A Review of Tennis Elbow
Rehabilitate The Whole Person, Not Just Injured Tissues
The presentation of pain in a tendon, does not always mean that the tendon is the primary contributor to pain. There research that suggests that a majority of nerves are found outside in peritendinous tissue, which is likely contributes to the complex clinical picture of tendon pain.
This is why clinicians should be thoughtful and skilled in managing the load on the tendons and supporting structures through a number of rehabilitation considerations including, but are not limited to:
• Manual Therapy (nerve mobilization, soft tissue massage, triggerpoint, IASTM)
• Education on psychosocial factors such as fear avoidance
• Loading Programs (eg. concentric, eccentric, isometric)
Why Does Massage Therapy Work for Elbow Pain?
A biopsychosocial framework helps put into context the interconnected and multidirectional interaction between: physiology, thoughts, emotions, behaviors, culture, and beliefs. In terms of clinical responses to massage therapy there are a couple of proposed mechanisms of action, including but not limited to: neuroplasticity, contextual effects, mechanical effects, and affective touch.
Structures to be Aware of When Treating Elbow Pain
A massage therapy treatment plan should be implemented based on patient-specific assessment findings and patient tolerance. There may be times that focal irritability (ie. nerve irritation, triggerpoints, nervous system sensitization) co-exists with common extensor tendinopathy.
Massage therapists are uniquely suited to incorporate a number of rehabilitation strategies for patients with Elbow Pain. Structures to keep in mind while assessing and treating patients suffering from elbow pain may include neurovascular structures and investing fascia of:
• scalene muscles
• pectoralis minor
• biceps brachii muscle
• bicipital aponeurosis
• anterior interosseous membrane
• common extensor tendon (extensor carpi radialis brevis, extensor digitorum, extensor digiti minimi, extensor carpi ulnaris)
• common flexor tendon (pronator teres, flexor carpi radialis, palmaris longus, flexor digitorum superficialis, flexor carpi ulnaris)
More to Explore
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