Joint Play Elbow | Basic Elbow Assessment | Physiotherapy Exam
The Elbow consists of three different joints: the humerulnar joint, the humeroradial joint, and the radioulnar Joint.
Let’s look at the different movements that are possible in these three joints:
Radial and ulnar deviation of the radius and the ulnar on the humerus
Ulnar deviation of the radius and ulna on the humerus
Distraction of the Olecranon from the humerus
Distraction of the radius on a humerus
PA and AP glide of the radius and humerus
Radial and ulnar deviation of the radius and the ulnar on the humerus: Have your patient in standing position with the elbow supinated and completely extended.Then fixate the humerus from the inside and grab on to the forearm proximal to the wrist and apply varus or an adduction force
Ulnar deviation of the radius and ulna on the humerus: Have your patient standing position with the elbow supinated and completely extended. Grab onto the humerus from the outside and onto the forearm proximal to the wrist from the inside and then apply a valgus or an abduction force.
Distraction of the Olecranon from the humerus: Have your patient in supine line position with the ulnar humeral joint in its MLPPWhich is 70° of Flexion and 10°of of supination. Then fixate the humerus with one hand while you palpate the joint line laterally with your thumb. With the other hand grab onto the ulnar and pull dorsally and distally
Distraction of the radius on a humerus: bring your patient’s radiohumeral joint in its MLPP which is full extension and 5° of supination. Then fixate the humerus with one hand while you palpate the joint line with your index finger. Grab on to the Radius proximal to the wrist with the other hand and then perform distal traction. You should feel the joint play in the joint line
PA and AP glide of the radius and humerus: have your patient and sitting position with the arm to be tested on the treatment table. Then bring the radio humeral Joint in its MLPP and fixate the humerus with one hand while you palpate for the joint line with your thumb. Try to find the radius with the other hand. For the PA glide give pressure into the direction of your patient’s chest. For the AP glide, you have the same fixation while you palpate the joint line. Then you have to remove all the extensors of the forearm and dig deep until you feel a dip. You have to be careful because this can be really sensitive for your patient. As soon as you find the dip There you can feel the head of the radius. Now your movement goes into a distal and a bit caudal direction
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