Tag Archives: mobilisation

Role of Shoulder Stability Behind the Tennis & Golfer’s Elbow

Elbow Anatomy

At Melbourne Massage and Treatment in Fitzroy North, we frequently encounter clients dealing with tennis elbow (lateral epicondylitis) and golfer’s elbow (medial epicondylitis). These conditions can cause significant discomfort and limit your ability to enjoy sports and everyday activities. While they are often associated with repetitive arm and wrist movements, it’s essential to consider how poor shoulder mobility and stability can contribute to these issues. What Are Tennis and Golfer’s Elbow? Tennis Elbow Tennis elbow affects the outer part of the elbow, causing pain and tenderness on the outside. This condition typically arises from overuse of the forearm muscles, especially those responsible for wrist extension. Activities such as painting, or even prolonged computer use, or overstreching of extensor muscles can trigger this condition. Golfer’s Elbow Conversely, a golfer’s elbow affects the inner part of the elbow, leading to pain on the inside. This condition is commonly associated with activities that require gripping, flexing the wrist, or repetitive forearm movements, such as golfing, throwing, or lifting. In this presentation is the common flexor tendon that get’s irritated, and refer with pain. The Connection to Shoulder Mobility and Stability While tennis and golfer’s elbow are localized conditions, they often stem from dysfunctions higher up in the kinetic chain, particularly in the shoulder. Poor shoulder mobility and stability can lead to compensatory patterns that place undue stress on the forearm and elbow joints. Shoulder Mobility Limited shoulder mobility can restrict the natural range of motion for various activities. For instance, if your shoulders lack mobility, you may overcompensate with your forearm muscles during tasks that require reaching, lifting, or throwing. This overcompensation can lead to strain, resulting in conditions like tennis or golfer’s elbow. To maintain proper shoulder mobility, you want to ensure the use of the glenohumeral joint along your exercises and move it with specific drills, as this would stimulate the joint synovial fluid and maintain the joint lubricated. On the other hand, if the joint is hypermobile, we should look into how to stabilize it better. Shoulder Stability Shoulder stability is crucial for maintaining proper alignment during movement. Weakness in the shoulder stabilizers can cause the shoulder joint to become unstable, leading to altered movement patterns. When the shoulder isn’t stable, the body often compensates by engaging the forearm and elbow excessively, increasing the risk of injury. As mentioned in the paragraph above, this is what would occur when someone presents with a hypermobility body. In the hypermobility presentation, the ligaments are more lax and don’t hold back the joint movement as expected. Assessing and Addressing the Issue At Melbourne Massage and Treatment, we recommend a comprehensive approach to address tennis and golfer’s elbow effectively: Assessment of elbow epicondylitis Understanding the root cause of your pain is vital. During an initial consultation, we still mainly focused on your elbow presentation and addressed what movement reproduced the discomfort. But not only that. Throughout a tailored investigation, we will address what could be the root cause of the problem. This way, it would be easier to develop a tailored treatment plan. Treatment for elbow epicondylitis Massage Therapy: Targeted massage can alleviate tension in the forearm and improve blood flow, promoting healing. MDN: Myofascial Dry Needling plays a really effective role in tendinitis management. It focuses on targeting the underactive muscles, restoring the neural connection between the central nervous system and muscle, and desensitizing the painful area. Mobilisation: Mobilisation is an ideal technique to address mobility issue, and improve the range of motion of a joint. For epicondylitis presentations, the mobilisation could focus on wrist, elbow or shoulder. This would be based on the finding along the assessment. Strengthening Exercises: In the exercise program, we will initially focus on exercises that can desitentize the elbow area, such as isometric holds, and then move to eccentric and concentric exercises. In this second step, we would already focus on specific shoulder mobility or stability exercises, as needed. Education Understanding proper biomechanics can empower you to make lifestyle changes that prevent future injuries. Giovanni will guide you through exercises and techniques to maintain shoulder health and prevent elbow pain. Conclusion Tennis and golfer’s elbow can be debilitating, but addressing shoulder mobility and stability is key to recovery and prevention. At Melbourne Massage and Treatment in Fitzroy North, Giovanni is dedicated to helping you achieve optimal function and well-being. If you’re experiencing symptoms of tennis or golfer’s elbow, don’t hesitate to contact Giovanni or Book Now your 15-minute free phone consultation to learn more about a personalized assessment and treatment plan. Together, we can work towards getting you back to the activities you love, pain-free. FAQ Q: What are tennis elbow and golfer’s elbow? A: Lateral epicondylitis, affects the outer part of the elbow, causing pain due to overuse of the forearm muscles, particularly those responsible for wrist extension. Common activities that can trigger it include painting and prolonged computer use. Medial epicondylitis, impacts the inner part of the elbow, leading to pain often associated with gripping, flexing the wrist, or repetitive movements like golfing or throwing. Q: How are shoulder mobility and stability related to these conditions? A: Poor shoulder mobility can lead to overcompensation by the forearm muscles during activities requiring reaching, lifting, or throwing. Similarly, weak shoulder stabilizers can cause the shoulder joint to become unstable, forcing the forearm and elbow to work harder, which increases the risk of injury. Both factors contribute to the development of tennis and golfer’s elbow. Q: What are the signs of limited shoulder mobility? A: Signs include restricted movement during overhead activities, difficulty reaching behind your back, and discomfort during routine tasks that involve lifting or throwing. These limitations can lead to compensatory movements that stress the elbow. Q: How do you assess tennis or golfer’s elbow at Melbourne Massage and Treatment? A: We conduct a thorough assessment that focuses on your elbow presentation, identifying movements that reproduce discomfort. This investigation also explores potential underlying issues related to shoulder mobility and stability, helping us understand the root […]

