A common misconception is that coaches and personal trainers live their lives without any musculoskeletal issues. Free from niggles or injuries and blissful in their pain-free existence! Watching a coach demonstrate a deep squat or a perfectly executed scapula push up gives the impression that they move so well that injuries must be uncommon for them. This, however, is not the case and coaches, given the nature of their active work, can present with frequent issues that require attention.
From working closely alongside the coaches at FFS, it has given me plenty of exposure to such issues. The fourth coach I would like to discuss in a series of monthly blogs post will be Cathal. See my previous articles on Sinead's Knee, Jamie's Hamstring, and Brian's Shoulder.
Assessing Cathal's Forearm Issue
Cathal is a Personal Trainer, TPI coach, and plays a pivotal role within the social media, marketing and maintenance teams at FFS. Cathal is an avid golfer and presented to me during a busy period of golf with wrist and forearm pain.
He presented to me with :
Pain along the side of forearm and along the extensor muscles.Discomfort felt through at end of range wrist flexion and extension.Discomfort with certain golf swing movements which had not presented as an issue before.
Assessing Wrist Range of Motion (ROM)
Testing Weight Bearing Activities
Palpating Wrist Extensor Muscles
The main findings were the following:
Reduced Wrist Flexion, Pronation ROM.Pain report at end ROM Wrist Flexion, Pronation, Ulnar Deviation.Mild pain reported bearing weight through wrist.Tenderness palpating the Extensor digitorum & Extensor carpi ulnaris muscles (forearm).
1. Extensor/Flexor Myofascial release with Kettlebell (KB)
I asked Cathal to spend 2/3 minutes daily using a medium weight KB to massage into both forearm muscle groups. Self myofascial release (SMR) can help reduce tenderness in a muscle tissue and allow for better movement, and potentially increased ROM.
2. Extensor Stretch
An extensive stretching programme was provided to aid with the tightness in the forearm area. Each stretch was held for 10 seconds each, for 2 sets.
3. Radial/Ulnar Deviation Strengthening
Light dumbbells (2-2.25kg) were used to strengthening the wrist joint in various planes of motion. 3 sets x 12 reps aiming for full ROM throughout.
4. Wrist Extensor Strengthening
The primary weakness from the assessment looked to be the extensor muscles which are the muscle group at the top of the forearm in the photo. This exercise progressed to a 7.5kg dumbbell for 3 sets x 12 reps.
Cathal's Rehab Plan
It was important to discuss the volume of Cathal’s training and potential aggravating factors. I asked him to cut down his time spent golfing by 20/30%– and then grade back into his normal training routine depending on overall symptoms. Strength training was also similarly regressed. We agreed that warming up before golf and training, in general, was a necessity and Cathal stuck to this religiously. As the symptoms started to improve and the pain started to diminish, we added in progressive wrist strengthening exercises and upped the frequency of golf.
The above exercises were prescribed following a detailed assessment of Cathal's forarrm and wrist issue but can provide benefits to those as part of an active warm-up or training session. However, they are not the solution to all problems. If you think you have a problem with your wrist, we advise you to see a Chartered Physiotherapist to get it checked out and given a tailored rehab programme for your specific issue.
Find Out More:
If you need advice, a physiotherapy assessment or feel your team/business could learn more about workplace ergonomics, contact Eric at firstname.lastname@example.org or visit www.ffs.ie/physiotherapy.
About the Author:
Eric Cullinane is a Chartered Physiotherapist working with FFS Physiotherapy, a practice based on Leeson St Lower.
Chartered Physiotherapists have specialist knowledge in the field of work related injury management.