Hey everybody it's Doctor Jo, and today I'm going to show you my top seven
treatments for tennis elbow. so let's get started.
So tennis elbow, or lateral epicondylitis, is
when this outer side of the elbow gets irritated usually because of those wrist
extensor muscles. so the first thing you want to do is just kind of warm up those
muscles. so an easy way to do that is just take your arm, you can either put it
straight out or bent, bent is going to be a little more comfortable, so if
you're really irritated you probably want to start bent, if you're not quite
as irritated, you can go straight out. just make a fist with your hand and then
at your wrist just go down and then come back up. so this is really just an active
range of motion movement, just warming up those muscles, so not necessarily a
stretch yet ,but just getting these muscles kind of warm and ready to be
stretched. so you don't really have to pause and wait, you can do maybe a
three-second hold if you want to, but you're really just going back and forth
right now. so just up and down and really get some movement in there. I just do
maybe five each way a total of ten, again you're just trying to get these muscles
going. so after you get that done and you can feel that those muscles are starting
to work a little bit, they're a little bit warm, then you can go into a stretch.
so to stretch these wrist extensors and I say wrist extensors and pointing up
here because the muscles that extend that wrist come all the way up and
attached to that epicondyle, so that's why you have that itis at the elbow, but
it's really a lot of that wrist movement, so to stretch those out, again you want
to start off maybe not so strong with the stretch and then you can progress to
something a little bit stronger. so this time you want your arm to be straight,
you want that elbow to be locked out because that's what's really going to
stretch those muscles. to start off keep your fingers straight, this is going to
be not quite as much of a stretch but at your wrists go down and you should feel
that stretch all the way along the outside here. if you want a little
bit more of a stretch, you can take your other hand and push down this way. some
people turn it in just a little bit you can do that as well and that just kind
of changes the position a little bit, but since this is a stretch you want to hold
it for 30 seconds and then you can take a little break. if that's not quite
enough stretch for you then when you go back down curl your fingers into a fist
and that's gonna give you even more of a stretch because those extensors go all
the way down in the fingers, so if you curl your fingers that gives you even
more of a stretch, and then again you can push through on it here to get that nice
stretch on the outside. so again this is a 30 second hold and you want to do that
a total of 3 times. so then taking a little break shake it out give yourself
about a 10 to 15 second break in between just to let those muscles reset a little
bit and then go into that stretch again. if you're standing up doing it, if you're
near a wall or if you're at a computer may be in a cubicle or something, you can
push this into a wall instead of using your hand, if this is a little
uncomfortable to reach around, you can just push it into a wall and get that
extra stretch, but if that's too much again fingers down not quite as much
fingers curled just a little bit more ,so 30 seconds three of those. so number
three Simien sent us some elbow support
braces these are really great for that epicondylitis because what they do as
you can see here is it has some little pressure spots that you put on the
muscle belly to take the pressure off of the epicondyle or the outer elbow there,
and so they work really great it comes with two which is awesome and it also
comes with a large strap and a small strap depending on the width of your
elbow, and it also comes with a really cool sweat band. I am probably more of a
small for mine, so I'll put this one on and so what you want to do the rule of
thumb, and I say rule of thumb with a pun there, is you want to take your thumb and
kind of put right at your here because this blue spot wants to
actually be on the muscle belly, so it's not up at that condyle, you want to come
down. so if you're pushing you want to actually feel muscle you don't want to
be on the bone here, so I like the rule of thumb of putting your thumb there and
then the brace starts after the thumb, so I'll just kind of show you here I'm
gonna put this on, so if I bring it up here what I want it to be is not up at
the elbow, but down a little bit so a thumb in between and that blue spot
underneath right on that belly and then you're gonna tighten it up. you want it
to be pretty pretty tight in there, not so much where it's cutting off
circulation, but see it's not right at the elbow,
I can still bend and move very easily it's right on that belly, and again what
that does is it puts pressure here to take pressure off of that elbow to get
rid of that inflammation, so it does a really good job. people can usually feel
immediate relief when they have it on, so again make sure it's not so tight that
is cutting off circulation, make sure your fingers don't get cold when it's on
there, but you want some nice pressure on there and you can use this throughout
the day. I wouldn't say sleep with it or anything like that, but if you know
you're going to be doing a lot of repetitive activities using the brace is
really really great for this, and so it's nice, it's very comfortable, it's is you
know not scratchy or anything, and I really like how it's adjustable so you
can have the large strap you can have the small strap, and you can even change
with the straps how much tightness you want to in there, so that's really cool
as well. so if you're interested in purchasing the brace you can click up
here. so the next exercise is going to be a strengthening exercise, so this time
use maybe just like a soup can or a vegetable can, you don't want to start
off with anything too heavy because this is an itis which means inflammation and
if you do too much weight too quickly, you're going to get just more
inflammation, so soup vegetable cans are usually just about a pound, and that's
really what you want to start with. you can place your arm on a table or
something to support and have your wrist hanging off so you have movement or if
you're comfortable, and you can just kind of hold your elbow up
in the air, but make sure that your elbows bent this time so you don't want
it straight out, you want it nice and bent and comfortable so with your palm
facing down towards the floor, just at your wrist, you're gonna go down nice and
slow and then back up nice and slow. so this is just kind of a continuous motion,
but you want to get as far of that range of motion that you can. so not just here
but going all the way down as far as you can and all the way up as far as you
comfortably can. so just making sure that it's smooth and controlled that you're
controlling it that you're not just dropping it back down, but really just
getting those muscles to activate and start strengthening a little bit, so when
you're doing these I would just start off with about ten the first time maybe
two sets of ten, if that's pretty easy and you're not super sore the next day,
then you can start pumping up a set so three sets of ten, two sets of fifteen. if
you get to 20-25 and it's really easy, then you can go up to a heavier weight.
