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MindMap Gallery Medical Android-Lateral Epicondylitis

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!

Edited at 2023-11-27 17:43:50

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Medical Android-Lateral Epicondylitis

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Outline

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