So with this not-so-vast wealth of knowledge, I set to work assessing different motions at the elbow joint, and making a sort of mental checklist as to what movements did what… e.g: Flexion + Internal rotation + Adduction = painful; Extension + Internal rotation + Adduction = painless; Etc.
I used a 1kg dumbbell as a ‘driver’ (something to increase the momentum in the movement) and, within about 10 minutes of assessments, I came to the conclusion that the pain was mostly being caused by the brachioradialis (the muscle that flexes/bends and supinates and pronates (rotates) the elbow joint).
Armed with this new-found information I asked Harry to do similar movements as before with his left arm, and I noticed that he had more ROM (range of motion) in his left arm and shoulder than in his right.
After doing some mobilisation exercises on his right shoulder and scapula (I asked him to put his arm straight up and step back and forth on the same-side leg, while I used one hand to pull his arm back further, and the other to mobilise the scap/shoulder blade by pulling it down and round), he started to feel a bit better in his elbow, but still uncomfortable!
So I then got him to flex and extend his elbow whilst I ‘scraped’ around the joint, mostly on the forearm and bicep. After maybe 2 minutes of scraping*, the difference was noticeable with regards to ROM, and he could feel benefits as well.
After scraping, I gave him back the dumbbell we used at the start, and got him doing the movements that gave him most grief before, and he felt fine!
* ‘Scraping’ is the colloquial term for a form of massage, often known as IASTM (Instrument Assisted Soft Tissue Mobilisation) which involves a specially shaped tool that is used to ‘scrape’ over an affected area. The technique supposedly works by manipulating scar tissue (fascia) and abnormalities in the muscle to free up more ROM. See this previous article by Ali West for more information on how tool-assisted massage can be used to treat pain and injuries.