Regional Interdependence In Treatment Of The Elbow: Difference between revisions
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== [[Regional Interdependence|Regional Interdependence]] == | |||
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*Treatment directed at one area of the body to elicit changes in another | *Treatment directed at one area of the body to elicit changes in another | ||
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*High velocity low amplitude (HVLA) thrust manipulation directed superior and medial towards contralateral eye | *High velocity low amplitude (HVLA) thrust manipulation directed superior and medial towards contralateral eye | ||
Cervical Thrust Manip Video | Cervical Thrust Manip Video {{#ev:youtube|SpMhG63CXFQ}} | ||
{{#ev:youtube|SpMhG63CXFQ}} | |||
== Cervico-Thoracic Mobilization for Lateral Epicondylagia == | == Cervico-Thoracic Mobilization for Lateral Epicondylagia == | ||
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*Stretching of wrist extensors, strengthening of wrist and forearm, and mobilizations of elbow/wrist | *Stretching of wrist extensors, strengthening of wrist and forearm, and mobilizations of elbow/wrist | ||
CT Manip Video | CT Manip Video {{#ev:youtube|xEd6VdQMKjM}} | ||
{{#ev:youtube|xEd6VdQMKjM}} | |||
== Thoracic Manipulation for Lateral Epicondylagia<br> == | == Thoracic Manipulation for Lateral Epicondylagia<br> == | ||
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*Wrist flexion maintained and HVLA thrust to triquetral palmarly | *Wrist flexion maintained and HVLA thrust to triquetral palmarly | ||
{{#ev:youtube|xodTPrizT_A}} | {{#ev:youtube|xodTPrizT_A}} | ||
== Nerve Mobilization for Radial or Medial Nerve Entrapment == | == Nerve Mobilization for Radial or Medial Nerve Entrapment == | ||
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{{#ev:youtube|-9BkFAdDGJo}} | {{#ev:youtube|-9BkFAdDGJo}} | ||
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{{#ev:youtube|ScuBg9Y22lY}} | |||
{{#ev:youtube|ScuBg9Y22lY}} | |||
== Physical Therapy Management in addition to manipulation…. == | == Physical Therapy Management in addition to manipulation…. == | ||
== Clinical Bottom Line (conclusion)<br> == | == Clinical Bottom Line (conclusion)<br> == | ||
• Manipulation of the wrist in those with lateral epicondylitis might have additional treatment effects short term compared with ultrasound, friction massage, and muscle strengthening and stretching <br>• Incorporating manual therapy directed at the cervicothoracic spine may provide additional benefits over treatment directed only at the elbow. | • Manipulation of the wrist in those with lateral epicondylitis might have additional treatment effects short term compared with ultrasound, friction massage, and muscle strengthening and stretching <br>• Incorporating manual therapy directed at the cervicothoracic spine may provide additional benefits over treatment directed only at the elbow. | ||
== References == | == References == |
Revision as of 17:04, 12 November 2012
Regional Interdependence[edit | edit source]
- Treatment directed at one area of the body to elicit changes in another
- In addition to treatment directed at the elbow, patients with elbow pain may benefit from treatment directed at the cervical or thoracic spine, elbow, and/or wrist.
Treatment Techniques[edit | edit source]
Cervical (link to spot within this page) (Patients - Treatments - Video - References)
CT (Patients - Treaments - Video - References)
Thoracic (Patients - Treatments - Video - References)
Wrist (Patients - Treatments - Video - References)
Carpal Mobilization (Patients - Treatments - Video - References)
Median and Radial Nerve mobilization (Patients - Treatments - Video - References)
Outcomes
[edit | edit source]
Pain |
Pain free Grip strength |
Pressure pain threshold | Disability | Perception of change | Global improvement | Max grip force | Carpal mobility | Elbow flexion test | |
Cervical | X | X | |||||||
CT | X | X | X | X | |||||
Throacic | X | ||||||||
Wrist |
X | X | X | X | X | ||||
Carpal mobilization | X | X | X | ||||||
Medain/Radial Nerve Mob | X | X |
Cervical Thrust Manipulation for Lateral Epicondylagia[edit | edit source]
- Patient supine with neck in nuetral
- Physical therapist positions neck into rotation and contralateral flexion
- High velocity low amplitude (HVLA) thrust manipulation directed superior and medial towards contralateral eye
Cervical Thrust Manip Video
Cervico-Thoracic Mobilization for Lateral Epicondylagia[edit | edit source]
- Non-thrust grade III and IV PPIVM and PAIVM directed at impaired segment
Done in combination with the following:
- Stretching of wrist extensors, strengthening of wrist and forearm, and mobilizations of elbow/wrist
CT Manip Video
Thoracic Manipulation for Lateral Epicondylagia
[edit | edit source]
- Patient is supine with arms across their chest
- PT places stabilizing hand just under restricted segment
- Other hand is used to stabilize neck, head, and upper thoracic spine
- PT performs gentle flexion to targeted segment
- High-velocity, low amplitude thrust in downward, cephalad direction
Wrist Manipulation for Lateral Epicondylagia
[edit | edit source]
- Therapist grips patient's scaphoid between thumb and index finger
- Place other hand over same landmarks for stabilization
- Extend patient's wrist while manipulating scaphoid ventrally
Carpal Mobilization for Cubital Tunnel Syndrome[edit | edit source]
- Patient seated
- Physical Therapist stabilizes patient's hamate palmarly
- Dorsally Physical therapist palpates triquetral bone with thumbs stacked on one another
- Patient instructed to lean back to provide traction on carpals
- Wrist flexion maintained and HVLA thrust to triquetral palmarly
Nerve Mobilization for Radial or Medial Nerve Entrapment[edit | edit source]
- Patient supine, placed in ULTT positions for radial or median nerve
- Flex/Extend patients elbow while in test positions
- Extend elbow about 2 seconds into range
- Tension felt/ no pain
- Flex elbow to point of no tension
- Repeat 6-7 times
Physical Therapy Management in addition to manipulation….[edit | edit source]
Clinical Bottom Line (conclusion)
[edit | edit source]
• Manipulation of the wrist in those with lateral epicondylitis might have additional treatment effects short term compared with ultrasound, friction massage, and muscle strengthening and stretching
• Incorporating manual therapy directed at the cervicothoracic spine may provide additional benefits over treatment directed only at the elbow.