The Single Stretch to Relieve Tennis Elbow & Golfer's Elbow at the Same Time

Table of Contents

• Introduction
• What is the Brachial Plexus Wall Stretch?
• The Brachial Plexus Wall Stretch is NOT for Muscles
• How the Brachial Plexus Wall Stretch Works
• How to Perform the Brachial Plexus Wall Stretch
• Important Tips for Success
• Who Should use Caution
• Conclusion

Introduction

Tennis elbow, medically known as lateral epicondylitis, is a common overuse injury that causes pain and tenderness on the outside of the elbow. It develops when the tendons that connect the forearm muscles to the elbow become irritated from repetitive gripping, lifting, or wrist movements. Although frequently associated with racquet sports, tennis elbow can affect athletes, tradespeople, office workers, and anyone who repeatedly uses their hands and forearms. Symptoms may include a weakened grip and pain during everyday activities such as shaking hands, opening jars, or carrying objects.

Tennis elbow can affect individuals differently. This is what makes treating it somewhat difficult. There are people that have fixed their elbow pain with just a stretch. Others have solved the tennis elbow problem with a trip to the chiropractor. These are all very valid claims. While we do not claim to offer a "quick fix" to your tennis elbow issue, the stretch we promote here is a preventative, a treatment, and a rehabilitation technique for both tennis elbow and golfer's elbow. In fact, this stretch can address many confounding upper limb pain conditions. Why? It's because this wall stretch addresses the brachial plexus nerve bundle that controls the entire arm. 

What is the Brachial Plexus Wall Stretch?

The brachial plexus wall stretch (BPWS) is a gentle exercise that helps mobilize the nerves and muscles running from the neck through the shoulder and arm. Also considered a nerve glide, or nerve flossing, technique, the BPWS also helps to target the thoracic outlet area of the shoulder girdle.

The Brachial Plexus Wall Stretch is NOT for Muscles

There are many stretches that are offered for tennis elbow, with most of them targeting the forearm extensor group. Muscles such as the extensor carpi radialis brevis, extensor carpi radialis longus, extensor digitorum, and extensor carpi ulnaris are important in relieving the tension placed on the tendons connecting them to the lateral epicondyle. 

When these muscles are addressed and the pain does not resolve, it is important to look higher up in the pain chain, which means looking at nervous system involvement. Here is where the BPWS comes in. The BPWS is a stretch that targets the peripheral nerves between the shoulder and fingers.

How the Brachial Plexus Wall Stretch Works

The brachial plexus wall stretch is a technique called nerve flossing, that uses coordinated movements to help a peripheral nerve slide, or glide through surrounding muscles and connective tissues. This technique is also known as nerve gliding, or neural mobilization.

Though it may look similar to a muscular stretch, nerve flossing uses joint angles to place the peripheral nerves in an extended position. This mechanical stretch stimulus can help to reduce soft tissue restrictions and restore neurodynamic dysfunction, or the ability for the nerves to safely operate during varying musculoskeletal movements.

The BPWS works for many confounding pain conditions in the arm. This is because the brachial plexus is comprised of spinal nerve roots C5-T1 that innervate almost the entire arm. Stretching the brachial plexus and releasing nervous tissue restrictions will make sure the nervous system can fire (or conduct electrical nerve impulse) everything between the shoulder and the fingertips without hindrance.

Note that clinical studies on the effectiveness of nerve system flossing is mixed. There are many reasons for this, one of which is that the interaction between nerves, fascia, & brain are both complex and poorly understood.

Our belief is that the mind body is continually finding more compact and efficient movement patterns, especially when these movements are repeated often. These adapted movement patterns are comfortable, but give rise to pain signals when the body is operated outside of these positions. Nerve flossing is a way to stimulate the nervous system to be more flexible again by reminding the mind body that stretched positions are still safe to operate in. 

How to Perform the Brachial Plexus Wall Stretch

To start, stand facing directly towards a wall. Space yourself away from the wall, such that you can place the palms of both hands out directly in front of you at shoulder height, flat against the wall, with elbows straight and fingers facing upwards. (See image below)

Now, drop the unaffected arm and leave the injured arm still connected to the wall. While keeping the outstretched hand connected to the wall, rotate the entire body and feet 90 degrees. (See image below) This is the beginning position of the brachial plexus wall stretch. For some, this position will already provide some stretch sensation to the peripheral nerves along the outstretched arm.

