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        • Gaenslen Test
        • Gillet Test
        • Gower's Sign
        • Lumbar Quadrant Test
        • POSH Test
        • Posteroanterior Mobility
        • Prone Knee Bend Test
        • Prone Instability Test
        • Resisted Abduction Test
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        • Seated Forward Flexion Test
        • SIJ Compression/Distraction Test
        • Slump Test
        • Sphinx Test
        • Spine Rotators & Multifidus Test
        • Squish Test
        • Standing Forward Flexion Test
        • Straight Leg Raise Test
        • Supine to Long Sit Test
      • Shoulder >
        • Active Compression Test
        • Anterior Apprehension
        • Biceps Load Test II
        • Drop Arm Sign
        • External Rotation Lag Sign
        • Hawkins-Kennedy Impingement Sign
        • Horizontal Adduction Test
        • Internal Rotation Lag Sign
        • Jobe Test
        • Ludington's Test
        • Neer Test
        • Painful Arc Sign
        • Pronated Load Test
        • Resisted Supination External Rotation Test
        • Speed's Test
        • Posterior Apprehension
        • Sulcus Sign
        • Thoracic Outlet Tests >
          • Adson's Test
          • Costoclavicular Brace
          • Hyperabduction Test
          • Roos (EAST)
        • Yergason's Test
      • Elbow >
        • Biceps Squeeze Test
        • Chair Sign
        • Cozen's Test
        • Elbow Extension Test
        • Medial Epicondylalgia Test
        • Mill's Test
        • Moving Valgus Stress Test
        • Push-up Sign
        • Ulnar Nerve Compression Test
        • Valgus Stress Test
        • Varus Stress Test
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        • Allen's Test
        • Carpal Compression Test
        • Finkelstein Test
        • Phalen's Test
        • Reverse Phalen's Test
      • Hip >
        • Craig's Test
        • Dial Test
        • FABER Test
        • FAIR Test
        • Fitzgerald's Test
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        • Hop Test
        • Labral Anterior Impingement Test
        • Labral Posterior Impingement Test
        • Long-Axis Femoral Distraction Test
        • Noble Compression Test
        • Percussion Test
        • Sign of the Buttock
        • Trendelenburg Test
      • Knee >
        • Anterior Drawer Test
        • Dial Test (Tibial Rotation Test)
        • Joint Line Tenderness
        • Lachman Test
        • McMurray Test
        • Noble Compression Test
        • Pivot-Shift Test
        • Posterior Drawer Test
        • Posterior Sag Sign
        • Quad Active Test
        • Thessaly Test
        • Valgus Stress Test
        • Varus Stress Test
      • Foot/Ankle >
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        • Talar Tilt
        • Tarsal Tunnel Syndrome Test
        • Test for Interdigital Neuroma
        • Windlass Test

Multiple Clinical Perspectives: A Look At The Elbow

4/23/2014

3 Comments

 
Picture
I've spoken before about one of my favorite aspects of this residency: the variety of resources. We routinely utilize the APTA Ortho Section's monograph for each joint, Shirley Sahrmann's texts, and a lecture from the clinical faculty for each joint. Recently, we covered the elbow, wrist, and hand in a couple lectures taught by a Certified Hand Therapist (CHT). CHT's are commonly known as experts in regards to assessing and treating these joints, so I was pretty excited for those lectures. If you have read the clinical practice guidelines on various elbow/wrist/hand pathologies or the monograph for those joints, you likely are aware of many of the commonly described clinical presentations, assessment and treatment techniques. If followed correctly, these patterns typically lead to good results.

Recently, my mentor, the other resident, our students, and I got together for some lab practice at the end of the day (another one of my favorite parts). We got to a point where we were discussing alternative assessment, treatment, and even philosophies of the elbow. As I have mentioned before, my mentor is a FAAOMPT and he receives regular updates from his fellowship regarding new assessment and treatment techniques throughout the body. We began discussing the implications of assessing compression versus distraction at the radialhumeral joint. Many elbow injuries result from either a traction or compression force. Think about the patient swinging a tennis racket, carrying a heavy bag, or grabbing onto something superiorly when falling. These are all traction forces. Push ups, a fall on an outstretched hand, etc. are compression forces. We commonly see scripts or we diagnose elbow injuries as overuse injuries, such as tendinopathy. The theory lies in the idea that the tendon is overly stressed from those activities, resulting in pain. While this may be true in some instances, it may not always be correct.

Think about how we have previously discussed the effect abnormal spinal mobility can lead to altered neural function and thus changes in muscular activity. We may find a tender or weak muscle or flaired up nerve that is ultimately the result of a poorly functioning joint in the spine. Why can't similar things happen peripherally? They can. It can be argued that either a compressed or distracted radialhumeral joint can result in an irritated radial nerve and lead to altered function of the radial nerve-innervated muscles as a result of altered joint arthrokinematics. This may be presented as "tennis elbow," radial tunnel syndrome, or PIN syndrome. Unfortunately, since this is a relatively new approach, there hasn't been much research performed on the topic. However, I challenge you to assess this joint when treating these elbow conditions in order to help determine the potential contribution for that particular individual. More importantly, we should be thorough with our exams and treat any related joint dysfunctions!

The video below discusses how to assess and treat distracted and compressed radialhumeral joints. Additionally, I briefly discuss assessing elbow abduction and adduction. This again plays a role in checking joint mobility and may determine the need for some form of manual therapy or alternative treatment.

