Medial Elbow Pain Flashcards
(25 cards)
How does an abducted elbow occur?
Trauma with a FOOSH
What does an abducted elbow lead to?
Medially fixated olecranon
During your scan with an abducted elbow what might you observe?
Increased carrying angle
What ROM limitations with pain will you see with an abducted elbow?
- Elbow flexion and forearm supination due to a lack of lateral ulnar glide
- Wrist flexion/ radial deviation due to the radius shifting distally from contact with capitulum
What will you see when you provide resistance and MMT with an abducted elbow?
Wrist extension and radial deviation pain
With an abducted elbow what glide would be limited and why?
Lateral because the elbow is stuck medially
With palpation of an abducted elbow, what would be tender?
Common extensor tendon
What kind of Rx would you provide someone with an abducted elbow?
- POLICED
- Correct lateral glide, possibly with a manipulation
- Stabilize with METs
What is the prevalence of medial tendinitis/ tendinosis?
0.4%
What is another name for medial tendinitis/ tendinosis?
Thrower’s, little league, or golfers elbow
What are the structures involved in a medial elbow tendinitis/ tendinosis?
- Pronator Teres
- Flexor Carpi Radialis
- Flexor Carpi Ulnaris
- Flexor Digitorum Superficialis
- Flexor Digitorum Profundus
What are the hallmark signs and symptoms of tendinitis specific to the medial elbow?
Opposite of lateral elbow tendinitis
What are complications of medial tendinitis/ tendinosis?
- Medial epicondyle apophysitis in adolescents overhead throwers
- Ulnar collateral ligament involvement
What is another name for medial epicondyle apophysitis?
Little league elbow
What population experiences medial epicondyle apophysitis?
- Adolescents, biological males > females
- Mostly overhead throwers but also racquet sports
What is the cause of medial epicondyle apophysitis?
Growth with high activity
What are the pathomechanics of a medial epicondyle apophysitis?
- Bone growth exceeds wrist flexor and pronator lengthening
- Increased tendon tension
- Growth plate is the weak spot as opposed to tendon in the adult
- Most often inflammation
What are complications of medial epicondyle apophysitis?
- Avulsion and or premature closure
- Ulnar collateral ligament involvement
What are symptoms of a medial epicondyle apophysitis?
- Gradual onset with overuse
- A “pop” may indicate trauma or an avulsion
- Above etiology with possible loss of velocity
What are signs of a medial epicondyle apophysitis?
- ROM: possible loss of extension with pain
- Resisted/ MMT: possibly weak and or painful muscles that attach to CFT
- Palpation: TTP over the medial epicondyle
What is the Rx for a medial epicondyle apophysitis?
- Patient education
- Soreness rule
- Load management (ex: pitch count, active rest with alternate positions, rest days)
- Movement cues (ex: throwing mechanics)
- POLICED
What do you need to be careful with in regards to Rx and medial epicondyle apophysitis?
Careful with prolonged stretching due to vulnerability of growth plate
What kind of METs should you do for a medial epicondyle apophysitis?
- For trunk, cuff, scapular, and LE impairments
- Caution with muscle/ tendons attached to the growth plate
What does RTP mean?
Return to play - throwing progression program
