Vacuum cupping for lateral elbow pain
Trigger points are really common in the elbow and forearm muscles; this may be connected to our increasingly sedentary and technology-based lifestyles. This doesn't only affect our clients either. As hands-on therapists, we can suffer from tense and stiff forearm muscles.
Why trigger points? They are one of the body's instinctive protective mechanisms. In an attempt to heal trauma, our body often “switches-off” around damaged tissue. Trigger points are a key part of the protect-and-defend mechanism. However, if a problem isn't managed correctly, it can crescendo and the trigger points become deep-seated, causing the host muscle to be shorter, tighter, and less efficient.
In addition, trigger points also add to the cycle of increased sensory input to our peripheral and central nervous systems (sensitization), which can lower the threshold for pain. In other words, if left untreated, trigger points can feed into the nervous system and prevent full recovery.
Trigger Point Treatment
Treatment will often include deep tissue massage therapy, muscle stretching, heat and ice therapy, and Kinesio taping. When treating trigger points, many practitioners will also apply dry needling (medical acupuncture) and vacuum or static cupping.
Tennis Elbow
Tennis Elbow, also called Lateral Epicondylitis can start as an annoying ache but rapidly degenerate into a debilitating problem, with pain on gripping, opening bottles, or even on shaking hands. Unless they have experienced it, people often don't understand how bad it can be.
The pain from a Tennis Elbow is often associated with trigger points in the muscles of the lateral epicondyle of the elbow, especially the lateral head of the triceps and the extensor carpi radialis brevis tendon (1-2cm distal to its attachment on the lateral epicondyle).
As shown in the video above, trigger points in the extensor carpi ulnaris are often implicated in lateral elbow pain.
Lateral Epicondylitis is more common than Medial Epicondylalgia (Golfer's Elbow) by a ratio of 9:1. Golfer’s Elbow is commonly misdiagnosed as Lateral Epicondylitis, but where the former is an inflammatory condition, the latter is not. Microscopic evaluation of the tendons does not show signs of inflammation, but rather angiofibroblastic degeneration and collagen disarray.
Light microscopy reveals both an excess of fibroblasts and blood vessels that are consistent with new blood vessels (angiogenesis). It is most often due to repetitive micro-tears in the zone, especially where the tendon of the muscle meets the bone (musculotendinous junction). This is because the tendons are relatively hypovascular close (proximal) to the tendon insertion.