How to fix elbow pain: Golfer’s golf elbow treatment exercises evidence-based

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And it is proven by many studies like this one tender stiffness can be reduced significantly with eccentric contraction whereas there was no change after static stretching, so what I always tell my patients is this no matter what you do your degenerative tendon cannot be repaired, but you've got plenty of good tissues you can work with so don't lose your hope, but I don't recommend stretching because it has started from the stretching force, applied to the tendon It can't really control the stretching force at the moment That's why it gets sore

So if you keep stretching out without your tendon being able to control that stretching force it can make it worse instead we're going to loosen up your muscle first, and then do some eccentric exercises we discussed in the last video and also when you do massage, you don't want to do massage around that bony area Because the tendons are hooked around the bony area like that If you compress on the tendon, that's the same as rubbing this rubber band around a rock, so you're going to loosen up this middle part (muscle belly) First of all, try to find a painful area or tight area like that normally right next to the bone, This is the bone, right next to it That's quite tight

So you hold onto the muscle and do some activities that has been painful for you like gripping something hard That kind of thing can be pain free if you hold onto the right muscle, so if this is the right muscle or painful muscle, and if you press down onto that and do painful activities, it can be pain free Not all the time, but most cases it can reduce the pain which means your muscle tension definitely contributes to that tendon problem When you do the massage you don't want to touch around the bony area again Maybe 5 centimetre away from the elbow and massage the middle muscles here

About 10 centimetre in the middle of your forearm you can go across like that for about 30 seconds, and then press down onto the muscle and move wrist up and down for 30 seconds You can do a few spots 5 to 10 seconds here 5-10 seconds there

all going down as well Try to do the massage on the whole forearm muscle, but do more on the tighter spots You can also do it with some tool something like this(stick?) I use my highlighter any tool to apply the pressure! you start with gentle pressure, but as you get used to it

Try to push a little bit harder and harder So, 30 seconds of massage and another 30 seconds of massage, and wrist movement and the exercise I showed you in the previous golfer's elbow video is this one you try to pull toward you with your right hand and push it away with your left hand like that while right hand keep pushing towards me like that when you do that, your right forearm muscles contract because you try to pull towards you but you're forcibly lengthening that right forearm muscle, using left hand so that your muscle can be lengthened or the tendon can be lengthened under loading So once you can do that with your elbow bent, you can go with elbow straight like this so push and try to resist through that right hand and straighten up your elbow a lot of people ask me "Isn't it the same as stretching?" but it's not there's a huge difference because this exercise has muscle contraction and tendon's controlling the loading

But if you do that just stretching for 30 seconds like that, there's no muscle contraction! tendon's not working and it's not effective and it is proven by many studies like this one tender stiffness can be reduced significantly with eccentric contraction whereas there was no change after static stretching so you do this exercise with tendon rehab principles applied And if you can do 3 sets of 15 twice a day, but that means you can actually progress on to next level this is a really good exercise pretty easy, and you can do anywhere anytime, but the problem with this exercise is you don't know how much weight you are putting on so it's hard to progress and hard to regress That's why you can use a dumbbell as well since I'm holding onto a weight

My muscle is contracted at the moment from there If I lower the weight, my whole muscle length will be elongated So going up my muscle is contracted and from there, The whole muscle length will be elongated That's the tendon controlling the stretching force and then last exercise's this one

Start from here like this And going out to the side lower down and come back up and lower down again It's exactly the opposite movement to the exercise I showed you in tennis elbow going down in 3 to 5 seconds at the beginning of tendon rehabilitation the slow movement is better and lightweight is better

The ways you can do this two action going down and rotating down like that You can apply these two movements into one action it's similar to biceps curl and I will tell you why later start from this position I'm going down and rotating out as you do that, You try to straighten your arm You try to go up with the other hand because we don't want that shortening phase of the exercises at the beginning going up and slowly lower down in about 5 seconds At the end position, your hand will be like that

as if dropping the weight like this so the muscles will be stretched out under loading you can actually do it to the front rather than down like that It is the same thing going forward and rotating out to the side like that the palm away from you that way Going down like that and coming up

and going down the reason why it is similar to biceps curl is your forearm muscles are actually two joint muscle That means they run through two joints (the elbow and the wrist joints) They start above the elbow and run through elbow and wrist joints and attach on your fingers so normally when they contract, they bend your wrist but if your wrist is fixed like this, holding onto a weight something like that? So when your wrist is fixed like this and you're doing biceps or triceps works your forearm muscles can be used in that action for example, let's say I am doing a rowing action with 10kg barbell so when I grip the barbell really hard my forearm muscles are contracted

But since it is two-jointed muscle, it's attached above the elbow joint So when I bend my elbow this muscle is shortened, and when I release the barbell, this muscle will be lengthened so I am already contracting my muscle and when I do that, my muscle's shortening, and when I release the barbell slowly(lower down) these forearm muscles will be stretched out the forearm muscle's normally bending the wrist, but since my wrist is fixed due to the barbell weight, and when I bend my elbow, this muscle will be shortened because it is attached above the elbow And when I lower the barbell that muscle will be stretched out which is eccentric control so the muscle's contracted while being elongated

That's why there are some people getting better with weight training that involves grip strength and arm extension and flexion, so it can be barbell row it can be biceps curl it can be triceps exercises anything that involves grip strength like gripping something hard(e

g dumbbell) the dumbell should be a little bit heavier than what you use for eccentric exercises so my recommendation is do the eccentrics with light weight first 1kg 2kg 3kg and get to 3 sets of 15 twice a day If you can do them without any problem, You can move onto weight training, and there is evidence slow heavy registance training is as effective as eccentric exercises So as long as you have eccentric components in your exercises, any exercise can be effective Plus, you need to work on spot-specific activities, depending on your goal

You're a golfer, you need to work on your speed If you're weightlifter, you need to work on heavy loading so I hope this video helps I'll see you next time Rehab safely!