Massage for lateral epicondylitis should begin by warming up the tissue in the forearm by using some effleurage along the wrist extensor muscles. Next, build to deep stripping effleurage with your thumbs, following the muscle fibers from the wrist to their attachments at the elbow. Another beneficial technique is adding static, direct pressure with your fist to the muscle bellies to help relieve the constant pull on the tendons and also provide immediate relief in many cases. Next, the therapist should apply deep, circular and cross fiber friction to the attachments at the elbow to break up adhesions. Always make sure the person can tolerate the treatment or adjust your pressure accordingly especially if there is severe tenderness in this area. Mobilize the wrist joint and stretch the extensors by flexing at the wrist. It is also beneficial to work the opposing muscles, the flexors of the forearm, and also the hand muscles of the affected side.
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