Rickard Gustafsson | Saturday, 22 March 2025
My journey in treating my fly casting elbow has been a bit back-and-forth, but it's trending toward improvement—especially when I consistently do my homework. It’s easy to become complacent and neglect the things that lead to improvement, such as regularly exercising the extensors of the wrist. Although I’ve recently had periods when my elbow felt completely fine, overall it's still significantly better than before. Unfortunately, whenever I've slipped off the wagon by neglecting the rehab exercises, I've experienced setbacks in my rehabilitation progress.
To heal our casting elbow, it’s crucial to stay consistent with rehabilitation. Additionally, it's essential to identify and address the root cause to fully resolve the issue. The first step should be examining and adjusting casting techniques to prevent flare-ups.
Load and volume are also important factors to consider. Reducing the amount of casting or using less physically taxing equipment can be beneficial. But not always a possible solution. Sometimes changing the equipment isn’t possible. Going lighter isn’t always possible depending on the fishing situation or rules in competition. Volume is easier, in theory at least. In reality we might still want to cast and fish as much as possible. But we can train smarter and be more picky with the casts we take.
Another helpful step in assisting recovery is checking the entire movement chain to identify any issues that may need fixing. Poor movement patterns due to mobility or strength deficiencies can put extra stress on compensating body parts, leading to muscle strain or bursa impingement. Runner's knee is a common example of this principle.
While analyzing my 170 back cast, I discovered areas to improve. By pantomiming this cast with the arm fully extended—particularly with the wrist at maximum extension—I noticed it aggravated the pain in my elbow. Examining the movement chain further, I found that stretching and massaging my triceps allowed me to perform the movement more comfortably and without aggravating the pain.
Additionally, I realized the scalene muscles were involved. Massaging and stretching the scalenes seemed to alleviate some of the hot spots I felt in my triceps. This experience helps explain what I felt during the World Championships: spending less time at the computer benefited my condition. Clearly, there's more work to be done here.
How can one identify the parts of the movement chain needing attention? By examining areas upstream and downstream of the pain location and consulting resources like triggerpoints.net —a visual guide to trigger points and referred pain. Although research on trigger points can be somewhat inconclusive, I still find it effective, at least as an inspiration.
I'll have to explore further how to manage wrist extension issues when my arm is fully extended since this seems central to my problem.
Some Tips for Rehab Exercises: The eccentric strengthening exercise for wrist extensors, which I've previously described, remains my favorite. However, I've recently discovered a small tweak that makes it even more effective. Initially, I couldn't fully target the entire affected area, but by using a rubber band to emphasize the fully extended wrist position, I felt I could "dig in" deeper into the painful area. This helped release tension in my arm—those with similar issues might understand exactly what I mean.
Another beneficial exercise to target different pain angles involves keeping the forearm at a 90-degree angle to the upper arm. Squeeze an object like a tennis ball, flex the wrist, extend the arm, and then rotate the forearm. This approach has also proven effective in addressing my elbow pain.
Cheers, Rickard
It seems like spring is here, at least according to my dog that has started sunbathing.