Last time we talked a lot about working with tennis elbow and the brain. We discussed the idea of using a metronome. If you have not watched that video go back and check it out it’s very important that you get that basic information. 

Today what I want to focus on is tissue mobility and joint mobility and these are things that you can do on your own. So remember that the first thing that we said is that we need to do first a test. So I want you to go ahead and if you’re experiencing tennis elbow do something that is generally irritating to you. That’s opening a door, picking up a cup of coffee, making a tight fist and grade yourself on the amount of pain that you’re feeling scale of one to ten.

We’re going to keep revisiting that as we move forward

The first thing that I want to talk about is skin mobility. Many people that are experiencing tennis elbow will have minor restrictions in peripheral nerves and those peripheral nerves will often be moving outward toward the surface of the skin.

Usually, whenever we have pain we like to dig around like we’re trying to work on the muscles and that’s fine but sometimes we need to do the reverse and we need to decompress.

So let’s imagine that you’re having pain in your left elbow or I’m having pain in my left elbow and I’m having pain as I make a fist.

So the first thing I would do is test that let’s say that’s a 5 out of 10 pain. I’m now going to begin working through the skin on the back of my arm. So if my palm is facing down, I’m going to be working toward where I feel the pain.

In order to do this though I need to loosen up my fist and I’m simply going to go in and I’m going to pinch the skin and I’m going to try and pull it away from the underlying tissue.

What will normally happen if you have tennis elbow is that somewhere along this line, I’m working up toward my elbow on a diagonal as you’re working through there and lifting the skin you’re probably going to find a spot that’s quite sore.

If you find that spot and it’s quite sore I want you to secure it lift it away from the underlying tissue and then try making the fist again.

In many cases you will find that the pain is either significantly diminished or gone if that’s the case we want to make sure that we’re utilizing this type of stimulus or this type of work while we’re doing other exercises.

So if you go back to the last video when we were talking about doing a little band exercise.

You may need to have a partner or someone help you with that but as you were doing the band exercise they would actually be decompressing the skin.

If you don’t have someone to work with you can also utilize tools we love to use cupping instruments like you can get silicon cups or traditional suction cups using air. They’re very cheap and they’re great tools for working on skin decompression.

So again we’re going to start palm down pinching the skin starting at the wrist or even in the hand working our way up and again what are we looking for we’re looking for areas that are exquisitely tender as we lift them away from the underlying tissue.

If we find those we’re then going to hold them as we do other exercises. In a pinch if you the pun intended if you don’t have anyone to help you you you can just do a basic gripping exercise grab a washcloth. Roll it up so that it’s nice and thick and you’ll be doing a squeeze using your metronome to a count of three so three squeeze three relaxation while you’re holding the area that was most tender and decompressing it.

A lot of people when they start working like this get an immediate reduction in pain so this is a great first mobilization to work on. Remember we’re not going after muscles or joints we are going after the skin.

If you do not find some success with that the next thing that we want to do is we’re going to work on the joints and for this, I’m going to demonstrate it in a chair. You can also do this against a wall. The wall is often more comfortable for people because you have to use some body weight.

If you’re going to do it against the wall you need two towels one for your elbow and then one for your grip exercise. 

So I’m going to just show this to you without the towel for the wall because I’m going to be using my own knee. So I’m going to be sitting here again imagining that I need to work on my left elbow I’m going to keep my little grip washcloth in my hand and what I’m going to do is I’m going to lean forward and I want to get some pressure above the point of my elbow so if I bend my elbow I want to be above that and I’m going to be using pressure from my knee.

Now my palm is facing down so I’m here my other hand is now going to come in below the point of the elbow so this is the point of my elbow here I want to be below that.

Now what I’m going to be doing is I’m going to be pressing in with my knee above the elbow and pressing out with my hand directly across with my opposite or with my hand.

So as I do that, I’m going to be getting a little bit of joint mobilization. So what I want you to do is do about three reps and then hold that and then squeeze the towel. 

What you may find is that with that pressure your squeeze becomes pain free.Iif that is the case then this is going to become one of your regular exercises. We would then set the metronome and we would continue to do our three second squeeze three second release while we were holding the pressure.

The other thing I want to point out here is that sometimes pushing directly across provides you a little relief, but not a lot. 

If you get a little relief but not a significant amount with a squeeze, I then want you to rotate your thumb down so that we’re now pressing across and up on a diagonal.

And then you’re going to test that and you can also go the opposite direction so that we’re going down on a diagonal.

It’s highly likely that one of those three directions will provide you the most relief.

So we’re building your own menu right we’re figuring out the things that work well for you.

If you find that let’s say an upward diagonal gives you the most relief you would again then hold that using the pressure of your leg or the wall in your hand while you’re using the metronome doing your squeezing exercise. Aim for three sets of ten each exercise during your rest period keep testing and retesting. Because you may find that after one set you feel great after two sets the pain starts to come back up. So once again you’re able to grade this based off your personal response to the exercise which is a Hallmark of how we approach things from a brain-based perspective. 

I love this particular exercise approach these are very powerful. So give it a shot and let us know what you think.