It is without failure that i will have at least one new patient, or pre-existing patient come into the clinic with elbow/forearm pathology.

Most elbow pathaology and discomfort will happen on the inside and outside (top of the forearm). These two pains are actually part of the same underlying issue.

The elbow is an extension of the shoulder via the arm, shocking i know. With this revelation its important to understand that the issues associated with the elbow are a by product to the shoulder for the most part. In some instances the wrist will effect the elbow as well, however in this log we are looking at how the shoulder relates to elbow problems.

The shoulder is a mobile and stable joint who’s mobility demands are >  than its stability demands. It’s position will often dictate its effectiveness. Meaning the better position, the better the press. So, with that being said when the shoulder is stuck in an internally rotated bias due to tight internal rotators, pec minor, lat, teres minor, etc the shoulder position will be off and stability along with mobility will be compromised. The body has a great built in system to sense this. When it does it limits the use of the shoulder so to speak by creating more stability at the elbow. The elbow and its tissues/tendons do not have the prerequisite resiliency or loading capacity to handle that. That is when you experience tendonosis, inflammation, weakness within grip and so forth.

The tendons that support the fingers when gripping  run all the way up into the elbow and a lot of people will have issues with grip and stabilizing a wrist position.

So how do we fix this......... Here are some general guidelines... Remember each person’s case will specific to these are general guidelines and are not meant to treat any individuals injuries.

Guidelines

   1. Find the wrist positions either in flexion or extension that cause pain and back off from that position by a couple degrees. Create isometric contractions by resisting wrist flexion or extension with your opposite hand for 5-10 seconds. Repeat for sets of 5-10 repetitions. Try and increase your tolerance and position closer to the position of pain as you progress. This can be done in the same session or through the week.

   2. Once inflammation in the tissues has decreased, isometrics should     Not increase inflammation, you should begin working eccentric control of wrist extension. This can be done in multiple ways

   3. Work on scapular stabilization and shoulder mobility. The more stable and better position the shoulder sits in the better down stream the arm will be.

   4. Modify training exercises to limit wrist/grip use as well as increasing the base of support for the shoulders when available. Below i have recorded two videos that demonstrate this. The band allows you to keep an open palm and not have to grip, to a certain extent. Also, by placing yourself on the ground you increase your base of support that you wouldn’t otherwise have on most regular benches.