another product that Simien sent us is their armbar. so this is really really
cool because what it does is it helps you get some eccentric exercises which
is really really important in helping muscles heal, and you can also do some
stability type of exercises with it as well. I really like this because it comes
with a couple different bars that you can put it in the main bar to make it
more resistance or less resistance, so this is really really coo.l I would
always start off with the lightest just because again you don't want to irritate
it anymore but this is so cool because you can do a whole bunch of different
things with it. so it's a nice additional equipment to have. so what we're gonna do
first is that eccentric kind of exercise for those wrist extensors, so this
movement is a little weird. what you want to do is start off with the hand you
want to exercise, hold the bar straight up and down, put your wrist into an
extension kind of position. so that's going out this way or up this way, so you
have that extension motion then you want to come
around with the other hand. so this one should feel pretty good this arm should
feel pretty good, so you can kind of really get around the top because the
more you twist it, the more exercise you're going to get on the bottom one so
come up here, and then you're gonna twist this one forward into a wrist flexion so
grab it around as far as you can, and twist forward while the bottom one's
still extended, and then straighten out your arms. so you can see here that it's
in that twisted motion and then as you hold it here you're just gonna slowly and
control take that left hand that's twisted and slowly go up that way. so you can
see then I'm coming back down and I'm eccentrically, which is controlling it
back into that motion, that that exercise for those muscles and this is a really
good one. but the eccentric motion is really
really easy to fatigue quickly, it's a harder motion to do, so you don't want to
overdo these. some protocols say 3 times 15, I wouldn't start with that,
I would start which is 3 times 5 and see how you feel because again it's a lot of
exercise on that muscle even though while you're doing it it might not feel
like it. so I'm going to go through the whole motion again so you can see it. so
wrist extension, come up on top, wrist flexion, twist,
straighten out your arms, and slowly then go into that wrist flexion with your
hands. so it's almost just like you're doing this motion but you'll really feel
as you come through that is working that top muscle, so that's a really really
great exercise to do. what I also like about the armbar is you can see that
it's twisty and bendy, so another great exercise is some stability for the
muscles. this exercise that I'm about to do makes these muscles really contract
and hold that stability, and it's kind of hard to get it down in the beginning but
it's a really great exercise and again it's working those muscles. these are
small muscles, so you don't want to do a whole lot, but you can definitely feel it
while you're doing it. so this time you want to you want to keep that elbow bent
the whole time pretty close to your side. you don't
have to stick it to your side, but keep it pretty close. hold the bottom part of
the armbar so you have a lot of space up here. now this this is the hard part, you
really want to kind of keep your arm in one spot and move at your wrist so it's
not this kind of motion, but it's really this motion. so if you can watch right
here watch how these muscles really activate. you know my biceps do, my wrist
extensors do, and they really are just contracting to control my arm from going
back and forth. so this is a really great movement and I like it, and so I would
just start off again maybe five or 10 seconds, and then take a break. you can
also go side to side with it which is a little bit harder, you can turn it down
and go this way, or you can go back and forth this way to get a little pronation
supination. so again really try and keep that elbow and that whole arm pretty
still. it's not doing this back and forth it's just wiggling it back and forth,
which again is really really cool and it's just working that whole arm, elbow,
and wrist. so you're getting that whole arm workout, so again really try and keep
everything stable here let that top part wiggle but it's not moving the whole arm,
and you're you're really gonna feel it. so again don't do a whole lot the first
time, just do a little bit and see how you feel the next day, and if you feel
good then you can add some more on to it. and if you're interested in purchasing
the armbar make sure you click up here. so the last treatment is going to be a
soft tissue mobilization right here at that epicondyle, right where that
irritation usually is. so soft tissue mobilization or some people call it
massage, is just really getting those tissues moving around. if there's scar
tissue in there, you're moving it around to break it up, so it's not necessarily a
massage I think people think you know rubbing on it kind of like that
sometimes that makes it feel better, but what soft tissue mobilization is, is
you're really moving that tissue around. so you're not rubbing it, but you're
taking that surface of skin and moving it back and forth, so if you can see the
difference I'm not just rubbing, I'm actually taking those
tissues and mobilizing them, so if you've got some irritation in here a lot of
times when you do this you're gonna feel some little pops going
on in there some some popping noises, you might feel it, you might even hear it and
that's usually just the scar tissue breaking up or those adhesions breaking
up. that's very normal as long as it might be just a little painful when you
first do it and then it goes away, that's completely fine, but if it's
hurting and it's not going away, you're probably pushing too hard. you
want to be firm, but again if you've got irritation in there if you're pushing
too hard, it's just gonna flare it up even more, so you can start off with
circles just kind of moving around in that area, you can go side to side in
that area just kind of up and down, and you can also go up and down along the
muscle fibers there. if you want to use a cream or a lotion to not have quite as
much friction you can, but again once you get that cream on there make sure you're
still moving the skin that it doesn't become just that you're kind of
massaging the area which is fine, but this mobilization is what you really
want. you're just moving that tissue to break up those adhesions in there and
usually it gets a little red after you're done doing that, but that's good
that's just bringing that blood and circulation to the area to help keep
that inflammation out. so just start off with about two to three minutes it
doesn't have to be a super long time, again if you do too much it's going to
get irritated, but it should feel pretty good and kind of loose and everything
back up after that. so there you have it. if you have any questions, leave them in
the comment section. if you're interested in purchasing any of those products, make
sure you click up here, and don't forget to subscribe by clicking down here. and
remember be safe (don't hit anybody), have fun, and I hope you feel better soon.