Gradually progress the duration of the stretch up to 10 seconds. If there is any pain or tingling in the arm or hand then stop immediately. Hold neural stretches initially for a maximum of 5 seconds. This neural stretch may be beneficial in helping to release tension, especially in conjunction with sports massage. Pain in the elbow may be contributed to by tension in the neck. Hold for up to 20 seconds and repeated up to 5 times. The forearm can be rotated inwards to increase the stretch which will be felt more on the outside of the elbow. Pull the hand towards the body to feel a stretch in the back of the wrist, forearm, and elbow. The arm is placed in front with the hand pointing down. Stretching should be maintained throughout the rehabilitation program and continued even after your injury has healed. Neural stretches will also be given as part of physical therapy. Stretching exercisesĮxercises to stretch the forearm muscles and in particular, the supinator muscles can be done as soon as pain allows. In severe or persistent cases a surgeon may operate to decompress the nerve which is generally successful. Massage will pump blood into the muscle, reducing muscle spasms and helping to relax any tension in the muscle. However, tennis elbow is usually caused more by repetitive wrist extension or bending the wrist back. This simply means turning your hand/forearm over. Radial tunnel syndrome is more common in those who pronate and supinate the arm repetitively. This may occur at several locations in the elbow and upper forearm. It is the posterior interosseous nerve that may become entrapped or compressed. These are the superficial radial nerve and the posterior interosseous nerve (PI nerve). The radial nerve divides into two branches at the elbow. If pain is reduced when ‘palpating’ (pressing in) at the tender spot on the muscle, then Radial nerve entrapment may be a cause. One aid to diagnosing radial nerve entrapment is to inject a local anesthetic into the muscle.Extending (straightening) the middle finger against resistance.Resisted supination (turning the palm of the hand up against resistance).Specific tests to help diagnose radial nerve entrapment will reproduce pain on: You may also experience aching in the wrist, or pain may also radiate upwards into the upper arm.In particular, maximum tenderness in the supinator muscle at a point about 4-6 cm down from the lateral epicondyle (a bony bit on the outside of the elbow).Tenderness may be felt in the muscles of the upper forearm.Pins and needles, or tingling in the hand and outer forearm.The symptoms of radial nerve entrapment are very similar to those of tennis elbow.
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