Elbow

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Fractures/Dislocation Elbow

Elbow fractures usually involve a fall onto the outstretched arm or a direct trauma to the elbow. With elbow dislocations there may be associated nerve and/or blood vessel injuries. X-rays may show the fracture or dislocation but small breaks may be difficult to see.

Fractures are an emergency and immediate reduction (or placing the bones together to allow healing) is necessary. Bone breaks within the joint need special attention to ensure recovery of proper function of the joints.

Possible Treatments

  • Cryotherapy or Cold Therapy
  • Elbow Active Range of Motion
  • Elbow Joint Mobilization
  • Elbow Passive Range of Motion
  • Isometric Exercise
  • Elbow Resistive Range of Motion
  • Physical Agents

Possible Treatment Goals

  • Improve Function
  • Improve Muscle Strength and Power
  • Decrease Postoperative Complications
  • Improve Range of Motion
  • Self-care of Symptoms
  • Improve Safety
  • Improve Wound Healing

Additional Resources

Loose Bodies

Loose bodies are usually the result of old injuries or osteoarthritis of elbow joint. Locking and pain are the predominant signs and symptoms. The condition may be treated by surgical removal of the loose bodies if conservative care fails.

Possible Treatments

  • Cryotherapy or Cold Therapy
  • Elbow Active Range of Motion
  • Elbow Joint Mobilization
  • Elbow Passive Range of Motion
  • Elbow Resistive Range of Motion
  • Isometric Exercise
  • Foam Roll Exercise
  • Electrotherapeutic Modalities
  • Physical Agents

Possible Treatment Goals

  • Improve Function
  • Improve Muscle Strength and Power
  • Improve Range of Motion
  • Self-care of Symptoms

Additional Resources

Ulnar Nerve Injuries

This injury is usually the result of excessive valgus stress on the elbow during repeated throwing (especially during the cocking phase of a throw). Sometimes a direct injury to the nerve within the cubital tunnel (“hitting your funny bone”) will result in nerve damage. Symptoms include tingling and numbness in the ring and pinky fingers. This may occur during or after throwing or with prolonged bending of the elbow.

Changing throwing technique, bracing if necessary, and therapeutic exercise may be helpful. If the problem persists, or there is prolonged weakness, then surgery is indicated.

Possible Treatments

  • Cryotherapy or Cold Therapy
  • Elbow Active Range of Motion
  • Elbow Joint Mobilization
  • Elbow Passive Range of Motion
  • Elbow Resistive Range of Motion
  • Isometric Exercise
  • Foam Roll Exercise
  • Electrotherapeutic Modalities
  • Physical Agents

Possible Treatment Goals

  • Decrease Risk of Reoccurrence
  • Improve Function
  • Improve Muscle Strength and Power
  • Decrease Nerve Compression
  • Increase Oxygen to Tissues
  • Self-care of Symptoms
  • Improve Safety
  • Improve Tolerance for Prolonged Activities

Biceps Rupture at the Shoulder/Elbow

This injury is usually the result of a sudden forceful straightening of the elbow during concurrent contraction of the biceps muscle. Typically, there is sudden forearm pain and weakness. Surgical repair is necessary.

Post-surgical rehabilitation can be helpful with the recovery of range of motion, strength, and function.

Possible Treatments

  • Cryotherapy or Cold Therapy
  • Elbow Active Range of Motion
  • Elbow Joint Mobilization
  • Elbow Passive Range of Motion
  • Elbow Resistive Range of Motion
  • Isometric Exercise
  • Foam Roll Exercise
  • Electrotherapeutic Modalities
  • Physical Agents
  • Proprioceptive Neuromuscular Facilitation (PNF)
  • Shoulder Joint Mobilization
  • Stretching/Flexibility Exercise

Possible Treatment Goals

  • Improve Function
  • Improve Muscle Strength and Power
  • Decrease Postoperative Complications
  • Increase Oxygen to Tissues
  • Self-care of Symptoms
  • Improve Range of Motion

Additional Resources

Distal Triceps Rupture

Sudden forced bending (flexion) while the elbow is being straightened (extended), is a common mechanism. As with biceps rupture, surgical repair is necessary.

