Tennis Elbow? Absolute Best Self-Treatment, Exercises, & Stretches.

Bob and Brad the two most famous

physical therapist on the Internet

hi I'm Bob Shrum physical therapist red

Hynek physical therapy we have the most

famous physical therapist on the

internet in our opinion of course Bob

Brad we've done a video on this before

but we're going to do kind of a

comprehensive one this is on tennis

elbow and these are the absolute best

treatment stretches and exercises you

can do in our episode and you've had

tennis elbow on both arms so you you're

you're a good sub a it's a very painful

when it's in in it's you know it's very

it's painful and it limits you a lot

people I think they're shocked how much

it hurts and the thing about this is is

you look perfectly healthy it looks

perfectly fine and you can just do the

smallest little motion like opening a

door and it just will bite and it lets

you know right now III yeah so alright

so what first thing is you know normally

what it involves it is the muscle going

into the tendon and attaching to the

bone here nine times out of ten that's

what it is

yeah and you're going to interrelate

generally a lot of times it's going to

hurt when you when you squeeze your hand

or bring your wrist up or deviate a

little bit this way that's the indicator

because it'll hurt down there those

muscles go all the way down the forearm

salt right I know one thing I do when I

have a patient

I'll palpate or feel on that bone and

usually where that bone is that connect

yeah very tender spot in there yeah all

right so you're going to start off with

ice massage I mean and maybe this is

something you've done already Brad you

watch Brad that's done yep you can just

take direct ice fill a cup up it can be

styrofoam or paper Bob likes to start

from I like paper ones better but it

doesn't matter fill it about this high

put it in the freezer so it doesn't tip

over freeze it solid and then peel away

the top so you have some ice exposed you

can rub the ice to get the sharp edges

off and go right over that area

I usually rub for five minutes the first

one or two minutes it kind of burns and

is little uncomfortable but then it goes

numb skin turns red and in five minutes

and I think you even do a little less

than that don't you by you I I mean if

you're really busy you can probably do

it in two three minutes it's going to

help it's going to help the second thing

that you may want to go ahead and invest

in a

race a tennis elbow brace yeah I like

the one by air cast here just me

personally Brad up it's worked well with


it's nice these they have a bladder on a

little air bubble thing there and you

usually put that over the sore area and

on the muscle belly just in front of it

stuff right there was a sore spot we're

going to go right in front of it and

you'll know because when you're on it

and you tighten this nut on the sore

area just a little bit off of it more

towards the hand exactly I thought I

said that it was a little confusing I

know I didn't say it very well did I but

what you're trying to do is take you

know the muscle the stress of the muscle

now is is a little bit more right here

instead of where it attaches right kind

of spreads it out did you use a brace

pad or not

yeah I use one and one thing I found

within other people have some patience

so mine is to get it in the right spot

sometimes when you're working if you're

working that physical type job and you

bend it it will get in the crux of your

elbow and it's uncomfortable so then it

would kind of bother you it all depends

on your situation but they are helpful

it was anyway it doesn't take away the

problem but it it seems to hell at least

you can work with it as long as your

elbows not real flexed a lot okay first

treatment you may want to do just just a

bob just wait right oh yeah by the way

before we go any further we want to make

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on alright moving on this is a this is a

