Hi, I’m Dr. Eric Cobb with Z-Health performance today we’re continuing our discussion of tennis elbow solutions. If you’re new to Z-Health we are a brain-based education company we work with doctors therapists and movement coaches from all over the world. So if you find this information interesting subscribe to the channel and also check out our free resources.
In video one, we talked about brain changes that we see in tendon issues around the body. We discussed an idea called tendon neuroplastic training where you use a metronome because whenever we use some kind of outside source for timing whether that’s auditory or visual, it changes how well the brain is able to synchronize the movement. It’s very very useful in dealing with tendon issues. We also started to show you some band exercises and then in our last video we talked about both dermal mobilization and joint mobilization approaches that we have personally found to be extremely effective.
So what we want to move on now to today is dealing with the nerve itself. Whenever we look at the course of different nerves they come from the neck down into the arm the nerve that is often indicated as a problem in tennis elbow is called the radial nerve. Now the radial nerve is very easy to mobilize we have some very kind of strict what we call neurodynamic or neuromechanic exercises that we teach.
But what I want to show you today is kind of a different approach because when we’re dealing with something like lateral epicondylitis or tennis elbow the area can be so tender that doing anything that really causes a lot of tension on the nerve like a traditional what we call neuromechanic drill can be too much. But it is important to get the nerves moving through the tissue.
If nerves are restricted they are more likely to be responsive to pressure and that pressure can start to contribute to the pain sensation.
So these are exercises that we use all the time. So what we’re going to do first is we’re just going to show you the basics. So let’s say I’m having problems on my left side.
I’m going to have my palm facing up and then I’m going to bend it like I’m looking at something and then I’m going to bring it in and then point it at the floor but you can see as I’m doing that I’m making a little bit of a circular motion and my wrist is ending up in a flex position so I have my palm facing me or facing the ceiling facing the ceiling facing the ceiling.
That’s the whole idea here now as I do this, I want you to look at it you’re going to be looking at your poem as you go through this.
The reason that I want you looking at your palm is that if I look away from it that’s going to add tension to the nerve if I look at my hand it’s going to reduce tension on the nerve.
So this is a very very gentle way to begin mobilizing that radial nerve. Now what I want you to also consider is that you can do this at many different angles right.
I can start that motion and come out to the front I can come out to the side out to the side behind me down toward the floor and what you’ll notice as you do this is that in some positions you’ll feel more tension through the nerve than others. So if you have a very very painful elbow you start with the positions that are less threatening.
So if this is really easy right I’m here and I just make this small motion and that’s comfortable great start there.
Do 15 20 30 reps and then try a new position and then a new position and then as always you’re going to retest and see how your elbow’s feeling.
If it has reduced the pain significantly for you this is something to again add to your own personalized exercise menu for dealing with your tennis elbow issues.
Now how can we increase the efficacy of this? Well there’s a couple different ways that we can do it. Number one we want to consider doing the exercise on the opposite side of the body.
If you are unfamiliar with brain based approaches very often we can see in the research that working contralateral so opposite the problematic side can be very effective.
We can do massage, tape, exercise on the opposite side and it has a carryover effect to the problem side. So let’s say I’m doing 10 reps over here my problem side I also want to consider doing 10 or maybe even 20 reps on the non-problematic side and again retest.
Many time times people find that working the contralateral side gives them the largest benefit.
So this applies to all the exercises that we’re doing everything that we’re showing you you can always begin on the opposite side of the body.
The next thing that we want to consider is adding in some kind of additional stimulation.
So now I want to I’m going to use my little jawku mini massager here I love this particular tool because it’s small it’s easy to hold and if you remember from our band exercise I don’t want to be gripping it like a tennis racket this allows me to use a very very comfortable kind of paw grip So now I can be doing my same little radial nerve exercise but this is causing finger relaxation but I’m now getting a vibratory stimulus as well.
So you can go through those same exact motions but now our brain’s getting more information hopefully helping us sort all this out and I can go back and retest.
Finally, we can then include the eyes and the ear by turning on our metronome as I mentioned I like to use this particular metronome app called prometronome because when I turn it on it’s set for 20 SEC 20 beats per minute so I’d be three second reps I’m getting the sound and the visual.
So now as this was running I could have my little massager going and I could be now timing the end of each one of these motions to the metronome as I was watching it and listening to it. So this now continues to give you more ideas about building again your personalized menu which as I always say is a Hallmark of how we approach things from a brain-based perspective.
So the takeaway here is do these exercises watch the hand at some point if you’re doing great you’re almost pain free you can then begin looking away from the hand.
That will increase tension on the nerve and you can do that in a graded fashion everything again trying to move you from whatever your you know eight out of 10 pain all the way down to a zero as you practice these.
Give these a shot these are very powerful so in the beginning start off with small numbers of repetitions and then build up over time.
We hope you enjoy them and find them greatly beneficial.