Mechanism of Dysfunction
Repetitive flexed hand and forearm activities that involves pronation and supination as well as sustaining hard grip hold may accelerates the progress of this injury. The main joint that contributes to this condition is the proximal ulnar misalignment. Once this joint is impaired, the soft tissue overlayer began to compensate in an attempt to stabilize the joint, which eventually causes the muscles and tendons to become overstressed leading to the development of this inflammatory syndrome.
Assessment Protocol
The entire upper extremity biomechanical chain must be evaluated as per the neurological and mechanical influences of the spine, shoulder, and hand.
Clinical assessment to identify the key joint dysfunctions of the elbow that have contributed to this condition. Soft tissue analysis to pinpoint the level of irritation in the tendon.
X-ray
Anterior – Posterior (AP) and Lateral X-ray Elbow views are essential to analyse the level and direction of the ulna misalignment.
MRI
Locate the exact injury point; Allows the treatment to be more specific during the application of the treatment modalities, in addition aids to identify the type of tendinopathy (tendinitis or tendinosis) and the corresponding appropriate treatment care.
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 any other condition that might mimic Medial elbow tendinopathies; There are rare disorders that may create similar patterns of dysfunction, is advisable to rule out these conditions prior to the start of the treatment.
Treatment protocol
Specific elbow adjustments followed by a rehabilitation regime to strengthen the entire soft tissue support of the elbow. In addition, application of tape and may be needed as part of the early rehab program.
Application of Low-level Laser and PEMF to aid on the cellular level of heling as well as improving the microcirculation for the area.
Friction soft tissue therapy helps to reduce dysfunctional scar tissue
Functional tape might be used to reposition the heel bone to reduce the stress on the tendon
Specific selected essential oil application to enhance healing
Depending on level of misalignment and chronicity a minimum of 6 weeks up to 12 weeks of treatment care may be necessary to resolve this deformity.