You may be aware that a good portion of my work has focused on teaching people how to heal their elbow tendonitis.
It’s an injury that greatly affects many people’s lives for months or years, and yet the solution to healing it is so relatively simple and shows results so quickly!
But every now and then I’ll get a message from someone who did everything I suggested but had next to no improvement. I can feel their frustration and very much want to help them figure out what’s missing.
Over the past few weeks, I’ve been working on The Elbow Tendonitis Toolkit. It’s my definitive resource for helping people with elbow tendonitis.
And one of the key sections is dedicated to these people. You see, after many conversations I’ve realized that the reason why the elbow tendonitis exercises don’t work for many of these individuals is that they don’t actually have elbow tendonitis.
But while doing further research for the toolkit I came across a third injury in which the pain can resemble tennis elbow…
radial nerve entrapment
It’s caused by a tight supinator muscle that refers pain to the lateral epicondyle, making it feel like lateral epicondylitis.
But there are a few other things you may notice with this injury that you wouldn’t with tennis elbow…sharp or burning pain and possibly even tingling or numbness on the back of your hand, thumb, index, and middle finger.
The image below lets you see where you’d feel a radial nerve entrapment.
This post focuses on helping the yellow and red areas. If you’re feeling things in the blue or green areas, look at my post on thoracic outlet syndrome.
Here we go…
5 STEP PROCESS TO FIX YOUR REPETITIVE STRAIN INJURy
STEP 1 – IDENTIFY OFFENDING ACTIVITY
For radial nerve entrapment in the forearm, there is one muscle that seems to be the main culprit here…the supinator. And this one muscle only does one movement. It supinates.
Hold your hand out in front of you, palm facing down. Now turn your hand over, as if you were to hold a bowl of soup. That is supination.
If you do a lot of twisting manual work, that’s your offending activity.
STEP 2 – REDUCE OFFENDING ACTIVITY
For this type of injury, you don’t need to stop the offending activity.
But it would be good to do less of it for a little while until you’ve strengthened the opposing muscles. We’ll cover that in step 5.
STEP 3 – RELEASE TRIGGER POINTS
You can dig into the trigger points of your supinator best with the middle finger of your opposite hand.
With your thumb in your elbow pit, take a pinch of the meat just below the fold of your elbow. Start digging your middle finger into the muscles, pressing against the bone.
When you find a tender spot, keep the pressure on it for upwards of 30 seconds or until the pain goes away. Then move around to find any other spots and repeat.
If you see a massage therapist or acupuncturist, this would be an ideal task for them to help you with.
STEP 4 – STRETCH TIGHT TISSUES
Once the trigger points have released it’s time to get proper length back into the muscle with a PNF stretch.
And now that you’ve stretched the supinator to take the pressure off of the radial nerve entrapment, let’s take this opportunity to do some nerve glides. This will help release any sticky adhesions holding onto the nerve so it can move freely when you twist and reach.
Want the radial nerve guide I mention at the end of the video?
STEP 5 – STRENGTHEN WEAK TISSUES
Earlier, I said that you don’t have to stop your offending activities but you do have to compensate for the muscular imbalances they create.
So if your supinator is being overworked, you need to strengthen the pronator muscle to balance the joint out. And that’s pretty darn easy.
The easiest way to do this is with a Flexabar like so…
Two sets of ten reps every other day should do the trick.
If you don’t get all the relief you were expecting from focusing on the forearm, then you should consider the possibility of thoracic outlet syndrome.
Thoracic outlet syndrome is the compression of veins, arteries, and the nerve structure called brachial plexus.
The brachial plexus is where the nerves for your arm make their way from your spine, through the muscles and bones in your neck, between the clavicle and first rib, and then through your armpit.
Learn more about what you can do in the next 5 minutes to possibly reduce pain from thoracic outlet syndrome in this post.
Or perhaps you have tingling and numbness in your pinky and ring finger. Check out my post on ulnar nerve entrapment.
Examination of and Intervention for a Patient With Chronic Lateral Elbow Pain With Signs of Nerve Entrapment Journal of the American Physical Therapy Association,
Myofascial Pain and Dysfunction: The Trigger Point Manual Volume 1. Upper Half of Body Janet G. Travell, M.D., David G. Simmons, M.D. ,1999 Williams & Wilkins