Week 4: Management of common elbow conditions Flashcards
When would a Pt. need a referral or review?
- serious pathology
- further investigations
- pain and sig. disability persisting >6/12, despite Rx
- sig. instability and injury
What are the general principles for stable elbow fracture Rx?
- arm immobilised
- then placed in removable splint and early ROM commenced
- protected 6-8/52
- early and freq. XR to ensure satisfactory union
- -> exercise and manual therapy for j. stiffness/weakness
What are Rx strategies for post. dislocation?
- AROM exercises to prevent loss of extension
- taping to stabilise
- ROM within pain limits
What is Rx for gout?
- pharmacology (NSAIDs)
- weight loss
- diet
What does Rx in the reactive stage of extensor tendinopathy involve?
- control pain
- analgesics
- avoid agg. activities
- taping or bracing
- isometric wrist extension strengthening
- stretching
- general UL strengthening as indicated
What does a multimodal approach to Rx for extensor tendinopathy involve?
- address central sensitisation
- spinal mobilisation (if Csp/Tsp involvement)
- mobilisation for stiffness
- trigger pointing
- neural mobilisations
- gradual return to aggravating activities
What does medical management for extensor tendinopathy involve?
- corticosteroid injection
- nitric oxide patches
- injection of platelet-rich plasma
- surgery
What is the Rx for LCL injury?
- brace/splint and forearm in pronation
- AROM exercises
- taping
What does Rx in the degenerative stage of extensor tendinopathy involve?
- improving tendon integrity
- progressive wrist extension strengthening
- slow eccentrice exercise
What does Rx in the reactive stage of flexor/pronator tendinopathy involve?
- education
- pain control
- NSAIDs
- isometric holds
what does Rx in the degenerative stage of flexor/pronator tendiopathy involve?
- improve tendon integrity
- progression wrist flexion/pronation strengthening
- slow eccentric contractions
- manual therapy and ulnar n. mobilisation as indicated
What does Rx for MCL sprain involve?
- acute: POLICE
- early focus on pain free ROM
- progressive strengthening
- address kinetic chain deficits
What is the Rx for olecranon bursitis?
- acute: ice, rest, compression and NSAIDs
- aspiration of fluid and corticosteroid injection
- surgery
What does conservative Rx for post. impingement involve?
- pain management
- minimise hyperextension (tape, education)
- strengthening and stability exercises
What is Rx for referred pain?
- address local pathology in C/sp or shoulder