Possible Treatments

  • Cryotherapy or Cold Therapy
  • Elbow Active Range of Motion
  • Elbow Joint Mobilization
  • Elbow Passive Range of Motion
  • Elbow Resistive Range of Motion
  • Isometric Exercise
  • Foam Roll Exercise
  • Electrotherapeutic Modalities
  • Physical Agents
  • Soft Tissue Mobilization

Possible Treatment Goals

  • Improve Function
  • Improve Muscle Strength and Power
  • Increase Oxygen to Tissues
  • Improve Range of Motion
  • Self-care of Symptoms
  • Improve Wound Healing

Additional Resources

Golfer’s Elbow (Medial Epicondylalgia)

People that suffer from golfer’s elbow are often involved with racquet sports or golf. As with tennis elbow, they may overuse the forearm, traumatize the elbow by hitting several “fat” golf shots, or have poor swing technique.

Pain at the inner aspect of the elbow and reproduction of symptoms with resisted wrist flexion are common.

Activity modification, anti-inflammatory medications, ice, and progressive stretching and strengthening will relieve most cases. Surgery is only an option in recalcitrant cases.

Possible Treatments

  • Cryotherapy or Cold Therapy
  • Elbow Active Range of Motion
  • Elbow Joint Mobilization
  • Elbow Passive Range of Motion
  • Elbow Resistive Range of Motion
  • Isometric Exercise
  • Foam Roll Exercise
  • Electrotherapeutic Modalities
  • Physical Agents
  • Proprioceptive Neuromuscular Facilitation (PNF)
  • Soft Tissue Mobilization
  • Stretching/Flexibility Exercise

Possible Treatment Goals

  • Decrease Risk of Reoccurrence
  • Improve Fitness
  • Improve Function
  • Improve Muscle Strength and Power
  • Decrease Nerve Compression
  • Increase Oxygen to Tissues
  • Self-care of Symptoms
  • Improve Safety
  • Improve Tolerance for Prolonged Activities

Tennis Elbow (Lateral Epicondylalgia)

Lateral (meaning away from the midline of the body) epicondylalgia (meaning pain of the epicondyle) is a painful condition on the outer aspect of the elbow. The common name for lateral epicondylalgia is tennis elbow but only 5% of the people afflicted with this condition play tennis.

Pain at the elbow may have one or more causes: it could be from the forearm tendons that attach at the outer aspect of the elbow, it could be referred pain from the next, it could be from one or more of the joints at the elbow, or it may originate from the radial nerve that is in close proximity to the elbow joint.

It often occurs with repetitive use of the arm especially with a clenched fist. Most cases are not due to tennis.

Local tenderness and pain with resisted and passive extension of the wrists is common.

Activity modification, anti-inflammatory medications, ice, and progressive stretching and strengthening will relieve most cases. Surgery is only an option in recalcitrant cases.

Possible Treatments

  • Cryotherapy or Cold Therapy
  • Elbow Active Range of Motion
  • Elbow Joint Mobilization
  • Elbow Passive Range of Motion
  • Elbow Resistive Range of Motion
  • Isometric Exercise
  • Foam Roll Exercise
  • Electrotherapeutic Modalities
  • Physical Agents
  • Iontophoresis
  • Soft Tissue Mobilization
  • Stretching/Flexibility Exercise

Possible Treatment Goals

  • Decrease Risk of Reoccurrence
  • Improve Fitness
  • Improve Function
  • Improve Muscle Strength and Power
  • Increase Oxygen to Tissues
  • Self-care of Symptoms
  • Improve Safety
  • Improve Tolerance for Prolonged Activities

Additional Resources

  • Fractures/Dislocation Elbow

    Elbow fractures usually involve a fall onto the outstretched arm or a direct trauma to the elbow. With elbow dislocations there may be associated nerve and/or blood vessel injuries. X-rays may show the fracture or dislocation but small breaks may be difficult to see.

