No Arm Wrestling Please

By Laura Gordon

The following is a scenario for you to put yourself into and work through with me:
You have just opened up your own massage therapy business and are building your clientele. One day a client comes in with a sore elbow. The client tells you his profession is carpentry. Examine his arm visually, and note that his dominate arm is inflamed on the lateral side of the elbow joint and is very warm, tender and painful to a light touch. He tells you it began several months ago and has progressed into the current painful condition. He also tells you he is losing strength in his grip which is particularly distressing to him as he has to handle power saws, drills, hammers etc. in his line of work.
Though you cannot diagnose, you are aware these are all the symptoms of Lateral Epicondylitis also known as Tennis Elbow. That means there are tears in the tendons on the lateral side of the arm. The most common is the tendon of the Extensor Carpi Radialis Brevis. You would muscle test not to diagnose but to confirm the location of the distress and talk with the client about his/her options.
If this is a condition that has persisted a considerable length of time, it is a good idea to have the client get an accurate diagnosis from an M.D. or D.O. to rule out arthritis or other disease related possible causes.
Do you need to muscle test for Tennis Elbow even after a doctor’s diagnosis?
Muscle Test:  Yes, it’s a good idea to pin point where your work would best benefit the client.
To muscle test you would have the client rest their arm on a flat surface palm down, have them extend their hand at the wrist as you resist the move with the palm of your hand over the back of their hand.
Technique:  If the client experiences pain at the wrist you would know to work the wrist area with stretches and cross fiber. If the client experiences pain at the elbow you would know to work the lateral epicondyle of the humerus. 1) Find the spot shown on the left. 2) Press into the area, to the depth that your client can tolerate. 3) Next cross fiber friction the area for at least 30 seconds. 4) Finish with a gentle stretch that lasts for 30 secs.
Additionally:  You can stretch the tendons by supinating and pronating the forearm. In each position cross fiber the tendons and muscles of the forearm starting in the area of most pain and working distally toward the wrist or proximal toward the elbow.
Homework:   Homework is an important feature of the work and the two images show the type of work the client can do on their own. It is recommended the client does each position for a set of 10 for a count of 10.
Encourage your client to come back at least twice a week until significant healing has occurred. The treatment as described above will only take 15 to 20 minutes.
Challenge:   Try this technique on a willing victim. Get their impression on how loose this made their already health arm feel.