Rehabilitation of Elbow injuries Chapter 18

Rehabilitation – Acute Phase Acute Rehabilitation Goals Prevent reinjury (immobilization) Prevent atrophy Minimize loss of motion Reduce edema Control Pain

Rehabilitation – Acute Phase Acute Rehabilitation (While Immobilized) Exercises Distally Gripping Finger Extension Wrist FLX / EXT Proximally Shoulder AROM FLX, EXT, ABD, ADD, HABD, HADD

Rehabilitation – Acute Phase Acute 0-7 Days (w/o Immobilization) Maintain Sling Immobilization Previous exercises Modalities Ice & IFC Stim before Ther Ex initially Effleurage w/ gravity assist Ice afterwards

Rehabilitation – Subacute Subacute 7-21 Days Goals Obtain full ROM Regain Full Strength Endurance Neuromuscular Control Note: Pt may be in a brace to prevent EXT

Rehabilitation – Subacute Active Elbow ROM in Warm W/P Alternate w/ US treatment then stretching 3MHz, 100% Duty Cycle, 1.0 W/cm2, 6mins, 3-4°C increase Superficial heat w/ Elbow EXT

Rehabilitation – Subacute Exercises Add Pronation & Supination to wrist strengthening Isometric Elbow Flexion & Extension Three separate plainer areas & Pronated, Neutral, Supinated Basketball Dribble Sets of 30 Seconds to build muscular endurance Work into wall chest pass

Rehabilitation – Subacute Exercises Isotonic Flexion & Extension PNF Patterns Passive, Active, Isometric, Isotonic Progress through dynamic stability to reactive NMC D2 Flexion / Extension D1 Flexion / Extension

Rehabilitation – Subacute Dynamic Stability Swiss Ball Medicine Ball Foam Rollers Balance Disks Reactive NMC Close Eyes

Rehabilitation – Functional Functional – 21+ Days Goals Engage in more sport specific or activity specific exercises Prepare for return to full activity

Rehabilitation – Functional Push-ups Wall Ground Plyometrics Plyometric Wall Knee Drop Push-ups Explosive Push-up Standing Drops

Rehabilitation – Functional Medicine Ball Strengthening Catch and Toss Concentric Eccentric