Wrist Pain from Elbow Dysfunction

Friday, May 10, 2024

AMT BLOG/Performance/Wrist Pain from Elbow Dysfunction

Wrist Pain from Elbow Dysfunction

A Simple Case Study for Regional Interdependence

I feel we can all agree that pain is a signal to pay attention to the body, and often correlates from some form of overuse or misuse of tissues.

Now, from my years of experience, what I've seen is that the painful area is seldom the cause of the pain, but the symptom.

In this quick fix case study, the athlete demonstrated with some very local ulnar wrist pain that only occurred with a very specific loaded movement, that being the barbell bicep curl.

Now to be clear, I'm defining a quick fix in this case not as a short term solution to an immediate problem, but within the context of the assessment location and time allotted to solve the problem.

Moving right along,

This particular athlete came to me after Jiu Jitsu, or rather in Jiu Jitsu class, reporting ulnar wrist pain anytime he performed bicep curls.

Working from first principles of looking from the Top-Down and Centre-out I had him perform some active upper limb neural tension tests (ULNTT) for the median and ulnar nerve, both of which were negative.

Active range of motion of the neck, shoulder and wrist were optimal and non painful (ON).

However, when looking at the elbow, he had difficulty actively supinating the elbow without creating compensatory movements elsewhere on his right side, and passive supination was suboptimal as well.

Thought that was interesting and would come back to that later after I had a look at the wrist.

Low and behold, the wrist was moving great, structural testing was all negative.

When performing resisted range of motion on the wrist flexors in the supinated position this reproduced his pain,

But, when testing in the pronated position there were no issues.

Already I knew that this is a positional/movement issue and not a structural problem, since the flexors worked just fine in the pronated position.

I started to palpate up the medial fascial arm line and found a nice juicy trigger point in the pronator teres muscle.

I thought well, what would happen if I continued to poke on this trigger point then retest the wrist flexors in supination.

At that moment his strength magically returned and pain with resistance fell from a 7/10 to a 1/10, hallelujah it's a miracle.

No it's not magic, it's just using critical thinking and not getting sucked into local pain problems with local solutions.

So, since he was going to be on his own for this one, I showed him where to poke (put pressure), what to move and how to load it up to “lock it in” so it doesn't return.

And in this short video, we go over some basic mechanics of the elbow and its influence on the wrist and some fast and effective strategies you can use for your clients with similar presentations.

But more importantly, what I want you to take away is a different perspective on how to approach local pain issues with a more global approach, for greater outcomes.

Be Your Best,

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Hi, I'm Tom Swales

Founder of the Advanced Movement Therapist Certification & AMT System

I'm a seasoned Physiotherapist and Strength Coach and on a mission to elevate orthopedic healthcare globally. I love to simplify complex practices and through the AMT system I'm empowering clinicians to deliver precise treatments and speed up patient recovery.
Let's set new standards & get patients better, faster!

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