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Upper 2 > Elbow interventions - Lecture 2 > Flashcards

Elbow interventions - Lecture 2 Flashcards

1
Q

What 4 motions can be acomplished at the elbow joint?

A

Pronation
Supination
Flexion
Extension

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2
Q

What would we use an elbow medial glide for?

A

pt w/ reduced flexion

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3
Q

What would we use an elbow lateral glide for?

A

pt w/ reduced elbow extension

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4
Q

Which kind of mobilization is best for having pain free grip strength?

A

Latearl mobilization of the elbow

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5
Q

What kind of glide is best for lateral epicondylagia?

A

Lateral glide

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6
Q

An anterior glide of the radius on the humerus helps w/ what?

A

Flexion (concave on convex)

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7
Q

When would we use an anterior radiohumeral glide? (2)

A

To help w/ elbow flexion and pronation

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8
Q

When would you do a posterior radiohumeral glide?

A

To help w/ reduced elbow extension and supination

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9
Q

What would an anterior glide of the ulna do?

A

help pt w/ reduced flexion and supination

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10
Q

What would an antrior glide of the radus do?

A

help w/ flexion and pronation

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11
Q

What would a posterior glide of radius do?

A

help w/ extension and supination

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12
Q

What would a posterior glide of the ulna do?

A

help w/ extension and pronation

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13
Q

When would you do a radioulnar inferior glide (distraction)

A

restricted elbow extension

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14
Q

When would you do a radioulnar superior glide (approximation)

A

used for pts w/ reduced elbow flexion

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15
Q

KNOW: PTs used to use cross friction massage w/ lateral / medial epicondyalgia - but it would actually be more beenficial to do a latearl and medial glide

A
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16
Q

What is iontophoresis used for?

A

Its a patch (negatively and positively charged) that treats inflammation

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17
Q

What does stretching address?

A

restores mobility (reduces protective tone)

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18
Q

What are the stretching principles (3)

A

20-30 seconds in duration
5 repetitions
Non-painful range

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19
Q

Does stretching increase sarcomere length?

A

No

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20
Q

Does serial casting increase sacromere length?

A

Yes

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21
Q

What does a dynosplint do? When is it used

A

Holds them in some ROM at the elbow (can change the degrees its held at)
*its a prolonged stretch
* this actually lengthens sacromere and m tissue

used w/ muscle contractures to try and legthen it back out

22
Q

pt has elbow flxn 2/5 will they get full range in the impage below?

A

Partial ROM (cant go against gravity in a 2/5)

23
Q

at what MMT should you add resistive movements?

A

4/5

24
Q

Isometrics –> eccentric / concentric –> plyometrics = tendon loading principles

A
25
Q

Whats good for isolating 1 muscle at a time –> open kinetic chain activities vs closed kindetic chain activities?

A

Open

26
Q

When going up in this image what motion is it?

A

Resisted supination?

27
Q

KNOW: If someone is having a hard time pouring something work on reissted supination / pronation

A
28
Q

Whats best for recruitment and utilization of multiple groups of muscles - OKC or CKC?

A

Closed kinetich chain

29
Q

What reduces protective tone / spasticity OKC or CKC?

A

CKC

30
Q

KNOW: Common causes of elbow pain:
* Medial epicondylalgia
* Ulnar collateral ligament injury
* Lateral epicondylalgia
* Elbow fracture/dislocatoin
* Olecranon bursitits
* Bicipital tendinopathy
* Triceps tendinopathy

Nerve entrapment:
* Ulnar nerve entrapment: (cubital tunnel syndrome)
* Radial n entrapment
* Median n entrapment

A
31
Q

What two muscles are primarily involved in medial epicondylalgia?
* NOTE: this affects the tendon bundle so what kind of progression of EX should we have them doing?

A

Flexor carpi radialis
Pronator teres

Lesser extent: PL, FCU, FDS

We need our tendon loading principles!
* Isometrics –> heavy slow eccentric / concentric –> low load fast concentric / eccentric –> high load fast concentric / eccentric

32
Q

Tendon loading principles (correct)

A

Isometric –> heavy but slow eccentric / concentric –> low load fast concentric / eccentric (looks more like plyometrics) –> high load fast concentric / eccentric (looks a lot like plyometrics)

33
Q

This is resisted pronation or supination?

What condition would we use this for?

A

resisted pronation

34
Q

is this resisted flexion or extension

A

resisted flexion

used for medial epicondyalagia

35
Q

What 5 exercises / interventions should we do for someone w/ acute medial epicondyalagia?

A

Mobility work (AAROM / PROM / AROM)

Joint mobilization

Distal/proximal joint EX (work in areas other than just elbow)

Isometrics (it is a tendon)

Ice massage / e stem

NOTE: Never to early to do resisted activity

36
Q

w/ moderate irritability medial epicondylagia = improve tolerance to load (utlize a variety of grips)

Low irritability goals =
* regular strengthening / power development
* specific to patient functional requirements

A
37
Q

What two things cause UCL injury (elbow)

A

valgus w/ shoulder ER
* NOTE: if I have limited ER i increase my valgus at the elbow

38
Q

What kind of traumatic injurys often cause UCL issues?

A

FOOSH (go into valgus when you fall)

39
Q

What stress test do we do to find UCL issues?

A

Moving valgus stress test

40
Q

If we have UCL issues what nervy condition can develop?

A

Cubital tunnel syndrome (Ulnar n)

41
Q

What motion would we want to avoid w/ acute UCL injuryies? why?

A

full extension because were going into valgus (further putting stress on that ligament)

42
Q

what is the carrying angle?

A

Angle between the humerus and ground and humerus and forearm when in full extension
* indicates the amount of valgus
* bigger angle = more valgus

43
Q

throwing injuries are normally where?

A

UCL (go into valgus when throwing)

44
Q

NOTE: treat UCL/MCL like any other tendinopathy (work on ROM/pain modualtion/isometrics acute then progress to more loading)

A
45
Q

What percent of UCL repairs have ulnar nerve issues?

A

12%

46
Q

What is the typical immobilization position (holding it in one spot) of UCL repair? WHy?

A

around 90 degrees of flexion for 7 days and working on ROM

because we dont want them to fall into extension and have valgus

47
Q

KNOW: crossover affects from strengthening = strengthen contralateral side and get cross over effects to the ipsialteral side (ipsilatearl side will get stronger [i think this is mind muscle related / nerve related])

Good thing to do if someone is immobilized on ipsilateral side

A
48
Q

ballistic = concentric and high velocity eccentric

A
49
Q

What % of global upper extremity limb semmetry index do we want them to have before going to return to sport?

A

70%

50
Q

what text measures side to side UE stregnth?

A

seated shock put

Upper 2 (2 decks)

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