Tennis elbow

Question 1

structures involved

Answer 1

• extensor carpi radialis brevis tendon
• arthritis in C5/C6
• forearm extensor muscles

Question 2

structure involved

reasoning for extensor carpi radialis brevis tendon

Answer 2

tendon inflamed/damaged from overuse, leading top pain and dynsfunction of the elbow

passes through the 2nd extensor compartment of the wrist

Question 3

structure involved

reasoning for arthritis in C5/C6

Answer 3

possible nerve compression due to degenerative changes

degenerative disorder, complicated by inflammatory reactions

Question 4

structure involved

reasoning for forearm extensor muscles

Answer 4

• most likely to be extensor carpi radialis brevis (as it’s tendon is affected)
• may also be contributing to pain/dysfunction due to overuse/strain

brachioradialis, extensor carpi radialis brevis/longus, extensor digitorum, extensor digiti minimi, extensor carpi ulnaris

Question 5

what are the tissue mechanic(s) present

Answer 5

• muscle/tendon strain
• nerve compression

Question 6

tissue mechanics

what is muscle strain

Answer 6

• when muscle fibres can’t cope with the demands placed on them by exercise overload and leads to tearing of the fibers
• contraction-induced injury where fibers tear due to extensive mechanical stress

Question 7

tissue mechanics

what is nerve compression

Answer 7

continuous compression can lead to chronic pain and nerve damage

of radial nerve

Question 8

what is the dominant pain mechanism

Answer 8

nociceptive pain

Question 9

pain mechanic

what is nociceptive pain

Answer 9

caused by damage to body tissue

Question 10

MUST tests

Answer 10

• elbow and wrist ROM
• elbow and wrist strength
• reflex of biceps tendon (C5/6)

Question 11

MUST tests

how do you test ROM

Answer 11

elbow = flexion, extension, rotation, ebduction, adduction
wrist = flexion, extension, ulnar/radial deviation

Question 12

MUST tests

how do you test strength

Answer 12

elbow = flexion, extension, rotation, abduction, adduction
wrist = extension (main), flexion, ulnar/radial deviation

Question 13

MUST tests

how do you test biceps tendon reflex

C5/6

Answer 13

• slightly flexed elbow, fully supported and relaxed
• place thumb over biceps tendon (inside of elbow)
• tap thumb with hammer
• looking for elbow flexion

Question 14

SHOULD tests

Answer 14

neurodynamic tests
- radial nerve ( provocation)
- radial gliders

Question 15

SHOULD tests

how do you do radial nerve provocation test

Answer 15

• supine, at angle, shoulder off bed
• fix shoulder with thigh
• abduct shoulder 45 degrees, flex elbow, wrisst, fingers and thumb
• medially rotate shoulder, pronate forearm
• extend elbow
  (depress shoulder, side flex neck to opposite side - sensitise)

Question 16

SHOULD tests

how do you do radial gliders

Answer 16

• cross hands in front with arm straightened
• bring arms/hands up above head

Question 17

COULD tests

Answer 17

dermatomes - C5/6/7

Question 18

COULD tests

how do you test dermatomes

Answer 18

• C5 = pronated, lateral side of top of arm to elbow
• C6 = supinated, lateral side of top of arm to thumb
• C7 = pronated, elbow to middle 3 fingers, top of hand to palm of hand