Joint Mobilisation

Feet Metatarsal Mobilisation

Joint mobilisations are manual therapy techniques that improve joint mobility and flexibility and reduce joint pain. Joint mobilisation can be applied to many body joints. Some contraindications have to be taken into consideration for mobilisation: Joint swelling Osteo Arthritis Bone Fracture Bulge disk (if the mobs are intended on a vertebra) Mobilisation VS Adjustment. Mobilisations are different from Chiropractic adjustment. The difference is that Chiropractic adjustments are fast movements applied with more significant pressure. Mobilisations are constant slow, repetitive movements applied to the joint. Along with a Myotherapy treatment, Giovanni would evaluate if mobilisation is the proper treatment for your condition. For example, mobilisation along the spine is recommended when someone presents with a stiff back in the sacrum, lumbar, thoracic or lower cervical area. Giovanni would always double-check with you about what the mobs felt like. Types of Mobilisation. As we already know, the body is made of different types of joints. Given the different types of joints, like socket joints, plane joints and more, others are the type of mobilisation. For example: For a joint like the hip, we can apply mobility like a distraction, anterior-to-posterior pressure or posterior-to-anterior pull, internal rotation or superior-to-inferior pull. Some of these techniques can be applied to other joints, and each way of using a mobilisation aims to improve a specific range of motion. So, all up, the type of mobilisation that we have are: Superior to Inferior; Inferior to superior; Distraction; Posterior to Anterior; Anterior to Posterior; Posterior glide; Anterior glide; Lateral glide; Medial glide. Mobilisation Belt. A mobilisation belt can be used to deliver the mobilisation based on the joint we aim to work on. A belt is a tool wrapped around the designated joint we want to work on and is used to apply stretches that would not be as easy to achieve by hand. An example is a hip distraction. For distraction, we refer to it as a force that pulls a joint apart. In the case of a hip, the head of the femur is pulled away from the hip’s socket from the medial to the lateral direction. As you would imagine, using bare hands for applying this technique not only could result in an uncomfortable approach to the intimacy of the patient, but it would requireFr too much effort for the therapist, resulting in poor mobilisation delivery and risk of injury. Therefore, the best tool is a belt wrapped around the patient’s hip and the therapist’s waist. Why use the mobilisation technique? The mobilisation technique aims not to reproduce pain, cracking sound, or sharp sensation. Indeed, the aim is to reproduce a firm pressure/pull on the joint area. Regarding the thoracic area, if any of those vertebrae reproduce pain or sharp sensation, applying the mobs along the vertebrae/ribs joint would be better. Doing so would still possible to affect spine mobility indirectly. Giovanni’s training for this type of modality started during the Advance Diploma in Myotherapy at RMIT and continued at the Bachelor of Health Science at Torrens University. Mobilisations technique can be applied to Big Toe, Ankle, Shoulder, Feet, Hip, Wrist, Elbow, Vertebrae, SIJ joint, Facet Joint, Clavicle and other body areas. An example of joint mobilisation for the feet. Mobilisations at the ankle area are used for improving ankle mobility. Indeed, improving ankle mobility is to better support during the walk, standing and or running. Always talking about the feet area, the mobilisation applied to the Big Toes is used along the Metatasolphalangeal Joint. Do you feel your joints stiff? Your booking for a Myotherapy treatment with Giovanni is just a click away. This mobilisation is applied by creating a distraction movement within the joint, pulling the toes away and then using it for passive flexion and extension. As mentioned in another blog post about wearing bear foot shoes, the Big toes are meant to extend from 65° to 70°. Conclusion The Big Toes are the feet joint that should push the most in the feet strike as we walk. In conclusion, mobilisations are a great way to increase mobility within a joint allowing better movement and improving the range of motion.

