MindMap Gallery Medical Android-Lateral Epicondylitis
An article about medical Android-lateral epicondylitis mind map, related physical examination, surgical treatment, and rehabilitation treatment. I hope it will be helpful to you!
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Lateral epicondylitis of humerus (tennis elbow)
lateral epicondyle
Extensor carpi radialis longus (ECRL)
lateral intermuscular septum
brachioradialis
dorsal lateral epicondyle
supinator
Anconeus (olecranon ulna)
Cervical spondylosis (radicular)
Conservative treatment
pain treatment
Fascia release, roller, self-traction
●When the acute pain subsides, begin gentle stretching of the elbow and wrist ●Do not cause pain in your elbows ●Keep stretching for 10 seconds and repeat 6 times
●Avoid activities that cause pain ●Do not exercise until the pain disappears and reduce elbow activity (braking) ●No playing badminton
Ice the outside of your elbow
●4 times a day, 15 to 20 minutes each time ●Do not put ice cubes in direct contact with the skin to avoid frostbite.
Lateral deep pressure friction massage
exercise maintenance
stability training
Can limit the amount of force produced by the forearm muscles
protective gear
Use compression resistance braces on your forearms
Grip
Resistance exercises (eccentric exercises)
Training to strengthen wrist extensor muscles
Improved endurance
Normal function restored
Gradually return to exercise
physiotherapy
Ultrasound therapy
Treatment: A continuous ultrasound with a frequency of 3MHz. Gives an intensity of 1.5W/cm2 in 8 minutes. Once a day, 3 times a week
shockwave therapy
This treatment is accomplished by applying sound waves of a specific frequency directly to the skin outside the extensor carpi radialis brevis muscle.
fascial manipulation
Coordination Center CC
Myofascial unit of external rotation chain ER-CU
➀Pain point or CP: near the radial head and lateral condyle ➁Disability Problem CC: Symptoms worsen when the forearm is pronated (supinator and biceps brachii) ➂Motion examination: Move the forearm to the pronated position against the resistance of the therapist. Other movement examination methods can be used, but the important thing is to clearly distinguish the MF (problematic fascial point) and the before and after comparison of treatment ➃Treatment: Palpate to find a dense point in the fascia and lateral septum (origin of the pronator and brachialis muscles), use the interphalangeal joints on the side of the triceps brachii to follow the direction of the muscle fibers, using constant force loosen
Lateral chain myofascial unit LA-CU
➀Pain Point or CP: A point that is often painful in lateral epicondylitis of the humerus ➁Hub Issue CC: Overuse of the extensor carpi radialis muscles leads to the formation of connective tissue adhesions between fascia ➂Motor test: The patient complains of pain when taking the bottle from the table. Quantitative examinations should be carried out before and after treatment ➃Treatment: The patient lies prone, with hands placed above the head. The therapist uses joints to release the fascial points until the local pain disappears. This point will be more painful, so the intensity should be based on the patient's acceptance.
Fusion Center CF
RE-LA-CU’s Fusion Center CF
➀Pain point: usually on the forearm or elbow, especially at the intersection of the two lines of force ➁Disability Problem CF: Dysfunction of any one CF may cause pain in many locations because they are related to several MF units and RE (retinacula) connecting different areas. ➂Palpation examination: the space between the extensor radialis brevis and longus muscles, as shown below ➃Treatment: The patient lies prone and stretches his arms. When treating lateral epicondylitis, attention should be paid to the combined use of CF and CC, LA-CU RE-CU
Surgical treatment
Surgical role: remove unhealthy tissue, improve or reestablish local blood circulation, and allow tendon and bone healing
Method 1: Minimally invasive arthroscopic surgery
Method 2: Open surgery with minimal trauma
diagnosis
Wrist extensor tendon stretch test
MILLS sign
Bend the elbow, make a half fist, pronate the forearm, and straighten the elbow joint. If there is pain on the outside of the elbow, it is positive.
extensor resistance test
Apply a load on the back of the hand to extend the wrist with resistance. If pain occurs on the outside of the elbow, it is positive.
Thomsen test
Instruct the patient to clench his fist and extend his wrist joint and elbow. When the patient extends his wrist joint on his back, the examiner resists with force and allows him to flex his palm. Pain in the lateral epicondyle of the humerus usually indicates tennis elbow.
compression check
Check whether there is localized pain or hardness at the lateral epicondyle of the humerus when pressing on the lateral side of the elbow.
