Hey, it’s Dr. Joe, chiropractor and owner of Ocramed Health. Finally, springtime in New England, and what does that mean for a professional myofascial release therapist? That means I’m treating tennis elbow and golfer's elbow almost everyday.
And guess what? You don't need to play tennis or golf to have symptoms of tennis or golfer's elbow. Any exercise you do in the gym or any physical activity around the house—such as gardening and other yard work—you’re using your wrist and forearm muscles, resulting in a tennis elbow or a golfer's elbow.
In today's FREE myofascial release video, I want you to understand the type of soft tissue injury you're dealing with, and of course, I'll demonstrate simple at home myofascial release techniques you can do yourself so you don't need to find a myofascial release therapist.
How Do I Know If I Have Golfer’s Or Tennis Elbow?
So, what is the difference between tennis elbow & golfer's elbow? Well, for starters, a golfer's elbow is when the pain is on the inside of the elbow and tennis elbow is when the pain is on the outside of the elbow.
If we want to get technical, a golfer's elbow is known as medial epicondylitis, because this little nub of bone—which is the bottom part of the humerus, the arm bone—is known as the medial epicondyle.
On the opposite side of the elbow, the humerus has another protuberance of bone known as the lateral epicondyle, and when you experience symptoms of pain and inflammation here it’s also known as tennis elbow.
To make the distinction clearer, all the muscles of the forearm you use to flex the wrist and the fingers come up the tendons attaching onto the medial epicondyle, and the muscles you use to extend the wrist and fingers—also known as the extensive muscles—come up and attach onto the lateral epicondyle.
While golfer’s and tennis elbow are two distinct soft tissue injuries, this doesn’t mean a tennis player will not experience pain on the inside of the elbow—meaning they have symptoms of golfer's elbow—and vice versa for a golfer experiencing pain on the outside of their elbow.
Most of the time people have pain and inflammation on either the inside or outside of the elbow, and I rarely have patients visiting my office with pain on both sides of the elbow.
Now that we understand the difference between golfer’s and tennis elbow, let me show you what you can do to treat elbow pain, whether on the inside or on the outside.
What Do Adhesions Feel Like In Muscles
So why do we experience this elbow pain from our favorite outdoor activities? Well, as I’ve mentioned, all the flexor and extensor tendons in the are attached to each other.
I'll tell you a secret about tendons. Tendons do not like to be tugged on—and shouldn't be tugged on—because all muscles have a tendon on each end. One end attaches into one bone and the other end attaches to another bone. When muscles are elastic like they should be, all is good in the world, and the tendons don't get tugged on.
But what happens—and this applies to other soft tissue injuries across the body—is we can build up what are called fascial adhesions (otherwise known as scar tissue), causing wear and tear on the muscles.
Whether we're talking about the flexor muscles or the extensive muscles, fascial adhesions cause them to start losing elasticity, and when a muscle loses elasticity it tugs on its tendons causing inflammation.
Performing activities where you need muscle elasticity—like hitting a golf ball or a tennis ball—requires your flexor and extensor muscles to be stretching and moving effortlessly, and when they don’t, they’ll start tugging on the tendons of the elbow, causing inflammation and resulting in tremendous elbow pain.
How Do You Fix Golfer’s And Tennis Elbow?
So what can we do to heal golfers and tennis elbow? Well, the best time to manage soft tissue injuries is as soon as you start feeling discomfort.
Get a myofascial release ball, such as a Massage Ball Max from our OcraMed Health online fascia care store. The reason I prefer a spiky massage ball is because the spikes can dig deep into stubborn soft tissue, giving us the most effective fascia massage possible, easily getting in between and breaking up tough to penetrate muscle fibers.
A spiky massage ball is a far better fascia release tool than a smooth tennis ball or lacrosse ball. A smooth massage ball will get the blood flowing, but you're not going to get the deep penetration required to fix golfer’s or tennis elbow.
Let's start with the flexor muscles. With any restricted muscles, we want to get blood flowing because muscles with restriction or adhesions usually have poor blood flow.
