As an extension of the shoulder mechanics, the elbow provides a great amount of versatility and freedom for the usage of the wrist and hands during daily activities adding a reliable and elaborate fine control mechanics in positioning the hand in specific locations as well as stabilizing the entire upper extremity for motor work activities, providing a fulcrum for the arm in lifting. Therefore, the elbow relies on the support of an extensive number of joints and soft tissue to allow this elaborate function to take place efficiently.
The 5 defence Elbow Mechanisms is hierarchically made up by the proper Alignment of the Humerus, Ulna and the radio joints followed by the strength and resilient of the flexor and extensor Muscles then by the health of the radial, ulnar and annular Ligaments, the proper cushion support provided by the Cartilage and by the frame support of the Bones. The extend and level of tissue damage is dependent on the number of protective layers that have been compromised from the trauma.
For instance, when the first protective Alignment layer is affected, there is a misalignment dysfunction resulting in potential deformities as seen in cubitus valgus (excessive elbow carrying angle) , therefore I consider as a Level 1 Injury as there is only one main structure that has been affected.
In Tennis elbow syndromes where the trauma impaired 2 layers of the protective mechanisms (Alignment and Muscles/Tendon ), its considered Level 2 Injury as there were 2 layers that have been compromised. In summary, there are 5 protective layers of defence and 5 corresponding Level of injuries, higher the level of injury the more substantial the number of tissue damage as per the accumulative damage that is passed from one phase to the other. (Level 5 injury means that all the previous defence mechanisms have been compromised up to the 5th layer, as seen in olecranon fractures).
Throughout my extensive education and clinical experience, I conclude that even though there are several named pathologies and diseases described by the traditional medicine, the origin and the predisposing factors that have lead the development these healthcare conditions shared a similar causation and pathophysiological principle.
In addition, due to the multiple level of tissue damage often seeing in injuries there is not a single approach that is enough in order to properly managed and fully resolve the condition in question, hence I developed specific treatment protocols utilising different health care methods and techniques that eventually allowed me to efficiently resolve and heal as well as prevent the further development of future injuries.
The protocols I developed aim to properly repair and restore the entire self defence mechanism
Level 1 injuries – Misalignment dysfunctions
Note: Minor joint misalignment does not create any visible deformation. Clinical assessment and X-ray imaging are paramount for diagnosing subtle joint dysfunction.
Certain Elbow Misalignments disturbs certain adjoining nerves at the level of the joint.
Cubital Tunnel Syndrome (Ulnar Nerve Entrapment)
Radial Tunnel Syndrome (Radial Nerve Entrapment)
Level 2 Injuries – Misalignment - Muscle/tendon/fascia Injuries
Level 3 Injuries – Misalignment – Muscle compromised - Ligamentous injuries
Level 4 Injury - Misalignment – Muscle compromised – Ligamentous weakness - Cartilage Injury
Level 5 Injury- Misalignment – Muscle compromised – Ligamentous weakness and Cartilage damaged leading to Bone fractures
Miscellaneous Elbow conditions
Osteochondritis dissecans: is a joint disorder that occurs most commonly in children. Bone and cartilage beneath the joints loses its blood supply, resulting in joint pain and stiffness
Elbow Neurological referral patters syndromes; Subluxations at the level of the neck and thoracic spine can create referral patterns of pain at different sites around the Elbow.
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Treatment methods I utilize in my practice to restore and enhance the healing of the entire layers of tissue injuries according to the specific healthcare conditions diagnosed.
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