Elbow

Question 1

Medial Epicondylitis

Answer 1

-tendinosis of flexor tendons

S/S: weak grasp, local tenderness over medial epicondyle

Cause: Insidious, repetitive mmts, young age
Primary: FCRB, pronator teres
Secondary: FDC, palmaris longus

Better: rest

Worse: throwing, gripping

Treatment:
-PT: reduce stress, strength
Phase 1: 1-2w, modification, isometrics, pain free stretching
Phase 2: 2-4w, stretching, concentric
Phase 3: 4-6w, eccentrics, endurance, technique
Phase 4: 6-12w, progressive return to sport, isokinetic

Question 2

Lateral Epicondylitis

Answer 2

-tendinosis of extensor tendons

S/S: local tenderness over lateral epicondyle, pain with gripping, stretching pain

Cause: Insidious, repetitive mmts
Primary: ECRB, ECRL
Secondary: EDC, Anconeus

Better: rest

Worse: gripping, turning

Treatment:
-PT: reduce stress, strength
Phase 1: 1-2w, modification, isometrics
Phase 2: 2-4w, stretching, concentric
Phase 3: 4-6w, eccentrics, endurance, technique
Phase 4: 6-12w, progressive return to sport, isokinetic

Question 3

Cubital Tunnel Syndrome

Answer 3

-mononeuropathy cause by entrapment of ulnar nerve
-second most common nerve compression injury

S/S: local tenderness over medial elbow, numbness and tingling, claw hand

Cause: direct trauma, stretching, compression
Stage 1: Neuropraxia; myelin sheath
Stage 2: Axonotmetris; interruption of axon
Stage 3: Neurotmesis, neurron disruption

Better: rest

Worse: compression, stretching, sports, position, sleep

Treatment:
-PT: decompression, lifestyle mods, education

Question 4

Elbow Dislocation

Answer 4

-discontinuity of ulnohumeral articulation
-most common in children and posteriorly
-leads to lateral instability

S/S: pain, swelling, forearm looks shorter

Cause: fall with hyperextension

Better: rest

Worse: use

Treatment:
-PT: initial immobilization, isometrics