very low level exercise but just to

start putting a little bit of stress on

the area without making it worse so all

you going to do is every you know

throughout the day you can do this every

hour in fact it's all you're going to do

is lift your make a fist and squeeze

you're going to feel a little bit of

pain but that's okay squeeze you don't

want to go to the sharp pain but a

little bit you do this ten times like I

said four to five times a day and you

notice he's got his wrist up we call

that extended that's the extended

position of the wrist and that's where

you want it not

like this all right now this next one is

one that we found a lot of people have

had a lot of help with Lonnie can you

throw me a pillow there's one over there

he meant to say a lot of success what

did I say help

oh well it's kind of true to it but it

has been a nice and it's not real hard

to do you can do it to yourself

so what we're going to do is yeah we're

cross-fiber friction massage you're

going to find the spot here right off

the bone and you're going to move a

little bit more towards the hand and see

the spot where you're going to you're

going to do this and you're going to

take one finger or two fingers you're

going to go across the fibers the fibers

are the muscles go this way so we're

going to take in the massage and go this

way yep

and what this does it because a lot of

times what has happened over time is

that scar tissue has formed in that

tendon or even a little bit in the

muscle Brad yeah and that scar tissue is

very weak and it breaks open very easily

so what happens is it starts to heal and

you think oh it's getting better

and then you use it and breaks open and

you starts all over again sure so this

helps it heal strong so like this in

instead of like a cobweb right we don't

yeah that's kind of we've got some other

things okay but it is definitely a nice

technique that's oh you're going to

you're going to go across like this and

you can do this for a good five minutes

if you can tolerate it and you can do

this every day if you like right if you

can tolerate it you'll know if it's the

right technique because when you start

will be a little painful but within 30

seconds to a minute the pain should

start decreasing it might be very

painful to start off and but yeah it

should level off at least if it's

getting worse and worse and worse as you

do this it may be too soon right you may

have to ice your back to give it a

little rest for a day or two put the

cold packs back on yeah

all right what we're going to do right

now Brad is so this is a great one to do

I really want you to focus on this was

probably one of the ones that will be

most helpful sure but we're also going

to show you some other techniques that

are maybe more for those stubborn types

of elbow that don't go away because

quite often what we'll see in people who

have tennis elbow is that that

particular elbow doesn't straighten as

much as the other L air not sometimes

you can compare the two and you'll see

it's just slightly bent and then these

techniques work out really well for this

so we're going to show the first one up

so if you find a doorway I'm

going to simulate this that this is a

doorway here you know I'm inside the

doorway what you're going to do is

you're actually trying to move this

lower floor arm that way while this is

supported by the doorway sure so it's

it's a little mobilization we're calling

it so I don't know if you can see it in

the camera you know here's a corner you

can you know it's just a molding of the

door a door jamb per head will keep your

thumb up okay

and while the thumb is up I'm taking you

know writing here in the between the

thumb and the first finger here and

pushing pushing and while I'm pushing

I'm pushing continuously I'm going to go

ahead and squeeze my hand like this and

while you're doing this it should feel

better right no pain with this this what

you can do first bad is do it this way

and that hurts yep okay you might even

squeeze a washcloth sure then you do it

this way and squeeze and it should feel

better if it does you know you're doing

there is I think this is a good

technique if it does that it's do you're

doing the right thing you can even do it

at different bends red you can do it

straightened okay and doing it different

way I had a golfer that she was a

semi-pro golf or okay and this actually

is what took work for her yup go ahead

well go back alright going back to some

of the other techniques now these are

different techniques for you to try and

see which one's work for you right again

if the elbow is not straining all the

way one technique very simple technique

they do is actually just have you turn

your arm this way and you just let it

drop sure you do that ten times and

you're doing kind of a little self

mobilization on the elbow and you know

you're doing the right thing is each

time you do it it feels a little bit

better yeah yep exactly if by some

reason it feels worse each time then

you'll stop the one I liked the one I

when I get a little bit of pain Brad I

actually just take my arm and I turn it

this way the hand is facing me and then

I go this way I turn it even a little

farther and bend it so he's rotating

low-rated this way the palma well in

this situation ten times I did want to

bring up something about this one I know

what patients have had and my own

experience is when you get out of bed

really painful obviously you're not

going to do this one early in the

morning you gotta be upbeat you might

try this one that that might that might

be work and it you can also go the other

direction where you turn the palm away

from you and turn it this way

and again I'm twisting it and bending it

at the same time and again if one of

these directions feels better with

repetition that's when you're going to

stick with because usually one will and

one will probably go on again that

worked for me i like i like this one i

would do it both directions actually it

worked out both way they're all worked

out for me another one to do brad this

one might be easier than the one we just

showed up against the wall you know put

your arm down your fingers are pointed

toward you okay like this elbow as

straight as you can

tie out of the way and now i again i'm

doing the same thing i'm pushing that

way yeah let's give them a different

view here so okay

forces that direction so pressure on

pressure off okay

pressure on pressure off about ten times

differently pressure off you have ten

times again we're looking for positive

results as you know smaller yep does

feels better as you do more

finally when when the pain is better you

want to do some strengthening Brad's

your show the eccentric strength you bet

I like to use stretch band or tubing

like this you can use like a dumbbell I

just think this is easier to vary the

resistance you're going to go down like

this take the other hand you're going to

help it up this is when you're starting

and then you're going to let it down

slow is called eccentric or negatives

which is a really good way to strengthen

a muscle jiù jiù jiù and as it gets

better you know maybe you can go into

the typical sure concentric yep

initially the eccentric really does help

healing right this is this is a really

gets directly to that I can feel these

muscles starting to burn already just

after them it looks easy but it's not

exactly alright if there's any other

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you take care of things