Forearm injury help needed - Detailed information provided

[sharkattack]

Hello. I've followed the request at the top of the Injury Section and have provided much more comprehensive information than I previously did. I sure would appreciate it if you kind souls could take a look at my situation and offer any advice you can. If you have any more questiosn, please feel free to let me know and I'll answer to the best of my ability.

1. When did the pain begin? I first noticed the pain around 11Apr07 or so.

2. What were you doing at the time? Or did the pain come on gradually over time? I believe that the pain is the result of using the straight Olympic bar for performing barbell curls. I normally use DBs, but tried the straight bar for a change.

3. Where, anatomically, is the pain? Per the diagrams on www.getbodysmart.com, the pain seems to be located in the Brachioradialis muscle. Here’s a link to the page showing the muscle. www.getbodysmart.com/ap/muscul arsystem/forearmmuscles/brachi oradialis/tutorial.html

4. What does the pain feel like? Sharp? Dull? Aching? Stabbing? Shooting? If I had to describe the pain, I’d say it was a dull, muscular ache. It’s not a sharp, stabbing type of pain, and it stays localized to the area. It doesn’t shoot up and down the forearm.

5. Is the pain constant, or intermittent, or only on certain motions? I basically only feel the pain when my forearm is bent at 90 degrees (relative to my upper arm) such as in when performing a Hammer Curl. I don’t feel much pain or discomfort at the bottom of a Hammer Curl, only when my arm is bent at approximately 90 degrees. It also lessens a bit once I get past the 90 degree point, such as the last few degrees of motion during a Curling type motion. The pain seems to be very consistent when tension is placed on

6. What motions make your pain worse? The pain seems to be worst when performing a Curl type movement with my palms in a neutral position. If I perform barbell reverse curls, I really don’t feel a significant amount of pain. Maybe just a little bit. I also feel the pain when performing Seated Rows when my arms reach the point where they are bent 90 degrees, but the actual rowing motion itself doesn’t seem to bother it. Pulldowns seem to aggravate it at the bottom of the movement, but the actual pulling motion doesn’t seem to bother it much.

7. What, if anything, makes your pain better? My PT has me doing left and right rotations holding a DB handle on the end. It’s getting easier to do these, so I assume I am progressing on this exercise. He also has me doing DB wrist curls and reverse DB wrist curls. Again, I’m progressing on these exercises, they seem easier now than they did a couple of weeks ago. I don’t feel any pain while doing any of these exercises.

8. Does your pain radiate to any other part of your body? No.

9. What things could you do before, that you cannot do now because of your injury? Hammer type curls, and DB curls. I feel the pain when doing DB curls mostly when the movement simulates a Hammer curl for that brief moment while my palms are rotating (supinating) during the movement. Also see the comments above in question #6 regarding rows and pulldowns.

10. What is your main concern regarding the pain and its consequences? I want to get rid of the pain so I can begin performing other upper body movements without the fear of re-injuring the area or not letting it heal completely. I don’t want to take any steps backwards.

11. Have you ever injured that part of your body before? If so, how? No.

12. Is your pain getting worse over time? And if so, how much worse over what time period? It’s not getting worse. It’s maybe slightly better, kind of hard to say. It’s not better enough to see a marked difference though.

Thanks for any help you folks can offer. Thanks also to UConnJulie for her help in my previous post.

Any new suggestions, now that I've provided more for you folks to go from?

Thanks,
Scott

[UConnJulie]

Scott, are you currently seeing a PT for this injury? If so, what is his/her take on it? What other treatment are you getting besides the exercises you described?

[sharkattack]

Julie,

He seems to feel that it is a slight tear in the muscle itself or the fascia. the initial consultaion seemed pretty thorough and he really seemed to palpitate the area extensively and asked me numerous questions about how I got injured, how long ago, etc.

Here’s the complete routine that I do when I go to the PT’s clinic:

• My forearm is wrapped in heating blanket for 8:00
• I warm up on a Schwin Air Dyne bike for 8:00, using only the handles. I push for 1:00 followed by pulling for 1:00
• I then go to towel grips. Roll a towel slightly and grip as tightly as possible for a count of 5. I release for a count of 5. Roll the towel a little more (to make it thicker) and repeat the grip sequence. Roll the towel one more time and repeat the grip sequence. Unroll the towel to the mid section, repeat the grip sequence. Unroll the towel to the starting position and repeat the grip squeezes. Each set of towel grips has 5 positions of three “thicknesses”: beginning, middle, end, middle, beginning.
• I perform the DB handle rotations, 3 sets of 12 reps, followed by stretching in between sets. For the stretching, I hold my arm out in front of me (like I’m saying ‘Stop!’) and alternate between stretching the inner and outer portions of my forearm. I hold each stretch for a count of 5. I do each stretch 10 times.
• I then perform DB wrist curls supersetted with reverse DB wrist curls.
• I repeat the rotations that I did with the DB handle, but this time I use a piece of green, surgical looking type tubing held down with my foot for resistance. I think it’s called Thera-band.
• The last exercise is 8:00 of ‘pedaling with my arms.’ I don’t know what the proper name of the machine is, but you are sitting, facing two handles and you ‘pedal’ or crank them with your arms. 1:00 forward rotations, 1:00 reverse rotations, etc.
• 15:00 of having small electrical pulses delivered to the area via small stick on pads, approximately 2”x2”.
• Massage and stretching of the area by one of the therapist.

I believe he told me that today he is going to introduce a seated row type of movement into the mix. I’ll report back after the session tonight.

I understand that this may take some time to heal, but I don’t want to get caught up in him insisting that I need to go for months and months, especially since I can do some of the movements at home in my gym. I just don’t have the ‘arm pedaler’ machine. All others I can mimic. That will get awfully expensive after a while, even with my insurance. After my deductible is met, BCBS pays 80%, but still. So far I have every reason to think that he knows what he’s doing, and I don’t think he’s the type to insist patients go to his clinic longer than necessary just so he can bill the insurance.

Here’s a link to his clinic if anyone’s interested: www.smtcstl.com

[UConnJulie]

Sounds like you are heading in the right direction ... keep in mind that there was probably some underlying weakness that precipitated the injury and that all of the isolation exercises are designed to help with that. If it is not better in a few more visits, you might ask him about the mobility of your proximal radio-ulnar joint ... your description does not immediately scream of this, but sometimes it can get hung up and need a little mobilization to get the wrist extensors/elbow flexors functioning properly.

Best of luck!