Myotherapy

A Hand inserting needle in to a forearm for a dry needling session

Myotherapy is a massage technique to treat or prevent soft tissue pain and restricted joint movement. “Myotherapy” stands for “Myo” Muscle “Therapy” therapy. In Australia, and specifically in Melbourne, it is a practice that took over the massage market in the last few decades and is not becoming more and more popular. There is Dry Needling and Joint Mobilization along the different techniques used in a Myotherapy treatment. Is Myotherapy Safe? Yes, Myotherapy is a safe treatment. Said so, you want to ensure that the therapist treating you has their qualification up to date. Here is a link to my qualification. What about Dry Needling in a Myotherapy Treatment? Dry needling is one of the many ways a Myotherapist can treat a client, but it is unnecessary. Before using needles, the therapist always has to double-check with the clients the following: No metal allergy No bleeding disorders No needle fear or phobia The client feels comfortable with such treatment The therapist does explain how dry needling works Is Myotherapy available at Melbourne Massage and Treatment? Yes, it is. I am a fully qualified Myotherapist who completed an Advance Diploma in Myotherapy at RMIT University. On top of all, I am now enrolled in the last year of my Bachelor’s Degree in the Myotherapy Clinic at Torrens University. What’s the difference between Myotherapy Treatment and Remedial Massage? Myotherapy is similar to a Remedial Massage session. The difference is that a Myotherapist has more knowledge about the human anatomy, joints, and functionality. So before the session, the therapist would guide the patient through a specific range of motion to evaluate the body’s presentation. Done so, the therapist has an idea of what can be done to improve the body’s presentation. Furthermore, a Myotherapist is trained to use mobilization, which is a repetitive joint movement to improve the joint’s range of motion. My favourite “mobs” are along the spine. They consist of a gentle push over the transverse process of the spine. Applying this constant firm push, the transverse process gain mobility, allowing all the muscle inserts originating from that joint to be more mobile. Is a mobilization the same as what a chiro does? No is not. The Chiro makes an adjustment, which is a fast joint pull or push, to adjust its position or functionality. Along with an adjustment, the patient has no control over the fast movement. Indeed, during mobilisation, the patient can take control of the push and stop the treatment if he/she does feel uncomfortable. Book Now your Myotherapy treatment with Giovanni. Giovanni is available in Fitzroy North at 175 Holden St Monday to Saturday 9 am to 7pm.  


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