Presentation on theme: "OMM for Repetitive Use Injuries of the Upper Extremity - Elbow Pain"— Presentation transcript:
1 OMM for Repetitive Use Injuries of the Upper Extremity - Elbow Pain Developed for OUCOM COREby Brad Werrell, D.O.Edited by David Eland, D.O.and theCORE Osteopathic Principles and Practices CommitteeSession #8 – Series B
2 History of IllnessInsidious onset of painProgressive courseExacerbated by certain actions, with a history of repetition of those actions over timeAlleviated by restNo paresthesiasNo acute trauma
3 Examination Through Observation Have patient demonstrate the location of the pain, and the motion which exacerbates that pain.2. Compare the injured limb to the uninjured limb.Make note of structural, pigmentary and soft tissue differences by observation.3. Observe the habitual function of the joint proximal to the injured joint.
4 Examination Through Palpation Palpate the bones – check for tenderness to palpation:Medial and lateral epicondylesRadial headOlecranon process of the ulnaPalpate soft tissues:For bogginessFor tendernessFor temperature
5 Examination Through Palpation Positional diagnosis of the radial headPosterior vs AnteriorFluctuanceFluid in the joint or bursaTenderness-- Temperature Changes
6 Functional Examination Active Range of MotionElbow Flexion and ExtensionForearm supination and pronationLook for:Limitations of range of motionPain with motion
7 Passive Range of Motion Elbow flexion and extensionForearm supination and pronationRange of motion (compare sides)End-feel of motion
8 Neurologic Examination 1. Tinnel’s Test of the Olecranon Tunnel- Tinnel’s Test of the Carpal Tunnel2. Evaluation of the sense of touch comparing both upper extremities3. Brachioradialis reflex bilaterally- Triceps reflex bilaterally4. Observation of the hands and wrists for muscular wasting
14 Counterstrain Treatment of the Radial Tenderpoint
15 Counterstrain Treatment of the Medical Coronoid Process Tenderpoint
16 Counterstrain Treatment of the Lateral Coronoid Tenderpoint
17 Counterstrain Treatment of the Medical Olecranon Tenderpoint
18 Counterstrain Treatment of the Lateral Olecranon Tenderpoint
19 ReferencesCounterstrain: A Handbook of Osteopathic Technique, Herbert A. Yates, D.O., F.A.A.O. and John Glover, D.O., F.A.A.O.; Y Knot Publishers, Tulsa, OK, 1995.Foundations for Osteopathic Medicine, Robert C. Ward, D.O., F.A.A.O., Williams & Wilkins, Baltimore, MD, 1997 (1st Edition); 2003 (2nd Edition).OMT Review, Robert G. Savarese, D.O., Robert G. Savarese, D.O., USA, 2003.An Osteopathic Approach to Diagnosis and Treatment, Eileen L. DiGiovanna, D.O., F.A.A.O., Lippincott Williams & Wilkins, Philadelphia, 2005.View-OMT Osteopathic Multimedia Reference Collection, Bradley H. Werrell, D.O., Bamboo Data Systems, Inc., Ashburn VA, 2006.