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Forearm Anterior

Pain here can be particularly debilitating as it may affect movements at both the wrist and the elbow. The muscles that curl the fingers towards the palm of the hand and bring the wrist forward attach in the palmar side of forearm. Hands are constantly needed for essential function, therefore avoiding the activities that aggravate forearm pain can be difficult.

Your physiotherapist will be expert in assessing your condition and planning a structured rehabilitation programme tailored specifically for your needs.

Treatments will depend on your rehabilitation goals, your lifestyle and the cause of your symptoms but may include:

  • All aspects of post-operative rehabilitation
  • Massage and tissue release
  • Mobilisation of joints in the elbow, forearm and wrist
  • Shoulder stability exercises
  • Exercises to mobilise compromised nerves
  • Postural retraining
  • Assessment for muscle imbalance
  • Therapeutic Ultrasound
  • Taping for proprioception and pain relief
  • Taping for arm pump
  • Fracture management


Examples of conditions treated:

Golfers elbow
Also known as medial epicondylitis. Wrist flexors are a group of muscles found on the ‘palm’ side of the forearm. Most of these muscles are attached by just one tendon to the bony prominence on the inside of your elbow (the medial epicondyle). When you grip, bring your palm forward, or twist your forearm, the flexor group contracts and pulls on the tendon.

Overload or constant repetition of the same activity can put too much strain on the tendon causing tears and changes in the tissue. Patients will feel pain on the inside aspect of their elbow which may spread down the arm. Bending your wrist forward, gripping and twisting your forearm can make the pain feel worse.

Cubital Tunnel Syndrome
The Ulna nerve leaves the spinal column at the neck and travels down the arm towards the hand. As it does this, it needs to move through various tissues. It crosses the elbow by entering a tunnel that is formed by muscle, ligament and bone. If you straighten your arm with your palm facing upwards and then bend your elbow slightly, you can feel this tunnel as a groove on the inside edge of your elbow. The nerve is very close to the surface here and is vulnerable. This is the nerve you hit when you “bang your funny bone”.

Constant direct pressure (eg: leaning your elbow on a desk), trauma or repetitive overload can lead to neural irritation. Initially a patient will feel numbness in the ring and little fingers of the affected hand, this may develop into more persistent symptoms and eventually pain. Grip strength can be affected.

Distal Biceps Rupture
Muscles are attached to bones by strong connective tissues called tendons. The biceps tendon inserts just below the elbow on the “palm” side of the forearm. A rupture occurs when the tendon is torn from the bone. Occurring mainly in middle aged men, and usually in response to a strong contraction of the muscle, patients may feel or hear a pop directly in front of the elbow. This is followed by intense pain. In a full rupture the intensity of the pain eases quickly as tension is immediately removed from the pain receptors in the torn tendon. In a partial rupture pain may prevail. Occasionally, the muscle may retract upwards, giving a prominent bump that makes your affected side look very different from your other bicep. (This is called “Popeye sign”) The arm will feel weak on twisting the forearm to a palm up position and on bending the elbow.

Arm Pump
Arm pump is the term given to exertional pain felt in the muscles on the palm side of the forearm. It is a condition most typically associated with (but not unique to) motorcycle riders. The muscles used to grip and move the wrist forward demand an increased blood supply for oxygen delivery under periods of intense exercise. Muscles are surrounded in a strong connective tissue (fascia) that doesn’t stretch. Blood comes into the forearm compartment and engorges the muscle tissue but the inelastic fascia prevents the muscle tissue from expanding further and exerts an opposing force. Pressure builds up, tissues become compressed and blood flow is compromised affecting oxygen delivery and removal of metabolic waste.

Surgery to release the strong connective tissue surrounding the muscles, either by splitting it or removing it (fasciectomy/Fasciotomy) has proven successful in reducing these symptoms.