Lecture 13 - Elbow/hand/wrist rehab

Question 1

2 main goals of rehab of throwing athlete -elbow injuries for phase 1

Answer 1

• ROM - PROM and A-AROM to decrease adhesions - wrist and elbow
• Sub painful and submaximal isometrics

Question 2

Goals of intermediate phase of throwing athletes - elbow injuries

Answer 2

Still protect valgus stress
Isotonic strengthening -> concentric -> eccentric progression
Shoulder stability continued (RC and scap m.)

Question 3

Goals of advanced strengthening of elbow injuries in throwing athletes

Answer 3

• introduce/progress valgus stress
• increase strength/power/endurance for gradual RTP
• higher resistance, functional mvts, eccentrics, plyometrics

Question 4

Program for OH athlete injuries

Answer 4

Advanced throwers Ten program

Question 5

Key concept of biceps strain rehab when doing strengthening

Answer 5

Work both at elbow and at shoulder

Question 6

How do you integrate biceps into combination movements?

Answer 6

Push and pull exercises with scapula
OKC and CKC exercises

Question 7

Goal of gentle stretching in medial epicondylitis

Answer 7

Stimulate a repair response

Question 8

Goal of aggressive stretching and high load low reps strengthening for medial epicondylitis

Answer 8

Emphasize on eccentric contractions - reduce risk of re-injury

Question 9

Wrist flexion and extension activities should be initially completed with ___ of elbow flexion

Answer 9

30-45d

Question 10

Goal of position of elbow in wrist strengthening

Answer 10

Limit the stress on the medial elbow structures

Question 11

What changes in medial epicondylitis if it’s a tendinosis?

Answer 11

Start eccentrics earlier

Question 12

See slide 13

Answer 12

Lateral epicondylitis research facts

Question 13

Which injuries has limited evidence for physical therapy

Answer 13

Carpal tunnel syndrome
TFCC tear

Question 14

Examples of exercises to do with carpal tunnel syndrome

Answer 14

Carpal mobilizations, immobilization, nerve flossing, ultrasound, yoga

Question 15

What is gymnast’s wrist?

Answer 15

Dorsal impingement or dorsal radial stress fracture

Question 16

important actions to do in gymnast wrist rehab

Answer 16

• Stretching wrist flexors is important
• Mobilizations - wrist glides
• Strengthen wrist extensors
• Flexibility and strength go hand in hand

Question 17

Surgery common with TFCC tear rehab, T or F

Answer 17

TRUE

Question 18

UCL sprain rehab - when is conservative tx suitable?

Answer 18

For patients with less than 30d of valgus laxity in extension

Question 19

Do you need to immobilize the wrist in a protective splint when splinting for thumb?

Answer 19

Yes, approx. 1 week

Question 20

After 1 week, what is the new splint for UCL sprain?

Answer 20

Thermoplastic splint allowing movement at IP joints

Question 21

UCL sprain (thumb) - 8 weeks

Answer 21

Progressive strengthening can begin

Question 22

UCL sprain (thumb) - 12 weeks

Answer 22

Unrestricted full return to activity

Question 23

See slide 21

Answer 23

Rehab UCL (thumb) exercises

Question 24

What is skier’s thumb?

Answer 24

Ulnar collateral ligament sprain (thumb)