Repetitive Strain and the Elbow

The elbow is one of the areas of the body most subject to repetitive strain because of all the tendinous attachments. Not only do the flexor and extensor tendons attach there, but also the tendons of the finger flexor and extensor muscles, and the tendons of the muscles that produce pronation and supination. With all these tendons having to operate within such a small area, it is easy to see why the elbow is vulnerable to injury. Tennis and golfer’s elbow are the most commonly known elbow injuries, but the use of the mouse has also created its own brand of elbow strain. Overuse of the finger flexor muscles also contributes to elbow tendinitis. One of the most common ways to treat elbow tendinitis is cross fiber massage. The theory is that by breaking up adhesions, the function of  the tendon will be restored. I do not disagree with this. However, I believe this to be an intermediate step in a successful treatment program. First we have to ask ourselves, what causes elbow tendinitis?

Clearly, a repetitive action that the body cannot withstand is the cause. But what conditions have made the elbow vulnerable? For example, in lateral epicondylitis, quite often the tendon of the extensor carpi radialis brevis becomes inflamed. Why? Is it possible that is compensating for a weak muscle that shares its function? I often find that the extensor carpi radialis brevis is compensating for weakness in the grip or in the finger extensor muscles. Test the grip by either the shaking the person’s hand (if this produces pain in the elbow you know you have a compensation). You can also place the thumb and pinky finger together and try to pull them apart. If this tests weak and produces pain in the elbow, you know you have a compensation pattern. This assessment technique can also be applied to any of the muscles that attach to either the lateral or medial epicondyle. A weak supinator muscle can cause pain and tightness in the pronator teres. Overuse of the finger flexors during such activities as typing can cause the finger extensors to become weak, thus creating inflammation in the carpal tunnel. But how do we treat this?

The NeuroKinetic Therapy protocol allows the practitioner to integrate into it any release technique that he or she already knows. First test the muscle you think is weak. Then, find a tender spot on a muscle that you think is compensating for the weak one. Keeping your finger there, retest the weak muscle. If it tests strong, then release that spot. This is called therapy localization. After 30 to 60 seconds of release, retest the weak muscle. If it tests strong, you have successfully reprogrammed the dysfunctional movement pattern. For homework, have your client stretch the tight muscle first followed by strengthening the weak muscle. It is crucial that the exercise is done in this exact fashion. For a wonderful therapeutic device for the elbow please go to

NeuroKinetic Therapy is the perfect complement to many bodywork techniques because it’s protocol allows the practitioner to incorporate whatever release technique he or she already utilizes. In the case of repetitive strain to the elbow, assessing the compensation patterns, followed by treating them and assigning an exact therapeutic exercise, leads to a successful outcome.