    Fractures are an emergency and immediate reduction (or placing the bones together to allow healing) is necessary. Bone breaks within the joint need special attention to ensure recovery of proper function of the joints.

    Treatments

    Cryotherapy or Cold Therapy

    Cold therapy is used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain. Cold therapy may be administered by using a cold pack or an ice massage as seen in the above video.

    Elbow Active Range of Motion

    The movement of the elbow, by the patient, through a range of motion against gravity. AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Elbow Joint Mobilization

    Hands-on therapeutic procedures intended to increase soft tissue or elbow joint mobility. Mobilization is usually prescribed to increase mobility, decrease joint stiffness, and to relieve pain. There are many types of mobilization techniques including Grimsby, Maitland, Kaltenborn, Isometric Mobilizations, etc.

    Elbow Passive Range of Motion

    The movement of the elbow by the patient or therapist through a range of motion without the use of the muscles that “actively” move the joint(s).

    Isometric Exercise

    An isometric exercise is a muscle contraction without joint movement. Isometrics are usually prescribed for gentle nerve and muscle reeducation. They are typically used for strengthening with arthritis patients, post-surgical patients, or as an introductory muscle strengthening exercise. A usual progression is from isometrics to active and resistive exercises that involve joint movement.

    Elbow Resistive Range of Motion

    Exercises that gradually increase in resistance (weights) and in repetitions. PRE is usually prescribed for reeducation of muscles and strengthening. Weights, rubber bands, and body weight can be used as resistance.

    Physical Agents

    Possible Treatments

    • Cryotherapy or Cold Therapy
    • Heat Pack
    • Ultrasound

    Goals

    • Improve Function
    • Improve Muscle Strength and Power
    • Decrease Postoperative Complications
    • Improve Range of Motion
    • Self-care of Symptoms
    • Improve Safety
    • Improve Wound Healing

    Resources

  • Loose Bodies

    Loose bodies are usually the result of old injuries or osteoarthritis of elbow joint. Locking and pain are the predominant signs and symptoms. The condition may be treated by surgical removal of the loose bodies if conservative care fails.

    Treatments

    Cryotherapy or Cold Therapy

    Cold therapy is used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain. Cold therapy may be administered by using a cold pack or an ice massage as seen in the above video.

    Elbow Active Range of Motion

    The movement of the elbow, by the patient, through a range of motion against gravity. AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Elbow Joint Mobilization

    Hands-on therapeutic procedures intended to increase soft tissue or elbow joint mobility. Mobilization is usually prescribed to increase mobility, decrease joint stiffness, and to relieve pain. There are many types of mobilization techniques including Grimsby, Maitland, Kaltenborn, Isometric Mobilizations, etc.

    Elbow Passive Range of Motion

    The movement of the elbow by the patient or therapist through a range of motion without the use of the muscles that “actively” move the joint(s).

    Elbow Resistive Range of Motion

    Exercises that gradually increase in resistance (weights) and in repetitions. PRE is usually prescribed for reeducation of muscles and strengthening. Weights, rubber bands, and body weight can be used as resistance.

    Isometric Exercise

    An isometric exercise is a muscle contraction without joint movement. Isometrics are usually prescribed for gentle nerve and muscle reeducation. They are typically used for strengthening with arthritis patients, post-surgical patients, or as an introductory muscle strengthening exercise. A usual progression is from isometrics to active and resistive exercises that involve joint movement.

    Foam Roll Exercise

    Exercises typically performed on a cylinder or half cylinder of foam for self-joint mobilization, postural exercise, core stability, and balance training.

