UE Diagnostic Manual - Movement Coordination Elbow Flashcards
pathologies associated with movement coord at elbow
MCL / ulnar collateral ligament tear
outcome measures associated with mvmt coord at elbow
PSFS
Quick DASH
diagnostic information associated with MCL/UCL tear
throwing athletes typically
- in baseball = improper mechanics, overuse, fatigue, and arm slot/angle
direct trauma into a valgus position caused by FOOSH
explain precipitating activities that can lead to MCL/UCL tear
repetitive microtrauma in attempt to decrease elbow valgus in late cocking phase of throwing
– can also be due to improper ROM in shoulder or wrist causing increased stress at elbow
ROM findings associated with mvmt coord deficit at elbow
painful at midrange
acute swelling could limit full ROM
PROM > AROM
explain the job of the UCL
stabilization of valgus and rotational forces at elbow
muscle performance finding associated with mvmt coord deficit at elbow
resisted - strong and painless
weakness, pain, or guarding may be present in medial elbow as protective response
palpation findings associated with mvmt coord deficit at elbow
localized pain upon palpation in area of MCL
tenderness of medial elbow stabilizers (overuse)
what muscles are considered the medial elbow stabilizers
flexor carpi ulnaris
pronator teres
flexor digitorum superficialis
- sometimes brachioradialis
joint mobility findings associated with mvmt coord deficit at elbow
stiffness
- based upon length of time since injury and associated immobilization
neurological findings associated with mvmt coord deficit at elbow
n/a
special tests associated with mvmt coordination deficit at elbow
moving valgus stress test
education intervention associated with mvmt coord deficit at elbow
rest and reduced activity (2-3 wks)
sport diversity encouraged
younger athletes, specifically baseball, adhere to guidelines regarding pitch counts
how to improve coordination and activation of muscles at elbow
coordinated co-contraction ex
- isometrics early
- dynamic joint stability later
what muscles should the focus of weight bearing exercises be on? why?
improving strength up and down the kinetic chain to reduce stress on UCL at elbow
- shoulder girdle muscles
- core and lower extremity
how to normalize movement at the elbow
graded loading
graded functional return
how to reduce stress on tissues at the elbow
bracing / sling early
= can be restricted or unrestricted depending upon grade of tear / associated growth plate involvement
medical interventions associated mvmt coord deficit at elbow
Platelet Rich Plasma (covered in MPD cards)
surgery - Tommy John’s Surgery
when is Elbow ORIF indicated
elbow fx
key points for protection in elbow ORIF
limit elbow flexion to 90° (first 4 wks)
splint at 90° flex, neutral pro/supination
– worn at all times except during ROM exercises
NWB in UE
Tommy John - key points for protection
no ER of shoulder (causes valgus stress)
no weights
no ROM during week 1
no stretching –> instead gently gain AROM to limits after week 1-2
