INSTITUTE: UIAHS
DEPARTMENT: Physiotherapy
      Bachelors of Physiotherapy
Advanced Physiotherapeutic in Orthopedics
               PTA-461
                    Dr. Taniya Wadhwa (PT)
                   E-9885
Elbow Joint        tT       DISCOVER . LEARN . EMPOWE
COURSE OUTCOME
    Elbow and Forearm Complex
• The elbow and forearm complex consists of
  four joints:
• humeroulnar,
• humeroradial,
• proximal radioulnar, and
• distal radioulnar
              Humeroulnar Articulation
The convex trochlea articulates with the concave olecranon fossa.
Resting position.
• Elbow is flexed 70˚, and forearm is supinated 10˚. Treatment
  plane.
The treatment plane is in the olecranon fossa, angled
  approximately 45˚ from the long axis of the ulna
Stabilization.
• Fixate the humerus against the treatment table with a belt or
  use an assistant to hold it. The patient may roll onto his or her
  side and fixate the humerus with the contralateral hand if
  muscle relaxation can be maintained around the elbow joint
  being mobilized.
Humero-ulnar Distraction and Progression
Humeroulnar Distal Glide
          Humeroulnar Ulnar Glide
• Indication
To increase valgus.
This is an accessory motion of the joint that accompanies elbow
   extension and is, therefore, used to progress extension.
• Patient Position
■ Same as for radial glide except a block or wedge is placed under
   the proximal forearm for stabilization (using distal stabilization).
■ Initially, the elbow is placed in resting position and is progressed
   to end-range extension.
• Mobilizing Force Apply force against the distal humerus in a
   radial direction, causing the ulna to glide ulnarly.
      Humeroradial Articulation
• The convex capitulum articulates with the
  concave radial head
• Resting position- Elbow is extended, and forearm
  is supinated to the end of the available range.
• Treatment plane- The treatment plane is in the
  concave radial head perpendicular to the long
  axis of the radius.
• Stabilization- Fixate the humerus with one of
  your hands.
Humeroradial Distraction
Humeroradial Dorsal/Volar Glides
Humeroradial Compression
      Proximal Radioulnar Joint
• The convex rim of the radial head articulates
  with the concave radial notch on the ulna
• Resting position- The elbow is flexed 70˚ and
  the forearm supinated 35˚.
• Treatment plane- The treatment plane is in
  the radial notch of the ulna, parallel to the
  long axis of the ulna.
• Stabilization- Proximal ulna is stabilized
Proximal Radioulnar Dorsal/Volar Glides
         Distal Radioulnar Joint
• The concave ulnar notch of the radius
  articulates with the convex head of the ulna.
• Resting position-The resting position is with
  the forearm supinated 10˚.
• Treatment plane- The treatment plane is the
  articulating surface of the radius, parallel to
  the long axis of the radius.
• Stabilization- Distal ulna
Distal Radioulnar Dorsal/Volar Glides
                References
• Orthopedic Manual Therapy;Chad Cook
• Colby, Lynn Allen_ Kisner, Carolyn-Therapeutic
  exercise. Foundations and techniques-F.A.
  Davis (2012)
• Maitland's Manipulation; Volume 1 and 2; Elly
  Hengeveld, Kevin Banks
• Principles of Manual Therapy; Deepak
  Sebastian