    Electrotherapeutic Modalities

    Possible Treatments

    • Neuromuscular Electrical Stimulation
    • Transcutaneous Electrical Nerve Stimulation (TENS)
    • Iontophoresis
    Physical Agents

    Possible Treatments

    • Cryotherapy or Cold Therapy
    • Heat Pack
    • Ultrasound

    Goals

    • Improve Function
    • Improve Muscle Strength and Power
    • Improve Range of Motion
    • Self-care of Symptoms

    Resources

  • Ulnar Nerve Injuries

    This injury is usually the result of excessive valgus stress on the elbow during repeated throwing (especially during the cocking phase of a throw). Sometimes a direct injury to the nerve within the cubital tunnel (“hitting your funny bone”) will result in nerve damage. Symptoms include tingling and numbness in the ring and pinky fingers. This may occur during or after throwing or with prolonged bending of the elbow.

    Changing throwing technique, bracing if necessary, and therapeutic exercise may be helpful. If the problem persists, or there is prolonged weakness, then surgery is indicated.

    Treatments

    Cryotherapy or Cold Therapy

    Cold therapy is used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain. Cold therapy may be administered by using a cold pack or an ice massage as seen in the above video.

    Elbow Active Range of Motion

    The movement of the elbow, by the patient, through a range of motion against gravity. AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Elbow Joint Mobilization

    Hands-on therapeutic procedures intended to increase soft tissue or elbow joint mobility. Mobilization is usually prescribed to increase mobility, decrease joint stiffness, and to relieve pain. There are many types of mobilization techniques including Grimsby, Maitland, Kaltenborn, Isometric Mobilizations, etc.

    Elbow Passive Range of Motion

    The movement of the elbow by the patient or therapist through a range of motion without the use of the muscles that “actively” move the joint(s).

    Elbow Resistive Range of Motion

    Exercises that gradually increase in resistance (weights) and in repetitions. PRE is usually prescribed for reeducation of muscles and strengthening. Weights, rubber bands, and body weight can be used as resistance.

    Isometric Exercise

    An isometric exercise is a muscle contraction without joint movement. Isometrics are usually prescribed for gentle nerve and muscle reeducation. They are typically used for strengthening with arthritis patients, post-surgical patients, or as an introductory muscle strengthening exercise. A usual progression is from isometrics to active and resistive exercises that involve joint movement.

    Foam Roll Exercise

    Exercises typically performed on a cylinder or half cylinder of foam for self-joint mobilization, postural exercise, core stability, and balance training.

    Electrotherapeutic Modalities

    Possible Treatments

    • Neuromuscular Electrical Stimulation
    • Transcutaneous Electrical Nerve Stimulation (TENS)
    • Iontophoresis
    Physical Agents

    Possible Treatments

    • Cryotherapy or Cold Therapy
    • Heat Pack
    • Ultrasound

    Goals

    • Decrease Risk of Reoccurrence
    • Improve Function
    • Improve Muscle Strength and Power
    • Decrease Nerve Compression
    • Increase Oxygen to Tissues
    • Self-care of Symptoms
    • Improve Safety
    • Improve Tolerance for Prolonged Activities

    Resources

  • Biceps Rupture at the Shoulder/Elbow

    This injury is usually the result of a sudden forceful straightening of the elbow during concurrent contraction of the biceps muscle. Typically, there is sudden forearm pain and weakness. Surgical repair is necessary.

    Post-surgical rehabilitation can be helpful with the recovery of range of motion, strength, and function.

    Treatments

    Cryotherapy or Cold Therapy

    Cold therapy is used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain. Cold therapy may be administered by using a cold pack or an ice massage as seen in the above video.

    Elbow Active Range of Motion

    The movement of the elbow, by the patient, through a range of motion against gravity. AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Elbow Joint Mobilization

    Hands-on therapeutic procedures intended to increase soft tissue or elbow joint mobility. Mobilization is usually prescribed to increase mobility, decrease joint stiffness, and to relieve pain. There are many types of mobilization techniques including Grimsby, Maitland, Kaltenborn, Isometric Mobilizations, etc.

    Elbow Passive Range of Motion

    The movement of the elbow by the patient or therapist through a range of motion without the use of the muscles that “actively” move the joint(s).

