Tennis elbow and Golfers elbow

Lateral and medial epicondylitis named for the part of the elbow that is in pain .  I do not think it really matters which one it is because the way I would treat it would be the same .

Some elbow anatomy .

There are sixteen muscles that cross the joint .

The triceps group on the back inserting onto the olecranon

The biceps group on the front including the Biceps brachii , Brachialis and Brachioradialis

The wrist and finger extensors originating from the common extensor tendon on the lateral epicondyle

The wrist and finger flexors originating from the common flexor tendon on the medial epicondlye

The forearm suppinator and pronator originating from the lateral and medial epicondyle respectively .

Yikes !!!!!   and that was the simple short version .

The brachial plexus

The brachial plexus is the nerve bundle that exits from the lower cervical and upper thoracic spine and branch out to become the radial , ulnar and median nerves .

I think you know where i am going with this one . If the nerves are in any way pinched or pressured it stands to reason that the nerves further down the arm may react and cause elbow pain .

So stressed out chest breathers with super tight scalenes may be causing problems for the brachial plexus .

A person with a kyphosis may alter the scapular mechanics and cause compensations further down the chain in this case the elbow joint .

It is a good idea to check for increased tone in the pec minor and weakness of the lower traps .  In such a situation the scapula will be pulled forward and down feeding into internal rotation and faulty mechanics .

Here is a simple check list I use

The first  two tests are up against the wall . in the presence of pokey chin or kyphosis make the correction and ask them to reproduce the painful movement . if the pain decreases you have your answer and solution .

  • Breathing
  • Posture , pokey chin , kyphosis
  • Neuro dynamics
  • Trigger points

You may find that with clients that have good posture and good breathing patterns the problem may actually be located locally and in this case direct soft tissue work and nerve flossing may be what is needed .

If you would like to learn more about neural dynamics and the nervouse system you can not do better than looking into David Butler .

For trigger points check these guys out , they are clear and simple .