Dana (not her real name) has been a dental hygienist for over 30 years and called to see if I could help with her tennis elbow and pain in her shoulders and neck. The clinical term for tennis elbow is lateral epicondylitis, and it happens when repetitive wrist and arm motions strain the tendons in the elbow. The pain will usually radiate from the elbow into the forearm and wrist.
It’s pretty easy to see from the description how tennis players are common enough victims of this condition to earn naming rights. But there are many other activities that require repetitive arm motions that could cause this pain as well. If you think that tennis elbow couldn’t possibly be the term for your arm pain because you’re not an athlete, you could be prematurely ruling it out. See if you can identify with Dana’s experience.
Physical Therapy Helped Temporarily, Then Made it Worse
As a dental hygienist, Dana engages in exactly the type of repetitive arm motions that can cause tennis elbow. Further, the way she needs to hold her arms and bend her spine and neck to perform cleanings could be causing neck and shoulder pain. She was also experiencing fatigue and weakness, though, which she wasn’t sure was related to her job.
Dana visited one physical therapist for the pain in her right elbow, which provided initial relief. Over time, the pain returned, and Dana tried a new physical therapist. This therapist used a different technique that involved “deep” work. Unfortunately, Dana felt more pain from that therapy, and even had bruising on her arm.
Rather than continuing with physical therapy, Dana decided to change her entire approach. She was hoping that a massage therapist would offer techniques that were gentler, but also that provided long-lasting relief.
Initial Consultation Guides the Therapeutic Massage Technique
Persistent pain is almost never attributable to a single cause. We all tweak a muscle the wrong way from time to time, and it usually heals within a week or so. But when that tweak comes back over and over, or the healing just never happens, something else is going on. When I meet a new client who has chronic pain, I assume there is an old injury at the root of their pain and ask questions to uncover it.
Dana, like most chronic pain clients, was surprised when I asked about any past injuries or physical trauma, even from a long time ago. She revealed that she was in a car accident 20 years ago, and then it clicked that maybe that was contributing to not only her right arm pain, but also the fatigue and weakness she was feeling.
Dana’s past injury indicated to me that her fascia, or the living matrix of tissue under the skin that connects the muscles to the joints and bones, had been affected. The fascia should be a fluid to promote smooth motion in the muscles and joints. When damaged, the fascia thickens or hardens. This causes pain, stiffness, reduced range of motion, and weakness from the increased tension in the body.
I recommended Myofascial Release as the therapeutic approach to Dana’s symptoms. After I explained my reasons for this type of massage and how it would promote her body’s self-healing mechanisms, Dana agreed. I also reassured her that the pressure would be gentle and manageable so that she wouldn’t have to be nervous about the pain she had experienced in previous therapies.
Reduced Pain with Myofascial Release and Ongoing Maintenance
After Dana’s initial session, she noticed an immediate difference. She felt much better at work, reporting reduced pain and far less fatigue than before. Prior to seeking massage therapy, Dana had been taking Advil a few times per day just to take the edge off the pain. Now she is taking it sporadically as needed. She returns for massage sessions every 2-3 weeks to continue the healing process and maintain the therapeutic effect on her muscles.
We may forget about an old injury, but that doesn’t mean our body has forgotten it. Damage to the fascia after an injury or repetitive movement often leads to chronic pain that can even spread to other areas of the body. The body can heal itself, even from long-term damage, with a little outside help. If you have been masking pain without ever truly feeling better, it may be time for something different. Contact me to talk about your pain points and learn whether Myofascial Release could help you stop masking the pain and start healing from it.