    Elbow Resistive Range of Motion

    Exercises that gradually increase in resistance (weights) and in repetitions. PRE is usually prescribed for reeducation of muscles and strengthening. Weights, rubber bands, and body weight can be used as resistance.

    Isometric Exercise

    An isometric exercise is a muscle contraction without joint movement. Isometrics are usually prescribed for gentle nerve and muscle reeducation. They are typically used for strengthening with arthritis patients, post-surgical patients, or as an introductory muscle strengthening exercise. A usual progression is from isometrics to active and resistive exercises that involve joint movement.

    Foam Roll Exercise

    Exercises typically performed on a cylinder or half cylinder of foam for self-joint mobilization, postural exercise, core stability, and balance training.

    Electrotherapeutic Modalities

    Possible Treatments

    • Neuromuscular Electrical Stimulation
    • Transcutaneous Electrical Nerve Stimulation (TENS)
    • Iontophoresis
    Physical Agents

    Possible Treatments

    • Cryotherapy or Cold Therapy
    • Heat Pack
    • Ultrasound
    Proprioceptive Neuromuscular Facilitation (PNF)

    Performed in diagonal patterns that mimic functional movements. Initially this technique was used in developmentally and neurologically impaired patients. Today, PNF (or a variation of it)is commonly used for almost every aspect of neuromuscular retraining. It can be used on the professional athlete or someone in a nursing home.

    Shoulder Joint Mobilization

    Hands-on therapeutic procedures intended to increase soft tissue or shoulder joint mobility. Mobilization is usually prescribed to increase mobility, decrease joint stiffness, and to relieve pain. There are many types of mobilization techniques including Grimsby, Maitland, Kaltenborn, Isometric Mobilizations, etc.

    Stretching/Flexibility Exercise

    Exercise designed to lengthen a muscle(s) or soft tissue. Stretching exercises are usually prescribed to improve the flexibility of muscles that have tightened due to disuse or in compensation to pain, spasm or immobilization.

    Goals

    • Improve Function
    • Improve Muscle Strength and Power
    • Decrease Postoperative Complications
    • Increase Oxygen to Tissues
    • Self-care of Symptoms
    • Improve Range of Motion

    Resources

  • Distal Triceps Rupture

    Sudden forced bending (flexion) while the elbow is being straightened (extended), is a common mechanism. As with biceps rupture, surgical repair is necessary.

    Treatments

    Cryotherapy or Cold Therapy

    Cold therapy is used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain. Cold therapy may be administered by using a cold pack or an ice massage as seen in the above video.

    Elbow Active Range of Motion

    The movement of the elbow, by the patient, through a range of motion against gravity. AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Elbow Joint Mobilization

    Hands-on therapeutic procedures intended to increase soft tissue or elbow joint mobility. Mobilization is usually prescribed to increase mobility, decrease joint stiffness, and to relieve pain. There are many types of mobilization techniques including Grimsby, Maitland, Kaltenborn, Isometric Mobilizations, etc.

    Elbow Passive Range of Motion

    The movement of the elbow by the patient or therapist through a range of motion without the use of the muscles that “actively” move the joint(s).

    Elbow Resistive Range of Motion

    Exercises that gradually increase in resistance (weights) and in repetitions. PRE is usually prescribed for reeducation of muscles and strengthening. Weights, rubber bands, and body weight can be used as resistance.

    Isometric Exercise

    An isometric exercise is a muscle contraction without joint movement. Isometrics are usually prescribed for gentle nerve and muscle reeducation. They are typically used for strengthening with arthritis patients, post-surgical patients, or as an introductory muscle strengthening exercise. A usual progression is from isometrics to active and resistive exercises that involve joint movement.

    Foam Roll Exercise

    Exercises typically performed on a cylinder or half cylinder of foam for self-joint mobilization, postural exercise, core stability, and balance training.

