MSK bott term 3 cases

Question 1

Recreational Tennis Player with End-Range Extension Limitation

Subject: 32-year-old recreational tennis player. No pain at rest or with ADLs. Noticed limited extension in the right
elbow compared to the left after a long weekend tournament. Reports mild tightness with full follow-through.
Findings:
* PROM: Elbow extension is limited by 10 degrees on the right
* No swelling, no pain, normal flexion and supination/pronation
* If you “clear” the joint, what other tissues may be limiting extension? Be specific.
1. Identify the most likely joint(s)/tissues involved.
2. Identify the open and closed pack positions of the affected joint(s).
3. Select a Grade I–IV mobilization appropriate for this case

Answer 1

2. open pack position of elbow
   70 degrees of flexion and 10 degrees of supination
   closed pack position of elbow
   elbow fully extended and the forearm maximally supinated

Question 2

what mob helps improve elbow flexion

Answer 2

anterior glide helps improve elbow flexion

Question 3

what mob helps improve elbow extension

Answer 3

posterior glide helps improve elbow extension

Question 4

posterior mobilization grade III will help with what?

Answer 4

elbow extension

Question 5

anterior glide/mobilization grade III will help with what?

Answer 5

elbow flexion

Question 6

54-year-old office worker who reports wrist and elbow tightness while typing and using a mouse. No pain,
but recent ergonomic assessment revealed reduced pronation which may be affecting desk posture.
Findings:
* PROM: Supination full, pronation limited ~15 degrees compared to left
* No tenderness or pain
* Full elbow flexion/extension
* If you “clear” the joint, what other tissues may be limiting extension? Be specific.
1. Identify the most likely joint(s)/tissues involved.
2. Identify the open and closed pack positions of the affected joint(s).
3. Select a Grade I–IV mobilization appropriate for this case

Answer 6

2. open packed position of proximal radioulnar joint
   70 degrees of elbow flexion and 35 degrees of supination
   closed pack position of proximal radioulnar joint
   full elbow extension and 5 degrees supination
   3.

Question 7

what mob for supination

Answer 7

posterior glide of radial head

Question 8

what mob for pronation

Answer 8

anterior glide of radial head

Question 9

Retired Carpenter with Limited Supination
Subject: 67-year-old retired carpenter who stays active with yard work and home projects. Reports no pain but has difficulty using a screwdriver or turning door knobs due to limited rotation in the right forearm.
Findings:
PROM: Supination limited by ~20 degrees on the right
Pronation full and pain-free
No tenderness, swelling, or instability
1. Identify the most likely joint(s)/tissues involved.
2. Identify the open and closed pack positions of the affected joint(s).
3. Select a Grade I–IV mobilization appropriate for this case

Answer 9

hmmm

Question 10

Collegiate Wrestler with Limited Flexion
Subject: 21-year-old collegiate wrestler during pre-season strength and conditioning. Reports difficulty achieving
deep elbow flexion when performing front-loaded movements such as cleans and chin-ups. No pain, but tightness is noticeable during strength work.
Findings:
* PROM: Elbow flexion limited by ~15 degrees compared to non-dominant arm
* Full and pain-free extension, pronation, and supination
* Firm end-feel with no swelling or signs of inflammation

Group Discussion Prompts:
* Which joint(s) are likely restricted?
* What arthrokinematic motion would you facilitate?
* What grade of mobilization is appropriate and why?
* What would you monitor during or after the intervention?

Answer 10

hmmmm