Bone spur (osteophytes) develops in advance cases of arthritis due to the significant joint deterioration disturbing the natural bone remodelling physiology. Due to the outgrown of the of the joint, adjoining nerves might be irritated and compressed as seen in ulnar, radial and interossei entrapment syndromes.

Mechanism of Dysfunction

The predisposing factors for the development of this condition began with a misalignment dysfunction at the elbow complex, which overtime causes  the  soft tissue ligamentous and muscle support to become overloaded and compromised allowing the biomechanical stress to reach the level of the cartilage and initiating the degenerative joint disease.

Is important to note that for the cartilage to become injured, the previous defence mechanisms have to have failed to allow the biomechanical stress to damage the cartilage, therefore, the treatment care must aim to restore the health of the entire elbow protective structures.

Assessment Protocol

The entire lower extremity biomechanical chain must be evaluated as part of the elbow analyses as per the neurological and mechanical influences of the spine, shoulder, and hand.

Clinical assessment to identify the key joint dysfunctions of the elbow (Humerus, Ulna and Radial) that have contributed to this condition. Soft tissue analysis to pinpoint the level of irritation in the soft tissue support.

 X-ray analysis

Anterior – Posterior (AP) and Lateral X-ray Elbow views are essential to analyse the level and direction of the different patterns of misalignments

MRI

Elbow MRI is essential for visualizing the extent of injury on the muscle/tendon ligamentous and cartilage layers.

Locate the exact injury point; Allows the treatment to be more specific during the application of the treatment modalities.

Identify the extent of tissue damage and the presence of scar tissue; Provides valuable information regarding prognosis and the application of friction soft tissue modalities to aid on scar tissue removal.

Rule out stress fractures not visible by the x-ray.

Treatment protocol

The treatment care should aim to restore the Elbow alignment, the soft tissue muscles/tendon and ligamentous health as well  as stimulating and remodelling  the cartilage growth.

Specific adjustments of key bones of the elbow followed by a rehabilitation regime to strengthen the entire soft tissue support of the ankle and foot.

Soft tissue and cartilage healing protocol

Application of Low-level Laser and PEMF directly over the injured tissues to aid on the cellular level of healing as well as improving the microcirculation for the area.

Friction soft tissue therapy helps to reduce dysfunctional scar tissue

Specific stretches and strengthening to improve the resilient of the soft tissue support

Specific selected essential oil application to enhance healing

Dry Needling to promotes blood flow and enhance the soft tissue and cartilage healing.

Depending on the level injury and chronicity, a minimum of 6 weeks up to 12 weeks of treatment care may be necessary to resolve this condition.