Hi, I’m Dr Eric Cobb with Z-Health Performance. Today we’re going to be discussing some soft tissue mobilization ideas for dealing with golfer’s elbow. If you’re new to Z-Health, we’re a Brain Based training company. We work with world-class doctors, therapists, and coaches from around the world. So, if you find this information interesting make sure to subscribe and also check out all of our free resources.
We have now done three different videos talking about golfer’s elbow. We’ve mentioned that there are a lot of unknowns still because golfer’s elbow does not seem to get nearly the amount of research attention as tennis elbow, but there are things that we know. We’ve so far talked about working on; thoracic mobility, opposite hip internal rotation, and we’ve also begun working on different shoulder strengthening exercises because problems along that kinetic chain can all contribute to the stress that’s generating the medial epicondylitis or golfer’s elbow. So, what we want to talk about today is the use of soft tissue massage mobilization, etc. Whenever we think about golfer’s elbow, we’re basically thinking about issues with our flexors. alright, wrist flexors may be being overused, tension in this tendon and there are a couple of key things that you will find for most people that if we focus on, will make some difference for them.
So, first thing I want you to do is palpate that area. Press on that area, get a pain level, and then I want you to squeeze and then pronate. And again get a pain level because we’re going to be using that as a guide for where you need to be working and what type of work you need to be doing. So the first thing that we’re going to focus on is a little bit of compressive relaxation, if you want to call it that release for the flexor groups. The way that we’re going to do this, we’re going to keep our hand open. I’m going to take my thumb and begin down by the wrist. I’m going to press across the muscles and I’m simply going to go into wrist extension. You’re going to feel some pressure underneath the thumb. Feel a little bit of a stretch. You’re then going to work your way up and we’re doing these gently. We’re not putting a ton of pressure but what you’ll notice is if you have issues with these flexors they’re going to be some pretty sore spots. I’m going to work my way all the way up to that medial epicondyle and again I’m just doing a nice slow, wrist extension while I’m using pressure then go bac,. repalpate, notice your pain level, squeeze, and pronate. Once again notice your pain level. Did it help? If so, what I would recommend is you go back to the areas that were most uncomfortable. I then want you to repeat those same mobilizations and do that five to maybe 15 times, and then go back and repalpate.
Now, the next area that may respond well, or may create changes in this golfer’s elbow presentation, are triceps, allright, so the muscles in the back of the arm.
Generally what we’re going to want you to do is, find that point again of the inner part of the inner bone of your elbow medial epicondyle. You’re then going to slide in on your arm and then I want you to straighten your arm out, and you should feel the tendon of your tricep. It’s going to be a big thick thing. It’s going to pop out into your thumb. You’re then going to move up two to three inches and then in about an inch. And you’re basically going to be near where the tendon and the tricep muscle itself come together. If you press in there, you may find that it’s a little bit tender. Once again, I’m going to use the flat of my thumb, I’m going to put pressure, and then I’m going to straighten my arm and bend my arm. Alright, same thing and then I will start to work my way up. I’ll move my way up toward the shoulder but most people will find that staying in that lower area is where you’re going to get the greatest result. So five or six flexions and extensions and then go back and do your same. Retest if you’ve got a great result from that. That’s going to be the focus.
Now, the next thing I’m going to have you do, however, is if you did not get relief from pressure, we then want to think about decompression. So, we will now repeat that same exact process. Only now, we’re going to be pinching the skin. We’re going to be lifting it away from the body and extending the wrist and then we’re going to work our way up toward that medial epicondyle and then we’ll repeat the same thing around the tricep. I would say experientially about 60 percent of my clients that I’ve worked with with golfer’s elbow got more relief from the decompression stretch, than the compression. So this is why I show both on video.
You need to actually test this to to find out what works best for you. Once you’ve determined whether the decompressive work or the compression work is more valuable and useful, you’re then going to need to start working on that on a daily basis. If you find that there are two or three points that you do decompression, you’re like, “oh man, my elbow feels great!” I want you to focus on doing 5 to 10 to 15 repetitions of that three to four times a day. Because, we’re trying to set in place a concept for your brain that it is safe to squeeze and to pronate. And the easiest way for us to do that is to have you work on soft tissue approaches that decrease the amount of pain you’re experiencing. Alright, so we’re going to now combine some of the local tissue work with the kinetic chain stuff that we’ve already been talking about and hopefully you’re starting to build a nice library of things that make a big difference for you.