Robin Lansman D.O.
Osteopath established “Body Back-Up Osteopathy & Sports Injury
Clinics” in 1988. He runs workshops for
healthcare professionals at under-graduate and post-graduate in London, across the UK
and Europe.
He practices in London
(Maida Vale) and in Berkshire (Maidenhead).
A pain in the elbow??
Pain in the wrist or elbow is a
common problem in any profession where the hands are used for precise and
awkwardly angled procedures. The control
needed to use tools, together with the fact that much of the day's work involves
using the hands and forearms in this demanding way, also affects the amount of
pain experienced.
Using one part of the body to excess over a long period
eventually causes the tendons and joints to become inflamed and sore, which
then causes the muscles to tighten. This
is known as Repetitive Strain Injury (RSI).
In the condition commonly
referred to as Tennis or Golfers' Elbow, pain is normally felt within the
forearm muscles and in the area around the tip of the elbow. However, this is only one way in which RSI
can affect the arm.
If gentle pressure is applied to the bony parts around the
elbow there may be areas of soreness or pain.
The forearm muscles may feel tight and tender.
The tightest bundles of muscles
may even be detectable as bumps under the skin surface. This is a strong indication that muscles have
not been given a chance to relax.
But what can you do to prevent
RSI?
Some of the larger forearm
muscles that produce grip are also involved in the twisting action of the
forearm, for example, when suturing. The
difficulty arises when the hand is closed, holding the needle, because
contraction of the opposing muscle groups within the forearm is required to
produce the motion.
After a time, dependent on the
workload and the tightness of the grip needed, the muscles will stiffen, so
that the turning action gradually becomes harder to perform.
The strength of the grip will
further deteriorate, partly due to the fatigue of the gripping muscles but also
because of an increase in the pull of the opposing group of muscles.
How to treat yourself
1.
Application
of heat
If overused muscles have no chance to meet their normal physical needs,
then any damage to the tissue will be slow to heal. Surrounding the forearm in heat produces the
most efficient means of relaxing muscle.
Ideally a hot bath will do that job.
However, applying a wrapped hot-water bottle to the forearm to allow the
heat to permeate it fully may provide a more convenient alternative.
2.
Application
of ice
Ice can be applied to reduce both pain and swelling, but it is important to
use ice carefully. Since cold causes
blood flow to be reduced, people with poor circulation must be cautious of
over-cooling.
To avoid skin burn, ice should not make direct contact with the skin. Instead, a liable bag of frozen peas with a
paper towel between the bag and the problem area should be used.
The pack should be left on until the pain has been numbed by cold. This should be done for no more than five
minutes at a time.
3.
Self-massage
By using self-massage to the forearm, you can stimulate blood flow as well
as loosening and relaxing the forearm muscles.
This is cone by using the thumb of the other hand to apply pressure in long
even strokes along the length of the forearm, from the mid forearm towards the
elbow. Some areas will appear more
tender than others, and will require more attention.
Massaging should continue, even withstanding a moderate level of
discomfort. After several minutes the
level of soreness should subside.
If this procedure is followed while bathing the arm in warm soapy water,
the process is even more effective and comforting.
4. Stretching exercises
Gently stretching forearm muscles while they are not in use can help
overcome some of the stiffness within the forearm.
First, close the hand tightly and straighten the elbow, putting the forearm
muscles in tension. Slowly bend the
wrist backwards until stretch can be felt along the forearm.
Hold that position, and slowly bend the wrist forwards until tension is again
felt along the muscle.
Since no gripping work is involved, the tension developed will merely
stretch the muscles gently. If there is
a focal point of tenderness around the elbow, the range and intensity of wrist
movement must not cause stretch that might aggravate the muscle origins and so
worsen the problem.
5.
Use
of elbow braces
Reducing the repetitive pull on tendons on their elbow attachments is
another way of minimising the risk of RSI.
Where the elbow area has become particularly tender, firmly wrap a forearm or
elbow brace just beyond the elbow joint itself around the forearm belly of
muscle.
This will effectively transfer the muscle origins. The pull, therefore, becomes focused on the
brace instead of the elbow.
This measure is, however, of only short term value, since moving the muscle
origin attachment just causes the tension and muscular fatigue to be confined
to lower in the forearm.
A brace can be purchased from chemists and sports
shops – ask for advice if you are not sure of your size or how to position the
brace properly or ask us at BODYBACKUP!
If the symptoms worsen or show no response to self-help measures, you should
seek professional advice.
