Understanding Injury Patterns: Desk Jockey's Tennis Elbow & Ankle Dysfunction Resulting in Back Pain
On this episode of The FARM Podcast, the team dives into three diverse and thought-provoking clinical cases that shed light on how functional assessment and critical thinking can outperform protocol-driven care. From a classic case of tennis elbow in a desk-bound worker to a surprising lower back issue rooted in ankle dysfunction, and finally, a broader philosophical discussion about injury categorization, this episode explores the nuances of real-world rehab.
The first case centers around a desk worker struggling with lateral elbow pain, often labeled "tennis elbow" or lateral epicondylitis. What makes this case compelling is the absence of any racquet sports—or even repetitive lifting. The team explores how static postures, prolonged typing, and dysfunctional upper quarter mechanics can create abnormal loading in the elbow tissues. They emphasize that just because someone doesn't fit the athletic profile of a typical tennis elbow patient doesn’t mean the condition isn’t present. What’s more, the conversation explores the impact of neck and shoulder positioning, scapular control, and ergonomic setup, ultimately leading to a more effective and tailored treatment plan. The takeaway? Diagnosis is just a starting point—the magic lies in the assessment of function and context.
The second case features a teenage soccer player presenting with extension-based low back pain. At first glance, the mechanics of lumbar extension during sprinting, kicking, or even core training might seem to be the primary culprit. But upon deeper analysis, the clinicians uncovered a significant issue: limited ankle dorsiflexion that was altering lower extremity loading and creating compensatory lumbar extension during movement. This case powerfully illustrates how a distant joint dysfunction—here, the ankle—can manifest as pain in a seemingly unrelated area. It also underlines the importance of movement screening and global assessments in young athletes, especially in sports with high demands on the kinetic chain.
Finally, the episode rounds out with a dynamic discussion around the question: Can you really categorize injuries? The clinicians unpack the pros and cons of injury labels—whether it’s tendinopathy, impingement, derangement, or something else. They question the utility of rigid categories when each patient’s experience is unique and multifactorial. Categories can help streamline communication and give general treatment guidance, but the danger lies in using them as crutches that prevent clinicians from asking deeper questions. Instead, the team advocates for a systems-based, pattern-recognition approach—where function, loading history, tissue health, and compensation are all assessed as part of a complex and evolving story.
Throughout the episode, listeners are treated to insight-rich discussion that bridges clinical expertise with practical application. The FARM team continues to push for a higher standard in musculoskeletal care—one that emphasizes individualized treatment, movement quality, and a refusal to oversimplify the human body. Whether you're a clinician, athlete, or someone dealing with nagging pain, this episode delivers powerful lessons about how thoughtful analysis can change outcomes—and how the root of the problem is often not where the pain is.
