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Pediatric Massage

By Tina Allen, LMT, CPMMT, CPMT, CIMT

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Pediatric Massage for Selfie Elbow

Children today are exposed to the use of electronics and technology at a much earlier age. While many times this exposure leads to great exploration and learning opportunities, we are also seeing an increase in the appearance of discomforts associated with the use of today's technology.

Simply stated, the use of computers, tablets and smartphones causes us to hold our bodies in unnatural positions for extended lengths of time. The cause of technology-related injuries is typically overuse mixed with repetitive use.

With today's youth addicted to taking "selfies," capturing their memories in pictures and living in a reality where "If there is no picture, it didn't happen", we have created a selfie-addicted culture.

What is "Selfie Elbow"?

Selfie elbow is a type of tendinitis and can be described as similar to "tennis elbow" (lateral epicondylitis). The feeling of pain and discomfort associated with "selfie elbow" is caused by the experience of inflammation in the tendons that run along the arm from the hand to elbow. The tissues become inflamed due to the form the body holds when taking a selfie. When taking that soon-to-be-treasured picture, the self-photographer extends their arm and at the same time grips their phone firmly to stabilize for the perfect shot. This is not a position we were designed to hold repetitively.

Children may feel tightness in their arms, wrists and even in the hands, but not report it to their parents. They may think it is harmless, will pass quickly and not recognize the trauma caused by overuse. Oftentimes they will use a selfie stick, thinking it will assist with the awkward (and achieve the optimal) selfie-taking position. However, if while using the selfie stick,  the arm is still extended, it is not helpful in minimizing the future discomfort.

Symptoms of "Selfie Elbow"

selfies - Copyright – Stock Photo / Register Mark With selfie elbow, the symptoms develop over time. In many cases, the discomfort begins as mild and then slowly worsens with continued, repetitive movements and overuse. Some of the common signs and symptoms of selfie elbow include:

  • Pain and tenderness at the outer area of the elbow (lateral epicondyle)
  • Pain / discomfort that may travel from elbow down the forearm into the wrist and hands
  • Weaker-than-usual grip strength
  • Typically pain in the dominant selfie-taking arm

Pediatric Massage for "Selfie Elbow"

Prior to providing any treatment in the form of pediatric massage therapy, you must assess the child's injury, understand which muscles, tendons and ligaments are involved, and make an informed treatment plan.

Lateral epicondylitis or "selfie elbow" involves the tendons and muscles located in the forearm. The muscles in the forearm help to extend the wrist and fingers, while the tendons, also known as extensors, attach the muscles to the bones. The attachment is located at the lateral epicondyle. It is at this attachment site that we find inflammation contributing to "selfie elbow."

The first and one of the best therapeutic approaches is to encourage the child to rest and help rehabilitate their injury by not continuing with the activity which initially caused the inflammation. However, we also should consider employing methods of treatment using ice to decrease inflammation, teaching the child some home care activities, and using pediatric massage to address the self tissues.

With children, use caution with any heat or cool therapies due to their developing nervous systems and possible inability to perceive heat and cold temperature differences quickly. If using cooling therapy, the therapist should do so cautiously and be mindful of site, color changes of the skin and reaction the child is having. The therapist should limit the time cooling therapy is applied to the inflammation site, using a method of less-is-more when it comes to pediatric clients.

Using pediatric massage techniques, the therapist should focus on those techniques which help to decrease stress, anxiety and tension overall; then focus on specific areas to alleviate discomfort.

Once a through assessment is completed and the therapist has gained the child's permission to receive massage, they can begin their therapeutic approach.

Begin by focusing on the back, neck and shoulders of the child. Provide gentle stroking techniques to decrease any tension contained in these muscle areas. This will help the child relax and prepare for focus on the area with pain and discomfort.

Next, the therapist should focus on the forearms. On the affected forearm, start with gentle, static holding to begin to introduce touch therapy. Gently stroke to warm the area. Then, knead the soft tissues, using a gentle, but intentional pressure. Once the tissues are warmed, the therapist should gently hold their hand in a static position on the child's forearm. While the therapist's hand provides warmed contact to the forearm, ask the child to alternate slowly bending their wrist (flexion) in the dorsal and palmar directions.

This movement should be performed slowly, and range of motion should be controlled by child, who will move their wrist on their own, comfortably. If monitored by parents, this movement can be performed at home by the child under a home care plan.

As a preventive measure, children should be encouraged to take breaks from selfies and regularly practice wrist movements of bending the wrist in the flexion motions. If they notice any pain or discomfort, they should bring this to the attention of the parent or therapist and then follow any recommended medical advice.

Please note the information contained in this article is an example plan of treatment. However, each pediatric client may have different health care needs. This information does not replace medical advice.

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