There are two goals for any myofascial release session:
- Boost blood circulation to the restricted muscles
- Break up the fascial adhesions.
If we’re focusing on the flexor muscles to treat golfer’s elbow, we're going to perform a transverse friction massage. Simply grab a massage ball and start right below the bony areas—and you’ll know what areas to avoid when doing self myofascial release, because when you touch these areas they'll feel really tender.
We don’t want to roll over any bones, so start massaging right below them, gently rolling the massage ball back and forth.
Slowly work downward towards the wrist, then come all the way back up to where you started, beginning to place firmer pressure on your injury (as much as you can handle).
If the soft tissue area is really sensitive, I advise going easy, but if you can press in deep, press in, continuing to massage up and down the flexor muscles.
Now, if you happen to come across an area where you feel a particular restriction—a fascia knot—spend some extra time massaging the soft tissue. Just a couple of minutes massaging up and down the flexor muscles will do wonders for treating golfer’s and tennis elbow.
If we're massaging the extensor muscles to treat tennis elbow, you’ll follow the exact same routine. We're going to start below the bony area, and trust me, if you mistakenly roll over a bony area, you’ll know.
And again, let’s do a transverse friction massage, rolling all the way down towards the wrist, getting the blood flowing to those extensor muscles.
Like I said before, chances are you'll be diagnosed with either golfer’s or tennis elbow, as I very, very seldom see patients coming into office with a golfer's and tennis elbow.
Golfer’s Elbow Pin & Stretch
Cool, we've got the blood flowing. Now let's do a pin and stretch manual therapy technique to fix golfer’s elbow, simply pinning the restricted tissue and then stretching it out, pulling apart those stubborn fascial adhesions.
What I want you to do is make a fist and then flex the wrist, which shortens all the muscle fibers. Now we're going to push the spiky massage ball into those flexor muscles, pushing in and then pulling the ball back towards the elbow, trapping the injured soft tissue tissue. Push down, pull back, and hold.
Next we're going to extend the wrist and open up the hand, allowing us to stretch out the flexor muscles to more effectively break up and pull apart the fascial adhesions.
Hands and arms out, fingers closed, and wrist flexed up, using the massage ball to push in and pull towards the elbow, trapping the soft tissue. And now, slowly with control, I'm extending the wrist and opening up the fingers.
Repeat these myofascial release techniques on different spots across your flexor muscles. If you find a particularly tight fascia knot, spend a little extra time massaging it because you’ve probably found one of the causes of your golfer’s elbow.
Tennis Elbow Pin & Stretch
If we're massaging the extensor muscles to fix tennis elbow, the process is the exact opposite. In other words, now I want to shorten the muscle fibers, so I'm going to bring the wrist back and open the fingers.
Now, again, push the massage ball down into the soft tissue and pull back, but now, I'm going to flex rather than extend the wrist, making a fist and flexing as far down as I comfortably can.
Then, I'm going to extend my fist back up and then flex again, but this time slightly lower than before. Again, push the massage ball into the muscle fibers and pull back towards the elbow, all while flexing the wrist all the way down and then all the way back up.
How Often To Do Myofascial Release?
Incorporating myofascial release techniques into your daily routine, whether during golf season, tennis season, or when you're doing a lot of yard work, will make a world of difference when suffering from symptoms of golfer’s or tennis elbow.
The sooner you can start doing myofascial release, the better. We want to treat injuries as soon as possible, but unfortunately, a lot of times we wait too long, resulting in severely inflamed soft tissue which requires treatment from a professional myofascial release therapist, or in some cases, surgery. So you want to fix golfer’s and tennis elbow as soon as you start feeling any symptoms.
Get Back In The Game With Ocramed Health
Anyways, I hope these myofascial release techniques help heal your golfer’s or tennis elbow, because we want to stay active.
The worst problem to face are injuries preventing us from enjoying our favorite activities. Humans are meant to stay active, and there's nothing worse than suffering from a serious injury.
Best of luck to everybody. Stay young and train hard. And of course, Ocramed Health is always here to keep you fit forever!