Elbow/Forearm Mobility Deficit

Question 1

Clinical Pearl

What is the Resting/Open packed positon for the Proximal Radioulnar joint?
What is the Closed Packed Position?

Answer 1

The resting or open packed postion is 70° of elbow flexion and 35° of forearm supination

Closed packed is 5°of forearm supination

Question 2

What subjective reports may you hear with patients with Elbow/Forearm mobility deficit?

Answer 2

• Pain and stiffness
• Limited ROM

May have Hx of trauma, fracture, surgery or immobilization

Question 3

With Mobility Deficits, what are the Agg and Easing factors?

Answer 3

Agg
- Prolonged periods of inactivity

EASE
- Decreased stiffness/pain with activity

Question 4

When conducting the Physcial Examination, what may you find with those patients with Mobility Deficits?

Answer 4

• Anthropometrics (swelling)
  –With this measure the circumference of the elbow; There may also be muscle atrophy with this
• Limited AROM/PROM in any or all direction
• Hypomobility in Humeroulnar, humeroradial and radioulnar joints

Normal ROM in elbow flexion is 150° (soft EF), extension is 0° (hard EF)

Question 5

When conducting the Physcial Examination, what may you find during the Muscle Performance portion with Mobility Deficits?

Answer 5

Muscle Length:
- Tightness/decreased extensibility in wrist and elbow flexors/extensors

Muscle Strength:
- Weakness in wrist and elbow flexors/extensors
- Decreased grip strength

Grip strength needs to be at least 20% for minimal ADLs

Question 6

With Interventions, what should be done with Manual Therapy with those patients with Mobility Deficits?

Answer 6

• Soft Tissue
• Early mobilization
• Joint Mobilization
• Manual Stretching

Question 7

With Interventions, what Therapeutic Exercises should be done with those patients with Mobility Deficits?

Answer 7

• ROM in all directions necessary
• Self-streching
• Strengthening