-Chris

3 Comments

Sports Resident's Google Hangout (Q&A)

4/2/2014

6 Comments

 
Picture
Want to know more about the life of sports physical therapy resident?  How about what you should do to get into programs?  Or why do a sports vs an orthopedic residency?  If you are curious to any of these questions look no further than this google hangout.  Representing 5 different sports residencies, you can be sure you get multiple different perspectives.  

Special thanks to:  Joe Micca (UPMC), Michael Scalafini (Cleveland Clinic), Chelseana Davis (OSU), and Sean Bardenett (Ben Hogan) for taking the time to sit down and talk about sports residencies with me.  Always great to talk sports PT with other passionate professionals.  



6 Comments

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Photos used under Creative Commons from Sand Paper, PPGWings, sridgway, NWABR, Samuel Mann, pennjapanesecollection, bil_kleb, Paul L Dineen, SnaPsi Сталкер, mahalie, COMSALUD, thmmrth, torres21, Strelka Institute photo
  • Home
  • About Us
  • Insider Access
    • About Insider Access
  • Online Courses
    • Hooper's Knee
    • Physical Therapist Entrepreneur Course
    • Physical Therapist Consultant Course
    • Orthopedic Management of the Cervical Spine
    • Return to Sport Essentials Course
  • Resources
    • Newsletter
    • Business Minded Sports Physio Podcast
    • Day in the Life of a Sports PT
    • Residency Corner
    • Special Tests >
      • Cervical Spine >
        • Alar Ligament Test
        • Bakody's Sign
        • Cervical Distraction Test
        • Cervical Rotation Lateral Flexion Test
        • Craniocervical Flexion Test (CCFT)
        • Deep Neck Flexor Endurance Test
        • Posterior-Anterior Segmental Mobility
        • Segmental Mobility
        • Sharp-Purser Test
        • Spurling's Maneuver
        • Transverse Ligament Test
        • ULNT - Median
        • ULNT - Radial
        • ULNT - Ulnar
        • Vertebral Artery Test
      • Thoracic Spine >
        • Adam's Forward Bend Test
        • Passive Neck Flexion Test
        • Thoracic Compression Test
        • Thoracic Distraction Test
        • Thoracic Foraminal Closure Test
      • Lumbar Spine/Sacroiliac Joint >
        • Active Sit-Up Test
        • Alternate Gillet Test
        • Crossed Straight Leg Raise Test
        • Extensor Endurance Test
        • FABER Test
        • Fortin's Sign
        • Gaenslen Test
        • Gillet Test
        • Gower's Sign
        • Lumbar Quadrant Test
        • POSH Test
        • Posteroanterior Mobility
        • Prone Knee Bend Test
        • Prone Instability Test
        • Resisted Abduction Test
        • Sacral Clearing Test
        • Seated Forward Flexion Test
        • SIJ Compression/Distraction Test
        • Slump Test
        • Sphinx Test
        • Spine Rotators & Multifidus Test
        • Squish Test
        • Standing Forward Flexion Test
        • Straight Leg Raise Test
        • Supine to Long Sit Test
      • Shoulder >
        • Active Compression Test
        • Anterior Apprehension
        • Biceps Load Test II
        • Drop Arm Sign
        • External Rotation Lag Sign
        • Hawkins-Kennedy Impingement Sign
        • Horizontal Adduction Test
        • Internal Rotation Lag Sign
        • Jobe Test
        • Ludington's Test
        • Neer Test
        • Painful Arc Sign
        • Pronated Load Test
        • Resisted Supination External Rotation Test
        • Speed's Test
        • Posterior Apprehension
        • Sulcus Sign
        • Thoracic Outlet Tests >
          • Adson's Test
          • Costoclavicular Brace
          • Hyperabduction Test
          • Roos (EAST)
        • Yergason's Test
      • Elbow >
        • Biceps Squeeze Test
        • Chair Sign
        • Cozen's Test
        • Elbow Extension Test
        • Medial Epicondylalgia Test
        • Mill's Test
        • Moving Valgus Stress Test
        • Push-up Sign
        • Ulnar Nerve Compression Test
        • Valgus Stress Test
        • Varus Stress Test
      • Wrist/Hand >
        • Allen's Test
        • Carpal Compression Test
        • Finkelstein Test
        • Phalen's Test
        • Reverse Phalen's Test
      • Hip >
        • Craig's Test
        • Dial Test
        • FABER Test
        • FAIR Test
        • Fitzgerald's Test
        • Hip Quadrant Test
        • Hop Test
        • Labral Anterior Impingement Test
        • Labral Posterior Impingement Test
        • Long-Axis Femoral Distraction Test
        • Noble Compression Test
        • Percussion Test
        • Sign of the Buttock
        • Trendelenburg Test
      • Knee >
        • Anterior Drawer Test
        • Dial Test (Tibial Rotation Test)
        • Joint Line Tenderness
        • Lachman Test
        • McMurray Test
        • Noble Compression Test
        • Pivot-Shift Test
        • Posterior Drawer Test
        • Posterior Sag Sign
        • Quad Active Test
        • Thessaly Test
        • Valgus Stress Test
        • Varus Stress Test
      • Foot/Ankle >
        • Anterior Drawer
        • Calf Squeeze Test
        • External Rotation Test
        • Fracture Screening Tests
        • Impingement Sign
        • Navicular Drop Test
        • Squeeze Test
        • Talar Tilt
        • Tarsal Tunnel Syndrome Test
        • Test for Interdigital Neuroma
        • Windlass Test