RSL: Right Lateral Epicondylosis: Week 4 (2-5-18)

  • Week 4
    • Recap from email follow up
      • Reports some concern that after the exercises the pain returns to being the same it was prior to the movements
      • This week will include some single arm movements highlighted below in bold
        • I would like to know specifically which movements reproduce pain or feel much weaker on the problematic arm
        • You will see in bold:
          • IS THIS DIFFERENT IN ONE ARM COMPARED TO THE OTHER
          • Please let me know specifically how these feel
    • Organization
      • Monday: daily movements
      • Tuesday: daily Movements + strength Circuit #1 (2x through the circuit)
      • Wednesday: daily
      • Thursday: Daily + Strength Circuit #2 (2x through the circuit….ice after)
      • Friday: Daily
      • Saturday: Daily + Strength Circuit #1 and #2( 1x through each)
      • Sunday: Daily
    • This  week we will continue to progress upper extremity strength, specifically trying to identify movements that feel weaker in the problematic upper extremity
    • I recommend that all single arm movements be done on both arms to attempt to assess if one arm is much weaker then the other
    • You will continue to do the daily movements with incorporation of a couple alternative positions to try
      • The goal with the daily sequence is to establish a sequence of 4-5 movements that you do daily to move areas of your body that typically don’t move enough during our day
      • As new options are introduced you want to pick and choose the movements that you feel are most beneficial
      • Judge that based on movements that feel really tight or movements that feel good/ pull on areas  that typically feel tight/uncomfortable
    • Strength Circuits
      • These will begin to get more challenging, so be careful with all newer movements
      • Each exercise will have a goal for time or for a certain number of reps
      • If you achieve the goal, you are probably ready to increase the resistance or the challenge
        • For example: I usually give a range of 8-20 reps for an exercise, if you get to 20 reps, you are probably ready to increase the weight and start back at 8-10 reps again gradually working your way up to 20 reps
        • Make sure you don’t rush it and end up increasing pain
        • IDEALLY: You should feel fatigue in muscle with very little to no tendon pain
        • If you are getting tendon pain, you want to adjust the parameters of the exercise to see if you can keep it less painful
          • This could be less weight, going through less motion, doing less reps
    • Try the strength sequence every other day
    • Kinesiotape may be helpful in reducing pain as we go through this process. Below is a video of a kinesiotape option that patients have reported to provide pain relief as we are in the process of strengthening the muscle tendon unit
  • Daily Sequence