Step 1: Make sure the shoulder is neutral and not elevated. The muscles in the shoulder should remain relaxed as much as possible. Flatten the palm and fingers against the wall. If you are feeling the stretch in this position, hold it here for 1-3 minutes at a time. Remember, this is supposed to be a gentle stretch. If it feels intense, try turning your torso towards the wall to moderate the stretch intensity.

Step 2: If you can hold the beginning position without much effect, you can add more stretch by rotating your head in the opposite direction of the outstretched arm. A cycle of rotating the head towards the wall and away from the wall will gently "floss" the nerves proximally and distally in the arm. Notice any areas of higher sensation. You can perform 10-20 cycles of head rotations at a time. Rest between sets. If more tension is needed, turn your body further away from the wall and opening the chest/shoulder area even more.

Step 3: If the above two positions are not providing enough stretch sensation, try rotating the hand on the wall so that the thumb is superior to the fingers and the fingers point in the same direction as the back of your body. 

Note all of the sensations between your neck and fingers. Some of your muscles will resist the stretch until your body adjusts. Try and stay relaxed throughout. You will feel mild muscular fatigue, which is acceptable. The nerve flossing sensation is slightly more "electric" or tingly than a muscular stretch, but this is not always the case. You will feel a stretching sensation somewhere between your shoulder and finger tips! That's perfectly fine! But, if you feel any sharp pain, check your posture, change position, or seek professional advice.

Important Tips for Success

Don't bounce! Jerking movements can overstimulate the nerves along the pathway. If overstimulated, the stretch should not be performed again until the nervous system has calmed down.

Try to relax the shoulder and arm muscles. You want to use as little muscular force to achieve the stretching sensation as possible. Remember, this is a passive, gentle stretch.

Focus on making sure your feet are planted, your posture is relaxed, and you are not leaning your body in any particular direction. 

 Avoid overdoing it. In the beginning, more is not always better. Perform the BPWS once daily, then progress to twice daily. Set small goals for yourself and scale back, if necessary. Slow progress is still progress! 

If you lead an active lifestyle, you may need to incorporate this stretch daily for general body maintenance. 

Some athletes test nervous system readiness through a hand-held dynamometer test. If you have access to one, check grip strength before and after performing this stretch. Maintaining brachial plexus pathways will allow you to more accurately monitor neuromuscular readiness and CNS fatigue. 

If you overdo it, scale back. Rome wasn't built in a day. Nerve flossing needs to be slow, gentle and consistent for progress to be made.

Who Should use Caution?

The brachial plexus wall stretch is generally safe, but may not be appropriate for everyone immediately. Individuals with:

• Acute elbow injury
• Acute cervical disc herniation
• Severe nerve compression
• Advanced shoulder instability
• Recent elbow surgery
  

should consult a qualified healthcare professional before beginning a brachial plexus nerve flossing or gliding program.

Conclusion

The brachial plexus is a complex of nerves that exits the lower cervical and upper thoracic spine. These nerves that innervate the arm and hand, serve to provide motor, sensory, and proprioceptive signals to/from the brain.

There are many reasons for nerves to be affected in our daily lives. We use our arms every day. For athletes, managing muscular and nervous system function is a never-ending process. All of the soft tissue is constantly competing for space. This is one core reason why we believe that many forms of stretching are key to movement optimization.

The brachial plexus wall stretch is a nerve flossing, or nerve gliding, technique that mechanically stimulates these nerves between the spine and fingers. The BPWS is a way to address any physical impedances that may be causing tennis elbow or golfer's elbow pain. As a bonus, the BPWS can also treat many other stubborn arm pain conditions that are idiopathic or unknown in nature. It's not magic, it's just that measuring the impact of compressed or pinched nerves are difficult. 

If you are struggling to manage your tennis elbow or golfer's elbow pain, and you are almost at your wit's end, we encourage you to try the brachial plexus wall stretch. It doesn't cost you anything and it can be performed in about 5-10 minutes. At the very least, your arm will thank you. Happy stretching!