Transcript Jamie Hane OTR/L, CHT Sport & Spine Physical Therapy
Jamie Hane OTR/L, CHT Sport & Spine Physical Therapy
WVAM 2015
Lateral Epicondylitis
Clinical observation Patient interview Patient goals Reproduction of symptoms Length of symptoms
Evaluation • ROM • Strength Grip Parascapular • Special tests Handshake Resisted middle finger lift off
Acute phase of rehabilitation: “resting pain and easy provocation of pain with ROM or functional activity” • Reducing pain • Facilitate tissue healing
Physical agents Soft tissue mobilization Orthotic intervention • Counterforce band • Wrist brace
Restorative phase of rehabilitation: “pain has subsided and there is little evidence of pain with active ROM or light activity.” • Gain flexibility, strength, endurance
Exercise • eccentric Work and Sport modification • Lifting technique • Gradual return to activity
Written instruction with realistic expectation for length of healing and plan for flares as they occur.
Ulnar nerve compression
Cubital tunnel vs. Ulnar Tunnel (Guyan) Observation of the hand • Wartenberg • Froment • Claw
Evaluation Tinels Bent elbow Strength ROM Tingling/numbness
Conservative management Muscle length and myofascial mobility • Moist heat • Ultrasound • PROM • kinesiotape
Neural mobilization • Fix the adjacent joint • Limit the ROM • Oscillate proximal or distal to compression • Slow, rhythmic motion • Symptom free
Orthotic intervention • Elbow • Wrist • Finger (figure of 8)
Activity modification • Avoiding positions that place stress on the nerve • Ergonomic considerations • Body posture