Scenario 13

Question 1

46 year old self employer insidious onset left lateral elbow pain over 4 months.. Tennis elbow?

Answer 1

Tennis elbow occurs as a result of overuse of the extensor muscles of the forearm whose orignin is the common extensor region (Lateral epicondyle humerus).

Question 2

Problem List (Sin Factors)

Answer 2

Severity: could ask patient to rate their feeling of pain on the VAS score and utilise this as a subjective marker.
Irritability: low irritability, as pain eases quicker then it takes for it to come on.
Nature: constant- indicating inflammatory. Gripping activities also brings on pain, so mechanical also?
Chronic stage.
Myogenic

Question 3

what can be utilised as outcome measures?

Answer 3

Objective measures: measuring A/P ROM wrist extension (Goniometer)
Subjective measures: Vas score

Question 4

Assessment techniques?

Answer 4

Muscle tests: isometric, palpation, stretch, strength
Cozens (positive if reproduction of pain along lateral epicondyle) , Mills, palpating the extensor muscle bulk, Active/passive range of movement wrist extension, varus stress test.

Question 5

Treatment Techniques?

Answer 5

DTF- to promote optimal alignment of collagen and breakdown of adhesions, SSTMS to the extensor Muscle bulk, exercises: wrist extension with weights, MWM- lateral glide to the forearm can help to reduce pain
Functional exercises incorporating gripping such as gripping a sponge ball

Question 6

Which muscles are most commonly involved?

Answer 6

ECRB and ECRL