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Tennis Elbow / Lateral Humeral Epicondylitis

WHAT IS TENNIS ELBOW OR LATERAL HUMERAL EPICONDYLITIS?

Tennis elbow is characterized by soreness or pain on the outside of the upper arm near the elbow. There may be a partial tear of the tendon fibers which joins the muscle to bone near their point of origin on the outside of the elbow.

HOW IS […]

Resisted extension of the wrist

Positioning.

The subject stands with the arm hanging, the elbow extended and the wrist in neutral position (between pronation and supination,and between flexion and extension). The examiner stands level with the subject’s elbow. The contralateral arm lifts and carries the elbow and keeps it extended. The hand stabilizes the forearm. The other hand is placed […]

Resisted extension

Positioning.

The subject stands with the arm alongside the body, the elbow flexed to 90° and the forearm in supination. The examiner stands level with the elbow. One hand supports the distal part of the forearm and the other hand is on top of the shoulder.

Procedure.

Resist the subject’s attempt to extend the elbow.

[…]

ISOMETRIC CONTRACTIONS

Resisted flexion

Positioning

The subject stands with the arm hanging, the elbow flexed to a right angle and the forearm supinated. The examiner stands level with the elbow. One hand is on the distal part of the forearm and the other hand on top of the shoulder.

Procedure.

Resist the subject’s attempt to flex the […]

Passive pronation

Positioning.

The subject stands with the arm hanging and the elbow bent to a right angle. The examiner stands in front of the subject. Both hands encircle the distal forearm in such a way that the heel of the contralateral hand is placed against the volar part of the ulna and the fingers of the […]

Passive extension

Positioning The subject stands with the arm outstretched. The examiner stands level with the subject’S elbow. One hand stabilizes the elbow,and the other hand grasps the distal forearm.

Procedure:

• To test the range: move hands in opposite directions – distal hand downwards and proximal hand upwards. • To test the end-feel: bring […]

FUNCTIONAL EXAMINATION OF THE ELBOW

PASSIVE TESTS

Passive flexion

Positioning. The subject stands with the arm outstretched. The examiner stands level with the subject’s arm. He places one hand against the back of the shoulder and grasps the distal forearm with the other hand.

Procedure. Bring the hand towards the shoulder,thereby stabilizing the latter, until the movement comes to a […]

MEDIAL-Palpation of soft tissue

Keep the subject’s elbow almost completely extended and in full supination. Move the finger from the medial aspect of the medial epicondyle about 1-1.5 cm towards the anterior aspect. Palpate for a tough round structure. This is the common tendon of the flexors.0.5 em more distally, just below the inferior border of the epicondyle and […]

Palpation of soft tissue

Over the olecranon lies the olecranon bursa,which is only really palpable when it becomes inflamed and swollen.Keep the subject’s elbow flexed. Palpate for the upper border (apex) of the olecranon. Feel just lateral to this apex for the insertion of the tendon of the triceps muscle. Move the fingers upwards: a broad and flat tendon […]

POSTERIOR

Bony landmarks

Three bony prominences can be identified. On an extended elbow they lie in one line. Laterally is situated the lateral epicondyle and medially the medial epicondyle. In between lies the olecranon, gross and prominent. During flexion of the elbow the olecranon moves downwards which makes its apex easily palpable. In a bent elbow […]