Elbow intervention

Question 1

what are some mobility exercises for epicondylitis?

Answer 1

Mobilization of surrounding regional areas
Mobilization with movement and/or joint manipulation (radial head)
Neural mobs → Radial Nerve
Transverse Friction massage/Tooling at tendon

Question 2

what are some strength & conditioning intervention for epicondylitis?

Answer 2

Eccentric loading
General conditioning (RC & scapular stability)

Question 3

what is the clinical prediction rule to identify MWM & exercise for lateral epicondylitis?

Answer 3

Age < 49 yrs
Affected PFGS > 25lbs
Unaffected PFGS < 75lbs

Question 4

what are some intervention for ulnar collateral ligament sprain?

Answer 4

Rest/Immobilization
Modalities for pain/swelling, NSAIDS
Gain pain-free ROM then begin strengthening at week 8
Strengthening flexor-pronator group are ineffective
Throwers ten (isotonis)
General conditioning (shoulder/scapular stability)
Core stability, balance, strength & flexibility
Throwing progression

Question 5

what are some intervention for cubital tunnel syndrome?

Answer 5

Splinting at 45° flexion & full supination for 4-6wks vs active rest
Modalites
Elbow pad or gel protective pad
Mobilization
Humeroulnar joint
Nerve

Question 6

what are some intervention for radial tunnel?

Answer 6

Immobilization
Relative Rest
Modalities
Neural glides

Question 7

what are some interventions for pronator syndrome?

Answer 7

Splinting at 90° flexion & gentle ROM for 2 wks
Modalites
Treat underlying cause of irritation to nerve
Soft tissue mobilization
Neural glides
Return to pain free aggravating activities at week 4

Question 8

what is the intervention following surgery for a distal bicep tendon rupture?

Answer 8

Posterior splint at 90° for 1-2 wks
Gentle ROM following d/c of splint
Full AROM at week 4
Strengthening begins at week 6 once full AROM
Unrestricted activity at week 8
Return to work/sports at 3-6 months
May be able to return w/ hinged brace at 8 weeks

Question 9

what is the intervention for osteoarthritis?

Answer 9

Modalities for pain → heat, paraffin
Maximize flexibility of surrounding tissues
Mobilization
Distraction
Muscle performance
Proximal strength/stability
Scapula
RC

Question 10

what is the intervention for simple dislocation?

Answer 10

Reduction & placement in padded splint
MCL involvement → supination
LCL involvement → pronation
Multiple ligament involvement → neutral
Begin rehab with no restrictions if stable
If unstable past 60°, begin in hinged brace w/ extension block

Question 11

what is the intervention for fractures?

Answer 11

Limb elevated 24 hours, may be in extension resting splint for week 1
Modalites for swelling/pain
Early controlled motion & AAROM
Modified codman
Table towel-sliding
Upon radiographic evidence of bone healing progress isometrics to isotonics at week 8

Question 12

what classify a patient as highly irritable?

Answer 12

Reports high levels of pain >7/10
Consistent night or resting pain
High levels of reported disability on outcome tools
Pain occurs before end range of A/PROM
AROM is significantly less than PROM

Question 13

what classify a patient as moderately irritable?

Answer 13

Reports moderate levels of pain 4-6/10
Intermittent night or resting pain
Moderate levels of reported disability on outcome tools
Pain occurs at end range of A/PROM
AROM is similar to PROM

Question 14

what classify a patient as low level of irritable?

Answer 14

Reports high levels of pain <3/10
No night or resting pain
Minimal levels of reported disability on outcome tools
Pain occurs with overpressure into end range of PROM
AROM = PROM

Question 15

what are some interventions for shoulder when the patient is in pain control category?

Answer 15

• patient eductaion
  -PROM/AAROM/ARON
  -submaximal isometrics
  -manual scapular stabilization
• Non-thrust manipulation
  -soft tissue manipulation
  -modalites

Question 16

what are some mobility impairments?

Answer 16

Pain with motion
Decrease joint play
Decreased A/PROM
Poor posture→ protracted, anteriorly tilted scapula, rounded shoulder
Decreased muscle performance (RC & Scapular stabilizers)
Substitute for decreased GH motion with poor scapulohumeral rhythm

Question 17

what are some mobility interventions for the shoulder?

Answer 17

-ROM
-Stretching
-Non thrust manipulation
-MWM
-Motor control

Question 18

what are some centralization exercise for the shoulder?

Answer 18

-extension open chain
-extension with clinician overpressure