How to Have Healthy Wrists, Forearms, and Elbows

By Dr. Ben Kim
DrBenKim.com

Tennis elbow, golfer's elbow, chronically tight forearm muscles, chronic wrist pain - these are all common health challenges that can largely be prevented and treated by simple stretches and pressure work.

Tennis elbow refers to inflammation of the tendons that attach to the outside or lateral part of the elbow.

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The tendons that attach to this region are the ends of the muscles that line the back of your forearm. These muscles and tendons allow your hands to grip and move objects. Try making a fist and curling it towards you - this movement should allow you to feel a stretch in the muscles that line the back of your forearm. If you strain these muscles and their tendons enough, you can develop tennis elbow.

One of the keys to allowing tennis elbow to heal is to rest your wrist and forearm. Specifically, you want to avoid activities that involve tightly gripping objects and/or curling your hands toward you. By resting your wrist and forearm, you can give the muscles and tendons in your upper forearm a chance to heal.

Often times with tennis elbow, there is chronic tightness in the muscles that lead up to the inflamed tendons. This makes perfect sense since it's overuse of these muscles (wrist extensors) that leads to inflammation of their tendinous attachment points. If these muscles remain hypertonic, you may have a difficult time fully recovering from tennis elbow, or if you don't currently have tennis elbow, having tight wrist extensor muscles may increase your risk of developing tennis elbow should you ever overuse these muscles. The reason for all of this is simple: when muscles are tight, some of the burden that they should be shouldering gets shifted to their tendinous ends.

So an important part of treating tennis elbow is ensuring that the muscles that line the outside of your forearm are at healthy lengths.

How to Prevent and Treat Tight Wrist Extensors

Begin with your arm in front of you with your wrist flexed towards the inner portion of your forearm. You should feel a stretch in the muscles that line your outer forearm. Be sure to keep your fingers curled towards your palm, or just maintain a fist.

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Use the fingers of your opposite hand to apply pressure to your outer forearm muscles. Begin close to your elbow joint. As you alleviate any tightness and tenderness in these muscles, you'll move your fingers right down your forearm to work on the entire length of your wrist extensors (please see arrow in picture below).

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While maintaining firm pressure on your forearm muscles, slowly flex and extend the hand of the forearm that you are working on, like you're turning the handles of a bicycle. Ideally, you want to keep your fingers curled forward, or even maintain a fist. With each forward flex, you should feel tightening of your forearm muscles (under the pads of the fingers of your opposite hand). If there are bundles of tight muscle fibers, you'll likely feel some tenderness with each forward flex. Move your wrist back and forth several times, then move a few inches down your forearm and repeat. Do this until you get close to your wrist and can't feel any muscle fibers.

Here's a closeup that shows how to apply pressure to your wrist extensors:

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Even if you don't have elbow pain, stretching and doing pressure work to your forearm muscles in this fashion can help keep your wrists, elbows, and the muscles that span between these two joints healthy. In some cases, pain on the outside part of the wrist can be "referred" pain that originates from tight muscles closer to the elbow joint - I've encountered a number of cases over the years where doing the pressure work in the elbow region as shown above has led to complete relief from wrist pain.

How to Prevent and Treat Tight Wrist Flexors (Golfer's Elbow)

Golfer's elbow refers to inflammation of the tendons that attach to the inner or medial part of the elbow. While tennis elbow tends to occur right up close to the bony insertion point of the wrist extensor tendons, golfer's elbow tends to occur a little further down from the elbow joint, within the meat of the wrist flexor muscles, approximately two to three finger widths away from the elbow joint.

medialepicondyle

Everything mentioned above on treating and preventing tennis elbow applies to golfer's elbow. Even if you don't have pain along the inner part of your elbow, by stretching and doing pressure work on your wrist flexor muscles, you can reduce your risk of experiencing problems in your wrist flexor muscles and tendons one day.

Begin standing close to a door or window frame (something sturdy that can support your weight) with your arm straight out in front of you, palm up.

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Now lean into the window or door frame, and allow your hand to bend down towards the ground with your palm in full contact with the surface that you're leaning against.

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You should feel an immediate stretch in your wrist flexors, most likely right up around the front, inner portion of your elbow. If you can't bend your hand enough to allow your palm to fully contact the window frame, just go as far as is comfortable. Maintain this stretch for as long as you'd like - about 30 seconds at a time can provide an effective stretch of the muscles and tendons that flex your wrist.

To amplify this stretch, try moving your hand up the window frame in increments - the higher you go, the greater the stretch of your wrist flexors. Just do what you can comfortably tolerate, and don't forget to breathe steadily.

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To further ensure that there is no lingering hypertonicity of your wrist flexors, go back to the first position where your palm is against the window frame and your arm is parallel to the floor, then use the thumb of your opposite hand to apply pressure to your wrist flexor muscles. Here, you don't need to move your wrist back and forth into flexion and extension; I've found that it's best just to keep it extended to maintain constant tension on your wrist flexor muscles, and then to do pressure work while these tissues are under tension.

Just like you did with your wrist extensors, you can move your thumb down the length of your wrist flexors while these muscles are being stretched by the window frame. Maintain steady breathing, and visualize these muscles getting to and staying at healthy lengths.

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Another way to elongate shortened forearm muscles is to use a hand-held roller.

In the case of your wrist extensors, begin with your wrist flexed to create tension along the target muscles, then roll these muscles back and forth against a hand-held roller that's kept upright with your other hand, almost like you're playing the cello.

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