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Jamie Hane OTR/L, CHT
Sport & Spine Physical
Therapy
WVAM 2015
Lateral Epicondylitis
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Clinical observation
Patient interview
Patient goals
Reproduction of symptoms
Length of symptoms
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Evaluation
• ROM
• Strength
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Grip
Parascapular
• Special tests
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Handshake
Resisted middle finger lift off
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Acute phase of rehabilitation:
“resting pain and easy provocation of
pain with ROM or functional activity”
• Reducing pain
• Facilitate tissue healing
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Physical agents
Soft tissue mobilization
Orthotic intervention
• Counterforce band
• Wrist brace
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Restorative phase of rehabilitation:
“pain has subsided and there is little
evidence of pain with active ROM or
light activity.”
• Gain flexibility, strength, endurance
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Exercise
• eccentric
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Work and Sport modification
• Lifting technique
• Gradual return to activity
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Written instruction with realistic
expectation for length of healing and
plan for flares as they occur.
Ulnar nerve compression
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
Cubital tunnel vs. Ulnar Tunnel
(Guyan)
Observation of the hand
• Wartenberg
• Froment
• Claw
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Evaluation
Tinels
Bent elbow
Strength
ROM
Tingling/numbness
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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
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