    Electrotherapeutic Modalities

    Possible Treatments

    • Neuromuscular Electrical Stimulation
    • Transcutaneous Electrical Nerve Stimulation (TENS)
    • Iontophoresis
    Physical Agents

    Possible Treatments

    • Cryotherapy or Cold Therapy
    • Heat Pack
    • Ultrasound
    Soft Tissue Mobilization

    Therapeutic massage of body tissue, performed with the hands. Soft tissue mobilization may be used for muscle relaxation, to decrease swelling, to decrease scar tissue adhesions, and for pain relief.

    Goals

    • Improve Function
    • Improve Muscle Strength and Power
    • Increase Oxygen to Tissues
    • Improve Range of Motion
    • Self-care of Symptoms
    • Improve Wound Healing

    Resources

  • Golfer’s Elbow (Medial Epicondylalgia)

    People that suffer from golfer’s elbow are often involved with racquet sports or golf. As with tennis elbow, they may overuse the forearm, traumatize the elbow by hitting several “fat” golf shots, or have poor swing technique.

    Pain at the inner aspect of the elbow and reproduction of symptoms with resisted wrist flexion are common.

    Activity modification, anti-inflammatory medications, ice, and progressive stretching and strengthening will relieve most cases. Surgery is only an option in recalcitrant cases.

    Treatments

    Cryotherapy or Cold Therapy

    Cold therapy is used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain. Cold therapy may be administered by using a cold pack or an ice massage as seen in the above video.

    Elbow Active Range of Motion

    The movement of the elbow, by the patient, through a range of motion against gravity. AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Elbow Joint Mobilization

    Hands-on therapeutic procedures intended to increase soft tissue or elbow joint mobility. Mobilization is usually prescribed to increase mobility, decrease joint stiffness, and to relieve pain. There are many types of mobilization techniques including Grimsby, Maitland, Kaltenborn, Isometric Mobilizations, etc.

    Elbow Passive Range of Motion

    The movement of the elbow by the patient or therapist through a range of motion without the use of the muscles that “actively” move the joint(s).

    Elbow Resistive Range of Motion

    Exercises that gradually increase in resistance (weights) and in repetitions. PRE is usually prescribed for reeducation of muscles and strengthening. Weights, rubber bands, and body weight can be used as resistance.

    Isometric Exercise

    An isometric exercise is a muscle contraction without joint movement. Isometrics are usually prescribed for gentle nerve and muscle reeducation. They are typically used for strengthening with arthritis patients, post-surgical patients, or as an introductory muscle strengthening exercise. A usual progression is from isometrics to active and resistive exercises that involve joint movement.

    Foam Roll Exercise

    Exercises typically performed on a cylinder or half cylinder of foam for self-joint mobilization, postural exercise, core stability, and balance training.

    Electrotherapeutic Modalities

    Possible Treatments

    • Neuromuscular Electrical Stimulation
    • Transcutaneous Electrical Nerve Stimulation (TENS)
    • Iontophoresis
    Physical Agents

    Possible Treatments

    • Cryotherapy or Cold Therapy
    • Heat Pack
    • Ultrasound
    Proprioceptive Neuromuscular Facilitation (PNF)

    Performed in diagonal patterns that mimic functional movements. Initially this technique was used in developmentally and neurologically impaired patients. Today, PNF (or a variation of it)is commonly used for almost every aspect of neuromuscular retraining. It can be used on the professional athlete or someone in a nursing home.

    Soft Tissue Mobilization

    Therapeutic massage of body tissue, performed with the hands. Soft tissue mobilization may be used for muscle relaxation, to decrease swelling, to decrease scar tissue adhesions, and for pain relief.

    Stretching/Flexibility Exercise

    Exercise designed to lengthen a muscle(s) or soft tissue. Stretching exercises are usually prescribed to improve the flexibility of muscles that have tightened due to disuse or in compensation to pain, spasm or immobilization.

