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Letter of 4/27/2021 Tennis Elbow? Scapular Stabilization might help

4/27/21


Hello Yoga friends, I know a lot of people have tennis elbow type issues as well as other wrist and hand issues.  One of the things I have seen in class is that if your wrist is tight your shoulder is most likely tight as well.  We know that whole line is connected. If one part isn’t moving well, the other part will take up the slack and over do.  And that’s what creates a problem. I just got this email from Jory Serota about the importance of Scapular Stabilization or how to strengthen your shoulder to support your elbow. I decided what he had to say was worth sharing.

In 2007 I was hired as a massage therapist at the US Open tennis tournament.  I grew up as a competitive tennis player and followed the game closely but I had never worked with professional athletes before.

I was soooooo nervous.

In the 3 weeks from when I was hired to the start of the tournament I read everything I could on treating common sports conditions like tennis elbow, rotator cuff injuries and low back pain.

In my first 10 days at the Open, I worked on about 60 players.

Not one presented with tennis elbow.

I began working other tournaments and it became quite clear, tennis players don't get tennis elbow.  In my 6 years on the tour I only treated one case!

One day, at the SAP Open in San Jose I discussed this with the tournament doctor.  His response made perfect sense...

Professional tennis players don't get tennis elbow because they spend so much time training their rotator cuff and scapula.  This gives them the stabilization in the shoulder so the elbow doesn't have to absorb extra shock.






Tennis elbow, known as lateral epicondylitis (LE), is a micro-tearing and inflammation of the common extensor tendon of the elbow.  


LE occurs when the common extensor tendon is overloaded by repetitive actions of the hand and wrist.  This causes degenerative changes, disorganized collagen bundles and scar tissue.  There are varying degrees of intensity to LE but at its worst it becomes near impossible to turn a door knob or pick up a cup of coffee.

Conservative treatments include soft tissue massage, strengthening the forearm muscles, acupuncture and wearing a brace.  But as the doctor and I discussed, researchers have identified shoulder girdle weakness in patients with LE.  Joseph Day and Heather Bush specifically observed scapular weakness in their clinical study on the subject.  1">https://pubmed.ncbi.nlm.nih.gov/25579691/"> 1

One rationale for strengthening the scapular muscles is based on the Kinetic Chain Theory (KCT). The KCT proposes that during functional arm motions kinetic energy is transferred from proximal to more distal segments of the arm, providing an effective and efficient mode for distal function. 
 As a result, proximal weakness increases the demand on the distal segment therefore overloading the distal segment. Without proper proximal scapular strength, there is an increased load on distal tissues at the elbow and wrist. 2">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6769266/#B12">2

Basically, if your shoulder is weak, your forearm is likely going to pay the price.  



For those suffering from LE or many other shoulder conditions, the following sequence should be quite helpful.  

Here is the video link.   https://www.youtube.com/watch?v=1oW5HxTYDwI

And the link to his website. https://appliedyogaintegration.com


We will be doing some of these things in class.  Seems like we all can use them.

See you in class!Julie