Lateral epicondylitis/epicondylosis, also known as tennis elbow, is a painful condition in which the soft tissues on the lateral aspect of the forearm become strained from overuse, commonly referred to as repetitive strain injuries (RSIs). It is commonly seen in laborers who work with tools/instruments, anything that requires maintaining a stronger than usual grip strength for an extended amount of time can contribute to this condition.

When the muscles on the lateral aspect of the elbow finally breakdown and cannot handle the repetitive strain any longer, the muscle fibers microscopically tear. The pathophysiology of lateral epicondylosis is degenerative. Non-inflammatory, chronic degenerative changes of the origin of the extensor carpi radialis brevis (ECRB) muscle have been identified in surgical cases.

The flexor muscles of the forearm should not be ignored in these cases.  It’s common to find adhesions in the forearm flexors in someone who is battling tennis elbow.  The flexors become overworked and the repetitive strain they undergo can wreak havoc on the extensors of the forearm.  It may not be where the patient is “hurting”, but stubborn cases require you to think outside the box and investigate elsewhere if the condition isn’t improving.  That being said, the forearm flexors are definitely worth looking at.

There are many different manual therapy methods that can help in treating soft tissue dysfunction and repetitive strain disorders (RSDs).  We offer Active Release Techniques (ART) to our patients who are dealing with pain in muscles, tendons, nerves and/or ligaments.  Using a combination of ART, chiropractic, Game Ready, and exercise rehabilitation, our patients typically recover from their injuries in a more timely manner.  Implementing stability and/or mobility drills for patients will help them maintain the positive changes that have been made ultimately leading to a complete recovery.

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