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Download Jamie Hane OTR/L, CHT Sport & Spine Physical Therapy
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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!
