Upper Extremity Condition/Treatment Elbow Flashcards
Source & Lou Point combo for Pain bw/scapula & elbow
TW issue: TW4 & PC6
Source & Lou Point combo for Palm contracture, arm pain w/inability to extend
PC issue: PC7 & TW5
Lateral Epicondylitis may be secondary to failure of -
Musculotendinous attachment with fibroplasia
Chronicity of Lateral Epicondylitis may be d/t
a poor repair process
Lateral Epicondylitis is commonly seen in
PT bw/ 30-50 YO
Lateral Epicondylitis happens 4-5x more in
males
What arm of Lateral Epicondylitis is mostly affected?
dominant
What is the cause of Lateral Epicondylitis?
Not clear, maybe repetitive motion
Where is the pain of Lateral Epicondylitis?
where the common extensor attaches
What makes Lateral Epicondylitis pain worse?
lifting even light objects, opening doors
Type of Pain w/Lateral Epicondylitis
sharp, stabbing, burning, and/or dull achy, radiating proximally or distally (up & down arm)
What is the typical Western remedy
Cortisone inj.
If tennis elbow is bilateral, check
lower cervical segments w/foraminal
test C6, C7
What is important in the treatment of Lateral Epicondylitis?
Treat the extensor group attachment not just Ah Shi
What tendons of what muscles are a problem
Extensor carpi radialis brevis
Extensor Digitorum
What tests for Lateral Epicondylitis
Cozen’s
Mill’s
Ext Dig
TCM Dx of Lateral Epicondylitis
- LV Qi Stag
- LV Bl Def.
- Stag. Q/B @ epicondyle
Tx idea according to Dx of Lateral Epicondylitis
- smooth LV Qi
- Build LV Bl to smooth
- Move Q/B @ epicondyle
- Relax sinews
Local treatment of Lateral Epicondylitis
LI 10, TW5 Zone
Distal treatment of Lateral Epicondylitis at HAND
Ling Ku: 0.5 cun proximal to Hegu, same side as pain, perpendicular 0.5 - 0.9 cun
Moxa Lateral Epicondylitis if
chronic
EA setting for Lateral Epicondylitis
4 Hz continuous
What ST Ch points are used w/ Lateral Epicondylitis in acute cases where needling close to Lateral Epicondyle is too painful?
opposite knee:
ST36, ST37 check Ah Shi
What needles are used for osteoacupuncture & where exactly are they used?
38G to #1 Serin, along lateral epicondyle and along the anterior border of the radius
What IZ for Lateral Epicondylitis?
Extensor Digitorum: pronated hand, proximal 1/3 from on line from epicondyle to wrist crease. Move middle finger to find and
Golfer’s elbow aka
Medial Epicondylitis
Medial Epicondylitis check what trigger points?
biceps, medial head triceps, pronator teres
Which epicondyle is easier to treat medial or lateral?
lateral
Why is Medial Epicondylitis more difficult to treat?
Muscles that attach to Medial Epicondyle have tendinous sheaths and are more tubular as compared to the extensor groups fan like attachment.
Flexor tendons are
rounded w/synovial sheaths
Extensor tendons are
flat
Medial Epicondylitis most common muscles affected
pronator teres, flexor carpi radialis
Test for Medial Epicondylitis
Medial Epicondylar Stretching
General Dx for Medial Epicondylitis
- LV BL def.
- LV Qi Stag.
- Local Stag. Q/B @ medial epicondyle
Tx idea according to Dx of Medial Epicondylitis
- smooth LV Qi
- Build LV Bl to smooth
- Move Q/B @ epicondyle
- Relax sinews
Local pts. for Medial Epicondylitis
HT3, SI8
IZ for Medial Epicondylitis
Pronator Terres, Wrist Flexors: Flexor Carpi Radialis
Distal pts. Medial Epicondylitis
SI3, SI5
