then you put that directly on it.
That's gonna make your eyes open up a little bit.
But after about a minute it starts to get numb.
And after two or three minutes, you're finding it really--
- And the advantage of that
is that you could do it very rapidly.
- Right. - You can cool it down
within a couple minutes as opposed to the ice pack
that takes 20 minutes.
- Yeah, it's a little messy.
You gotta put a towel underneath, 'cause it does drip.
- Yeah, and once it gets numb, you can tell by,
you can use two fingers and it feels like one finger,
that means it's numb.
- Sure, good point.
It'll be red, you'll see. - Right.
And that's the advantage.
It'll help you to see-- - Hyperemia.
- Yep.
Help the circulation overall.
Then, also, if you wanna use some ibuprofen,
that's up to you.
And make sure you know the amount to take.
We're not gonna get into that.
- Yeah, I think a short bout of ibuprofen.
You know, I would try it.
- Sure.
- Just see if you can knock it out.
- That's not the list of five so don't count that one.
- Right, that's not number five.
(Brad laughs)
Or two or three or four.
- The next thing is I mentioned
that those muscles will tighten up.
Oftentimes, getting up out of bed in the morning,
it can be real painful just to bend your elbow
and to move your wrist,
so we don't wanna stretch it aggressively,
'cause it's tore already, microtears.
But we do wanna get it moving in such a way
that it does stretch the muscle's fibers up in here.
So just doing some gentle range-of-motion
as it loosens up, you can flex the elbow,
and then you can pronate and supinate back and forth.
And you do these about 10 times.
- So, you're flexing the elbow.
- Yep.
- Then you go on.
- Yep. - Hand palm-up, palm-down.
- Yep, and then arm out like this,
a gentle fist and go down.
And then rotate towards your pinkie.
- Or if I'm doing both of them,
I'm down, I rotate out like this.
- And if this creates some real sharp pain,
don't do so much.
It's a gentle stretch, remember.
- So the idea is, if there were microtears in there,
they're gonna re-tear in the morning
unless you stretch it gently.
- Gently, right.
- So that way you're preparing it for the day.
- Right.
- Rather than it get a sudden jolt
and tear open. - Exactly.
- You can give it a little stretch.
- It's like taking one step forward
and two steps back.
- Right.
- The next thing is, 'cause we want to get
the muscle bellies here relaxed,
so that takes pressure off.
Plus we increase our circulation.
So the next one is simply massage the muscle belly,
which is here, not up where it's connected.
We're gonna talk about treating that in just a second.
And this is just, typically you can a cross-friction massage
on the muscle belly, but the big thing is,
is just to get in and get those muscles to relax.
And it helps with circulation as well.
Bob, do you have any tricks for that?
- Well that's a good preventative one, too.
- Sure. - I mean,
it's one if you start to feel
a little bit of discomfort there
or tend to be prone to this issue,
it's just a great idea to keep these muscles loose.
- Yep.
- And get more blood flow going.
- Sure. - I mean,
you're just gonna have less problems.
You're less likely to get it.
- Right.
And then we're gonna go to the cross-friction massage,
which is right at that point where the muscles connect.
Now, you're gonna have to use your judgment.
If you go right on the real tender spot,
you may have to back off a little bit.
In other words, go in this direction.
And you're gonna go this way across,
and you're gonna push down
and get into those fibers and massage,
and it may be painful at worse.
Now this is where you have to listen carefully.
- It may be painful at first, but wait another 30 seconds
to a minute and it should start to level out.
- [Brad] Or even feel better.
- Or even feel better. - Yep.
If, on the other hand you do it,
and it seems like after 30 seconds
it's getting worse, it's not ready for that.
- No.
- Go back to your cold pack.
Do the massage on the muscle bellity. (laughs)
- Muscle belly.
- Bellity. (laughs)
- Yeah, the bellity.
- (laughs) Yeah, that one, too.
All right.
- This is a really good massage, to do it across-fiber.
I've seen people where it's helped take it away.
It's breaking up the scar tissue.
- Yep, yeah.
- It's helping it heal strong.
- Right.
- So it's a very good massage to do.
- Yeah, I have good luck with patients,
and we get a lot of comments back.
- Lotta comments people that stated that it helped them.
- Right.
- Actually we did this video a long time ago
and it's still getting good, strong, comments.
Then you can use the elbow brace.
- Sure.
_ This is a Aircast, we like Aircast.
There are other ones on the market.
The idea is you're gonna put that
not directly over the sore spot but close to it.
And I like the Aircast 'cause they got a bladder,
an air bladder that's squishy.
- That seems to be pretty comfortable.
- Yeah.
- You've had this before, Brad.
- Oh yeah, I've used this exact--
- No, I mean you've had, yeah, this disorder.
That's what I'm trying to say.
- [Brad] You're saying I have a disorder?
(Bob laughs)
No, Bob, (laughs) why Bob?
- [Bob] Did you have it on both arms?
- I did.
- Yeah. - I did, actually.
So you're gonna put that over the muscle belly
close to the injury and you simply tighten it down.
Now you're not gonna wear it tight the whole day.
I always recommend to my patients keep it loose,
but when you start doing something that irritates it,
that's working those muscles, then tighten it down
while you're doing that task.
But if you leave it tight all day long,
it's gonna cause a circulation problem.
- Yeah, you're gonna have problems there.
But if you look here, now what should be happening here,
instead of pulling on the bone,
you know, if you think about a rope attaching to the bone,
it's now pulling here.
You know, the force is being transferred to here.
So you're taking the stress off of that.
- Right, kind of spreads that out a little bit.
- Right, right.
- And if you get this too close to your elbow,
it gets in the crux of your elbow
and it's a little uncomfortable.
So you have to work with that.
But I think that's gonna be true
with any, with any brands. - Yep.
- I haven't seen any, it's just the mechanics of it.
- Right. - You can't get away from it,
and these aren't real expensive
and they can be real helpful.
- Yep.
- So, keep working all of those
and it's really gonna make a big difference
on getting this thing better faster so you can get
back to a normal life, and not have that pain.
- And remember, Brad and I are not just pretty.
- We're pretty ugly.
- No, we're pretty helpful. - Oh, that's right.
- That's why you all subscribe to us.
- Right, right.
- Thanks for watching.
- I always forget that part.
(Bob laughs) (gentle electronic tones)