Lecture 12: Elbow/forearm Complex Treatment Flashcards
(53 cards)
• Protect injury site
• ↑ pain-free ROM in entire kinetic chain
• Improve pt comfort by ↓ pain and
inflammation
• Retard muscle atrophy
• Minimize detrimental effects of
immobilization and activity restrictions
• Maintain general CV fitness
• Ensure pt is independent w/ HEP
These describe what phase of goals
Acute
How is the PT management different for elbow sx vs conservative
Sx: u move them
Conservative : they move their arm
What does PRICE stand for
- protect
- rest
- ice
- compression
- elevate
What must be avoided in the acute phase interventions
Elbow flexion contractures
What kind oof isometrics can u do for acture phase interventions
Sub max
In the acute phase interventions once full pain free AROM is restored what do u do
Progressive resistance exercseis (concentric 1st then eccentric)
What is the criteria for a pateint to move from acute —> subacute phase
- Full pain-free ROM achieved
- Muscle strength >/= 70% of
contralateral limb
What kind of activities do u introduce in the sub acute phase interventions
CKC
When can u progress to UE plyometrics
Sub acute phase with 70-90% of strength back
What does resisted shoulder ER increased at the elbow
Increase valgus strsss at elbow
When can a patient return to gradual return to sport
Strength , power and endurance > 90% of contra limb
What is the most common lateral elbow pain
Lateral epi
What is lateral elbow tendinopathy
Degeneration of extensor
tendon origin
What kind of management is more common for laterla elbow tendinopathy
Conservative
Sx only if symptoms > 6 month
What are the CPG recommendations for therapeutic exercises for lateral elbow pain
B: use isometric , concentric and/or eccentric ther ex resisted exercises of the wrist extensors with subacute or chronic patients
What is the multimodal interventions: including therapeutic exercises for lateral elbow pain CPG recommendations
B: use resisted wrist extension strengthening exercises in combination with other interventions like manual therapy for patients in subacute or chornic
C: may include shoulder and scapular stabilizer mm training exercises
What is the interventions: manual therapy joint mobility/maip for lateral elbow pain CPG recommendations
B: should use local elbow joint manip or mobs to reduce pain and increased pain free grip strength
C: may use manip or mob directed at the c spin , t spin and/or wrist
What is the interventions: manual therapy soft tissue mobs for lateral elbow pain CPG recommendations
C: may use soft tissue mobs like manual release therapy to improve pain and function for chronic patients
C: may us instrument assisted soft tissue mobs combinated with exercise for chronic
What modalities for lateral elbow pain are recommendaed by CPG
- dry needling - B
- taping -B
What is the clinical presentation for lateral elbow tendinopathy
• Lateral elbow pain w/ active wrist extension and
supination
• Gripping tasks or end range stretch
What is the treatment for lateral elbow tendinopathy
• No consensus
• ↓ inflammation (consider activity modification)
• Joint mobs
• Progressive resistive ex’s
• Gradual return to function
What is the clinical presentation for medial elbow tendinopathy
• Medial elbow pain w/ active wrist flexion and
pronation
• Gripping tasks or end range stretch
What is the treatment for medial elbow tendinopathy
• No consensus – must determine ALL structures
involved to effectively manage
• ↓ inflammation (consider activity modification)
• Joint mobs
• Progressive resistive ex’s
• Gradual return to function
What are 4 causes from elbow stiffness
• Post-trauma, fracture and/or dislocation
• Following cast/sling/brace use
• Joint arthropathy (OA, etc)
• Pathologic bone formation (HO, myositis ossificans, etc
