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

THANK YOU!