Lateral Epicondylitis (tennis elbow) is a condition where the attachment of the wrist extensor muscles to the distal humerus becomes irritated.
The natural healing mechanisms of the body can fail in attempts to repair the tissue damage. The condition, and the debilitating symptoms, can become chronic. Sufferers can complain of the difficulty grabbing and lifting objects, and participation in the activity that started the symptoms is often impossible.
“Tennis elbow” is common in carpenters and manual laborers, and has been known to afflict politicians. Lateral epicondylitis is called tennis elbow because arguably the most common occurrence is in tennis players hitting a backhand. The biomechanics that is common to all of these scenarios is the firm grasping of an object. When the finger flexor muscles contract to grab something, these muscles will also flex the wrist. The wrist flexion is not desired and will actually weaken the grip. So the wrist extensors must contract to offset/negate the wrist flexion. Traditional efforts to resolve the symptoms are directed at the elbow, but practitioners of Applied Functional Science also will recognize, evaluate, and treat dysfunction in other locations that are negatively impacting the functional activity.
Looking for the suspect that is causing excessive stress to the wrist extensor starts with trying to identify the activity that precipitated the problem.
The Chain Reaction biomechanics of the activity will suggest the potential causes. It is especially helpful to look at the Transformational Zones, where the movement changes direction from loading to exploding. Let’s use the one-handed tennis backhand as our example. Not only does the player need to grip the racket firmly, but the ball will create a sudden and forceful stretch to the wrist extensors at contact. Without good load and explode of all the joints involved in the backhand stroke, the stress to the muscle attachment may exceed the tolerable level.
The essential loads for a right-handed player are:
- Subtalar joint pronation and ankle dorsiflexion to allow the left foot to maintain firm ground contact
- Good hip motion to load the powerful posterior hip muscles. Hip internal rotation is particularly critical
- Thoracic rotation to the left with a variety of motions in the other planes depending on the height of the ball
- Cervical rotation to the right created by watching the ball and the trunk rotating to the left
The challenge of assessing all of the above probable suspects can be daunting without a movement strategy that integrates all the joints in global movements that can drive the client into and out of the Transformational Zones. 3DMAPS was designed to do just that in each of the planes of movement, and with minor tweaks can be adapted to the specific activity. For the “backhand suspects” the …
- Right Anterior Chain will assess dorsiflexion
- Left Posterior Chain will assess hip flexion
Right Opposite Side Lateral and Opposite Side rotational will assess the subtalar joint pronation as well as hip adduction and internal rotation
Left Same Side Rotational and Right Opposite Side Rotational will assess left thoracic rotation. These chains will also assess right cervical rotation with a simple tweak of head position.
Not only will the six movements of the 3DMAPS Analysis identify which of the suspects is the cause, but the Performance component will provide the basis for resolving the dysfunction that was the cause of the lateral epicondylitis.