'Not Always Tennis Elbow'
Lani Guskich - Elite Myotherapist
Recently we had an office manager in her 40's present to the clinic with a constant ache in her right forearm. The pain radiated down the outside of her elbow, into her forearm, wrist and thumb. She had been experiencing this pain for approximately three months.
The patient in question had a past history of tennis elbow which had affected her other forearm and had been rectified with treatment over 18 months ago. When the patient had first started to notice the pain, she had seen her doctor who diagnosed it as extensor tendinopathy or more commonly, ‘tennis elbow’. She was advised to manage it as previous with a forearm brace, stretches and rest from aggravating activities.
Unfortunately, following this advice had made no change to the pain levels she was experiencing, and if anything the pain was slowly progressing. At this point she came to me to see if Myotherapy could help.
After a thorough examination of the patient's wrist movements and palpation of the areas normally involved in tennis elbow, I wasn't convinced that she had been given the right diagnosis. She definitely had tightness in the associated musculature, but I felt there may be more going on. In the first treatment I focused on the elbow, forearm and wrist along with the neck and thoracic spine. I also did a little work to help her posture as she was spending long hours hunched over a computer. I sent her home with some forearm strengthening exercises and general stretches to help with her posture.
Unfortunately, this patient had reported back that the first treatment hadn't been successful in changing her pain levels. As the first treatment had predominantly focused on the diagnosis the doctor had given of ‘tennis elbow’, my suspicions of a misdiagnosis were correct. In this session I focused much more on her neck and freeing up the neural network that runs from the neck down the arm. I also changed her ‘at home’ exercises to neck strengthening and postural realignment. After this shift the patient reported a definite change in her symptoms, albeit a small one. Change though, however small is always positive.
As this particular patient spent eight or more hours a day on the computer, I felt posture was going to be a huge factor in her recovery. I had previously prescribed strengthening exercises 3 x per day, which she had been very vigilant in doing. However, due to the nature of her job I started to think that may not be enough. I asked her to try them hourly, which she was happy to try.
I called her three days later to check on her progress and the patient had already noticed a big shift in her pain levels. The C5/C6 level in the cervical spine (neck) has a similar pain pattern to tennis elbow, if there is irritation or injury. Her forearm pain was referring from her neck and due to her previous history, a diagnosis of tennis elbow was too hastily made.
With the right exercises and treatment this patient happily made a full recovery.