September 22nd, 2005
Looking for suggestions for your next massage on a client with lateral epicondylitis? This article gives a summary of the massage techniques used to help this injury from three experienced and prominent therapists.
Tennis elbow, or lateral epicondylitis, is a very common disorder of the lateral proximal forearm. While it has an athletic sounding name, tennis elbow can affect anybody participating in an activity that places excessive and repetitive stress on the wrist extensors, flexors, supinators or pronators.
Tennis elbow can cause severe tenderness on the lateral side of the elbow. The affected area becomes painful during extension, flexion, supination or pronation of the wrist, or finger extension. The pain becomes more obvious if resistance is offered against one of these movements.
Massage therapists are often recruited to help during recovery from tennis elbow. Below are summarized lists of massage therapy protocols for this disorder by three prominent practitioners. Incorporating the methods used by others with your personal experience can be an excellent combination to create your own effective therapeutic routine.
According to Whitney Lowe, LMT, NCTMB, in the Assess & Address column in Issue 109 of Massage Magazine, choose your massage techniques for tennis elbow in these sequential steps:
- Do compressive effleurage, general sweeping and cross fiber techniques to reduce tension and enhance tissue mobility.
- Perform deep compression broadening strokes to the wrist extensor muscles. Compression broadening techniques enhance the ability of the fibers to spread and broaden as they go into concentric contraction.
- Lengthen the tissue by using longitudinal stripping of the posterior forearm muscles.
Art Riggs, Certified Advanced Rolfer, CMT, in the book Deep Tissue Massage, offers the following guidance when treating someone with tennis elbow:
- Have the client lift his/her wrist against your resistance to determine the specific location of the strain pattern.
- Focus massage on the supinator muscle, as it is a common culprit of tennis elbow.
- Soften all of the arm muscles, including the lower triceps.
- Design a conservative stretching and strengthening program for your client. It is important to begin modestly and increase intensity of this program slowly.
- Instruct your client to refrain from the offending activity.
- Frequently apply ice to tender forearm muscles.
In the Institute for Integrative Healthcare Studies Sports Massage manual with James Mally, ND, additional suggestions for tennis elbow are given:
- Apply cross fiber technique to the extensor tendons near the lateral epicondyle of the humerus.
- Apply ice after the cross fiber friction massage for 10 to 15 minutes, until numb.
- Use Soft Tissue Release by pressing into tender spots along the extensor muscles while the client flexes his/her wrist and fingers.
While a massage therapist is just one professional that may be consulted to treat lateral epicondylitis, it can be an extremely effective choice. The information provided above is intended to give you some ideas so that you can formulate your own tennis elbow treatment plan.
There is a possibility that deep massage, stretching and strengthening of vulnerable tissue can perpetuate an injury, so proceed with caution. Caution entails having a full understanding of the disorder you approach, enlisting cryotherapy, communicating with your client, beginning conservatively (both in duration and intensity), advancing slowly and consulting with other healthcare professionals when needed.
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