Video Transcript Below
Hand
Let’s take a moment to talk about the elbow, the wrist and the hand. Now, if you have something going on down there, it probably sounds something like golfer's elbow or tennis elbow.
You may have some pain or discomfort down at the base of your bicep. Carpal tunnel is a big one out at the wrist that we see all the time that can tend to lead to a feeling of weakness on one side versus the other. Maybe there's some numbness or some coolness, because you're not getting full blood flow. On the back side, we see ganglion cysts and then out on the hand itself.
Lots of things can happen on the hand, but the kind of stuff that we see most often are things like arthritis out on the thumb or sometimes out into the other joints. And if this sounds like something you've been putting up with, well, I'm not surprised pretty much everybody is going to put up with something like that at some point in their life, just like with back pain. I know I’ve had to put up with tennis elbow and I’ve had to rehabilitate it, and I want to talk a little bit about the process. So if you have something going on there, I have a feeling that you've probably already asked a friend or family member.
Maybe you've gotten on Google or you went to YouTube to try and figure out what's going on, and what can I do about it. You may have already tried to take some medications like maybe ibuprofen or Advil, or Motrin or Tylenol. You may have a muscle rub or something that you put on, or a tiger bomb to try and help it feel better, and I mean this is great.
I applaud you for taking initiative to try and figure out what's going on and to heal it yourself, because it's that initiative that separates the people who will get better faster and those where it may take a little bit longer.
Elbow
How are we going to treat elbow pain like golfer's elbow and tennis elbow? You know if you have sharp pain, if you have numbness, if you have throbbing or aching in or around the area or anything that goes down toward the wrist and hand or even up toward the shoulder, come and see me for physical therapy. Now, in the meantime, there are some self-treatment strategies that you can use and I have five of them.
First, we're going to start out with heat. Second we're going to do some self-massage. Third, we're going to do some stretching and mobilization. Fourth, we're actually going to work on some light strengthening of the elbow. Then fifth we're going to work on the shoulder itself. Let's go through each one of these. The first thing we're going to do is we're going to heat up the tissue to help make it more pliable, more malleable, improve the blood flow.
That way we can start to actually reduce the swelling, and how do we do that? Well, a heating pad is easiest. Now, if you don't have a heating pad, that's okay. Just soak a hand towel or washcloth in hot water, and you can use that. What you're going to do is you're going to heat the whole area all the way around for five minutes. So set a timer sit back, relax but just make sure it's not so hot that you burn yourself. We don't need to cause any other problems. Second, after you're done heating, what you're going to do is you're going to set another timer for five minutes.
You're going to get some sort of lubricant like moisturizer, something to make your skin a little bit more slippery and with a couple of fingers, placed right over the tender area. You're going to start moving in a few different directions. You're going to move lengthwise along those muscles and tendons all through the area. Then after a few beats of that you're going to go across massaging and moving and mobilizing the entire area. Then you're going to do circles or spirals that get bigger and spirals that get smaller and then you're going to go the opposite direction, a spiral that gets bigger and then a spiral that gets smaller. Then you're right back to the forward backward, your side to side and your circles. You're going to do that for five minutes.
The third thing that we want to do now, after everything has been heated up - and it's been mobilized and massaged by your hands - is we actually want to start using and moving the tendons. Here's a nice gentle progression that you can use, that goes from easier and gentler to a little bit more challenging for the elbow. You're going to start with your hand right by your side and you're going to bend your wrist inward. You do that five times. Then you're going to make a fist and do the same thing five times.
After you do it palm inward we're going to turn and go palm downward and the same thing. Start out with the hand flat. We're going to go palm down five times. Then again, you're going to make a fist guess how many times? Five more. After you've completed these with your elbow bent, you're going to reach forward. Imagine at this point, you're holding a cup. You're going to do the same thing five times and then we're going to go straight to palm down five times. Then, lastly, make a light fist, you're not squeezing as hard as you can.
You're, making a light fist and again going five repetitions down. What this does is it progressively creates a little bit more stretch. When I bend my wrist, it gets a little more stretch and a little more movement, kind of like we're flossing this tendon back and forth, through the angry, irritable, possibly swollen area, and that nice gentle activity done within your tolerance. We're not trying to create pain.
We're not trying to create any sharp discomfort, but within the tolerance that works for you, you gently allow the elbow and its tendons to move and work a little bit more pleasantly. The next thing you can do from a stretch perspective is you're going to start with your arm right by your side, you're going to make a fist and you're going to put that fist downward. Hang on to that and you're going to reach straight forward.
I've had this type of elbow pain bit before and the first few times I can't straighten my elbow all the way and that's okay, but the more you do it, the more your body gently allows you to be able to straighten out. As you get out there brief hold come on back in. You're, going to do about 10 repetitions of this and then relax. Shake it out a little bit, let the elbow breathe before you do your second set same thing.
Now, if you find you've been doing this for a few days, this is getting kind of easy. You add in just a little bit of a twist kind of like you're, reaching toward the outside, adding just a little bit more stretch along the outer side of the elbow for treating this tennis elbow. If you are working with golfer's elbow, the same activities apply for the active stretch and mobilization, we just go the opposite direction.
Instead of palm down wrist down, we go the other direction or if that doesn't feel so good, turn it over and go that way. Now the fourth thing we're going to do is we actually want to start to do some specific strengthening for these elbow muscles. With tennis elbow in mind, you can use anything now, for example, if you don't have any implements, like you know, hand weights or stretchy bands, that's okay, what you're going to do so, for example, I’m here in a park right now.
I have a rock right down here, this is what I’m going to use. What I do here is we want to use this muscle all right, but we're going to use it in a way that doesn't pull up and strengthen against it. We're actually going to put the weight in our hands when the wrist is bent like this and slowly lower it down so under tension again we're elongating we're stretching. It's a different way to strengthen that stimulates these muscles and stimulates these blood vessels to start to remodel themselves, in a way that helps them, move better and feel better over time and you're going to do a series of two to three rounds of 10 repetitions resetting every single time.
Take your time as you drop this down, and you can do this with your arm out in front of you just like I have it. If that is too uncomfortable, put your arm down by your side how we started our stretches and do the exact same thing. If this is still uncomfortable, you can sit down on a chair at a table and get your elbow supported by that table with the wrist hanging off the end, and you can do the same thing. That is strengthening for the elbow. Let's talk about the shoulders next.
Shoulders
Now last but not least are the shoulders. The shoulders are an important component of this because everything that happens down the length of the arm. All that movement all that support starts up at the shoulders and really a little further back at the shoulder blades. The last exercise, let me demonstrate for you. The arm position is going to be such that we go from in front of us elbows bent up to a pinching of the shoulder blades. Kind of making the letter W with our hands and our arms.
You hold that for two to three seconds and then relax. You're going to do 10 repetitions of that. But we want to add a component of resistance and we're going to use gravity as our resistance. Now there are many different positions you can do this in. The first one is what you're going to do is you're going to spread your legs out a little bit, you're going to stick your bottom out behind you and bend forward so you're in a position where you can squeeze back.
I'll show you the side view as well. Now one of the things that you may not be seeing right now is actually what's happening with my shoulder blades. I am doing a little bit of a pinch together. However, an additional component is as I squeeze back I’m actually trying to take my shoulder blades and tuck them down into my pockets back behind me. That is a key component because often times when we're trying to do work and exercise with our shoulders, you know these upper trapezius the muscles that tend to carry all of our stress those tend to get really excitable and we shrug our shoulders.
Well, we're trying to do the opposite. As we come back, we're actually trying to pinch and draw the shoulders back.