Lecture 13 - Elbow/hand/wrist rehab Flashcards
2 main goals of rehab of throwing athlete -elbow injuries for phase 1
- ROM - PROM and A-AROM to decrease adhesions - wrist and elbow
- Sub painful and submaximal isometrics
Goals of intermediate phase of throwing athletes - elbow injuries
Still protect valgus stress
Isotonic strengthening -> concentric -> eccentric progression
Shoulder stability continued (RC and scap m.)
Goals of advanced strengthening of elbow injuries in throwing athletes
- introduce/progress valgus stress
- increase strength/power/endurance for gradual RTP
- higher resistance, functional mvts, eccentrics, plyometrics
Program for OH athlete injuries
Advanced throwers Ten program
Key concept of biceps strain rehab when doing strengthening
Work both at elbow and at shoulder
How do you integrate biceps into combination movements?
Push and pull exercises with scapula
OKC and CKC exercises
Goal of gentle stretching in medial epicondylitis
Stimulate a repair response
Goal of aggressive stretching and high load low reps strengthening for medial epicondylitis
Emphasize on eccentric contractions - reduce risk of re-injury
Wrist flexion and extension activities should be initially completed with ___ of elbow flexion
30-45d
Goal of position of elbow in wrist strengthening
Limit the stress on the medial elbow structures
What changes in medial epicondylitis if it’s a tendinosis?
Start eccentrics earlier
See slide 13
Lateral epicondylitis research facts
Which injuries has limited evidence for physical therapy
Carpal tunnel syndrome
TFCC tear
Examples of exercises to do with carpal tunnel syndrome
Carpal mobilizations, immobilization, nerve flossing, ultrasound, yoga
What is gymnast’s wrist?
Dorsal impingement or dorsal radial stress fracture
important actions to do in gymnast wrist rehab
- Stretching wrist flexors is important
- Mobilizations - wrist glides
- Strengthen wrist extensors
- Flexibility and strength go hand in hand
Surgery common with TFCC tear rehab, T or F
TRUE
UCL sprain rehab - when is conservative tx suitable?
For patients with less than 30d of valgus laxity in extension
Do you need to immobilize the wrist in a protective splint when splinting for thumb?
Yes, approx. 1 week
After 1 week, what is the new splint for UCL sprain?
Thermoplastic splint allowing movement at IP joints
UCL sprain (thumb) - 8 weeks
Progressive strengthening can begin
UCL sprain (thumb) - 12 weeks
Unrestricted full return to activity
See slide 21
Rehab UCL (thumb) exercises
What is skier’s thumb?
Ulnar collateral ligament sprain (thumb)