    Goals

    • Decrease Risk of Reoccurrence
    • Improve Fitness
    • Improve Function
    • Improve Muscle Strength and Power
    • Decrease Nerve Compression
    • Increase Oxygen to Tissues
    • Self-care of Symptoms
    • Improve Safety
    • Improve Tolerance for Prolonged Activities

    Resources

  • Tennis Elbow (Lateral Epicondylalgia)

    Lateral (meaning away from the midline of the body) epicondylalgia (meaning pain of the epicondyle) is a painful condition on the outer aspect of the elbow. The common name for lateral epicondylalgia is tennis elbow but only 5% of the people afflicted with this condition play tennis.

    Pain at the elbow may have one or more causes: it could be from the forearm tendons that attach at the outer aspect of the elbow, it could be referred pain from the next, it could be from one or more of the joints at the elbow, or it may originate from the radial nerve that is in close proximity to the elbow joint.

    It often occurs with repetitive use of the arm especially with a clenched fist. Most cases are not due to tennis.

    Local tenderness and pain with resisted and passive extension of the wrists is common.

    Activity modification, anti-inflammatory medications, ice, and progressive stretching and strengthening will relieve most cases. Surgery is only an option in recalcitrant cases.

    Treatments

    Cryotherapy or Cold Therapy

    Cold therapy is used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain. Cold therapy may be administered by using a cold pack or an ice massage as seen in the above video.

    Elbow Active Range of Motion

    The movement of the elbow, by the patient, through a range of motion against gravity. AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Elbow Joint Mobilization

    Hands-on therapeutic procedures intended to increase soft tissue or elbow joint mobility. Mobilization is usually prescribed to increase mobility, decrease joint stiffness, and to relieve pain. There are many types of mobilization techniques including Grimsby, Maitland, Kaltenborn, Isometric Mobilizations, etc.

    Elbow Passive Range of Motion

    The movement of the elbow by the patient or therapist through a range of motion without the use of the muscles that “actively” move the joint(s).

    Elbow Resistive Range of Motion

    Exercises that gradually increase in resistance (weights) and in repetitions. PRE is usually prescribed for reeducation of muscles and strengthening. Weights, rubber bands, and body weight can be used as resistance.

    Isometric Exercise

    An isometric exercise is a muscle contraction without joint movement. Isometrics are usually prescribed for gentle nerve and muscle reeducation. They are typically used for strengthening with arthritis patients, post-surgical patients, or as an introductory muscle strengthening exercise. A usual progression is from isometrics to active and resistive exercises that involve joint movement.

    Foam Roll Exercise

    Exercises typically performed on a cylinder or half cylinder of foam for self-joint mobilization, postural exercise, core stability, and balance training.

    Electrotherapeutic Modalities

    Possible Treatments

    • Neuromuscular Electrical Stimulation
    • Transcutaneous Electrical Nerve Stimulation (TENS)
    • Iontophoresis
    Physical Agents

    Possible Treatments

    • Cryotherapy or Cold Therapy
    • Heat Pack
    • Ultrasound
    Iontophoresis

    Medications are propelled through the skin by an electrical charge. This modality works on the physical concept that like charges repel each other, therefore, a positively charged medication will be repelled through the skin to the underlying tissues by the positively charged pad of an iontophoresis machine. Iontophoresis is usually prescribed for injuries such as shoulder or elbow bursitis.

    Soft Tissue Mobilization

    Therapeutic massage of body tissue, performed with the hands. Soft tissue mobilization may be used for muscle relaxation, to decrease swelling, to decrease scar tissue adhesions, and for pain relief.

    Stretching/Flexibility Exercise

    Exercise designed to lengthen a muscle(s) or soft tissue. Stretching exercises are usually prescribed to improve the flexibility of muscles that have tightened due to disuse or in compensation to pain, spasm or immobilization.

    Goals

    • Decrease Risk of Reoccurrence
    • Improve Fitness
    • Improve Function
    • Improve Muscle Strength and Power
    • Increase Oxygen to Tissues
    • Self-care of Symptoms
    • Improve Safety
    • Improve Tolerance for Prolonged Activities

    Resources