Elbow Flashcards
What is lateral epicondylitis?
“tennis elbow”
Overuse inflammatory injury involving common extensor tendon
Repetitive wrist or combined wrist and finger extension.
PE findings in lateral epicondylitis?
Significant pain and 3/5 strength with resisted 3rd digit extension.
Tendonitis v. tendonosis?
both are tendon overuse injuries
itis: Inflammation, fiber disruption/ degeneration
osis: Mucoid degeneration, Sporadic inflammation
Inflammatory process “stalled”, fiber disorganization
Tx of tendonitis?
Steroid injection
Activity modification
NSAIDs
Ice
Therapeutic exercise
(Stretching
Strengthening)
+/- Bracing, PT
Tx of tendonosis?
Activity modification
PT, exercise
+/- Bracing
NSAIDs & Steroid injection = NOT beneficial long term
Fundamentals of tendonosis tx?
Mod aggravating activity
correct biomechanical
faults
address degenerative component
exercise
What can be used to help tendonosis-address degenerative component
ASTYM
Graston
Dry Needling
PRP injections
Who is usually affected by distal biceps tendon tear?
Men > 40 years of age with preexisting degenerative changes in biceps tendon
MOA of distal biceps tendon tear?
Rapid eccentric contraction of biceps leads to distal tendon tear at radial insertion
Non surg tx for partial distal biceps tendon tear?
Bracing with ROM limitation X 4 weeks
Gradual progression of ROM and strengthening
Non surg tx for complete distal biceps tendon tear?
Older patients with sedentary lifestyle who are willing to accept strength loss
Surgical tx for distal biceps tendon tear?
Complete tendon rupture in young active individuals (quick surg consult is imperative for best outcomes)
Elective for partial tears in young active individuals
“hurts when I throw a baseball” + mild swelling in region of medial epicondyle and focal tenderness over medial joint line, medial epicondyle and adjacent portion of the common flexor tendon
Medial epicondylitis/osis
v.
ulnar collateral ligament tear
v.
Medial epicondyle apophysitis “Little leaguer’s elbow”
what tests can you use to test ulnar collateral ligament?
Valgus stress test
Milk maneuver**
moving valgus stress test ***
How is the milking maneuver performed?
Tests posterior band of UCL
Assess for pain, medial joint laxity, and end feel