Monday, April 5, 2010

Neural Glide, Median Nerve @ the Pronator Teres/Flexor Digit. Superficialis

Phil Donley feels that medial elbow syndrome in pitchers is a result of faulty mechanics elsewhere. If you treat the kinetic chain dysfunctions that created the injury, the elbow will get better without any further intervention(provided of course that the injury has not progressed to an MCL tear etc.). Different from the traditional reductionist approach that focuses on a lot of wrist curls/pronation exercises etc.

I agree with him for the most part; the injury most likely had nothing to do with weak elbow muscles. However, the medial structures have been overloaded to a large degree. If you run your IASTM tools over the area, you'll pick up the myofascial restrictions in the area. A valgus stress test may pick up pain/laxity over the MCL.

I'll do plenty of ART to the distal brachiialis & triceps, flexor muscles and pronator teres. Do some strumming and DTFM with the instuments over the MCL and flexor tendons. And, neural glides to the ulnar and median nerves.

Here I'm using my thumb to hold the pronator teres away from the flex.digit.super. and flossing the median nerve through. At the start, the head is side bent away, while the shoulder is abducted, the elbow is extended & pronated, and the wrist and fingers are also flexed. The athlete side bends his head toward the same side shoulder as I bring the arm into the "waiter" position. At that point I switch my thumb contact distally, holding the flexors away from the pronator teres, as I bring the arm back to the starting position and the athlete sidebends his head to the other shoulder.

All the techniques mentioned above only take a few minutes and feel great.