Film degree exam
Frontal and lateral X-ray
Calcification can be seen at the attachment site of the lateral epicondyle tendon
Power Doppler
show new blood vessels
MRI
High signal at the lateral epicondyle tendon insertion on T2-weighted images
Adjacent soft tissue suggests surrounding edema
inducement
Excessive strenuous exercise
when batting
The elbow is not fixed
●Specific problem: During the elbow-brightening stage of the badminton swing, the elbow is not fixed before hitting the ball. ●Reason: I didn’t insist on practicing the correct swing when I was learning to play badminton. ●Improvement plan: Practice 500 racket swings every day without going to the court to play ball. Set the cycle for one month first!
Too much arm movement
●Specific questions: Most shots only require force from the wrist and fingers, and you need to understand how to transfer arm power to the wrist. ●Reason: Insufficient wrist strength, not used to or unable to use the wrist and fingers to exert force. ●Improvement plan: Practice wrist strength 100 times every day!
Long hours of computer work
Keep typing on the keyboard
●Reason: There are many projects and work content, and you have to work overtime for a long time, reaching a state of selflessness. ●Improvement plan: Learn to combine work and rest regularly to relax your joints and mind; report to superiors to transfer part of your work; if it has a negative impact on your body, consider changing to another job
long term labor
●Specific problems: repetitive household tasks such as knitting sweaters, car repairs, etc. ●Reason: Loving family members requires sacrifice, or in order to earn ●Improvement plan: combine work and rest with lifting to relax joints and spirit
aging
●Specific problems: Muscle relaxation, weakness ●Reason: Didn’t keep exercising when I was young ●Improvement plan: Start exercising properly now; hire a nanny; arrange work for your children
Performance
Radiate to the forearm, dorsiflexion of the wrist with force
Aggravated by forearm pronation
intermittent pain, mild pain, persistent severe pain
Early symptoms
●I just feel soreness on the outside of my elbow joint ●Pain when moving outside and above the elbow joint. The pain may sometimes radiate upward or downward. ●Feeling sore and uncomfortable, unwilling to move
Mid stage of symptoms
●The hand cannot hold objects with force. Exercises such as holding a spade, lifting a pot, twisting a towel, knitting a sweater, etc. can aggravate the pain. ●There are localized tenderness points outside the humerus at the epicondyle, and sometimes the tenderness can radiate downward. ●There is also mild tenderness and movement pain on the extensor tendons.
Later stage of symptoms
●Elbow joint extension and flexion are not affected, but pain may occur during forearm rotation. ●Pain can be caused when stretching fingers, wrists or holding chopsticks ●The pain worsens on cloudy and rainy days
common extensor tendon
Aseptic inflammation of soft tissue
Extensor carpi radialis brevis (ECRB) tendinosis
extensor carpi ulnaris
extensor digitorum communis
intrinsic muscle of little finger
tendon degeneration
Fibrosis/calcification
joint
Changes in radioulnar joint relationship
anterior displacement of humeral head
Tension imbalance between biceps and triceps
Scapulothoracic wall connection activity
Humeral head
Ribs, vertebral costal joints, cervicothoracic spine (breathing)
muscle
brachialis
Bend the elbow
C5-7
Musculocutaneous nerve
Biceps
Pain area: radial tuberosity
Elbow flexion, forearm supination
C5-6
Musculocutaneous nerve
Flex the upper arm forward and adduct
triceps brachii
Pain area: olecranon of ulna
Extend your elbows and draw your upper arms inward
C6-8
Muscular branch of radial nerve
thoracolumbar fascia
latissimus dorsi
glenohumeral joint motion
abdominal muscles
respiratory movement; abdominal pressure
Soft tissue
Annular ligament: lateral collateral ligament, radial collateral ligament (humeral head, humeral neck)
brachioradial joint capsule
Compression of the synovial wall of the humeroradial joint (boxer)
common extensor tendinosis
lateral upper arm intermuscular space
radial tunnel syndrome
Deep branch of radial nerve (supinator)
Typical manifestations: weakness of innervating muscles
pain
Pain on the back of the forearm
Pain in dorsal wrist and hand
Thumb and radius side pain