Lab 11: Elbow, Forearm, Wrist, and Hand

Lab 11: Elbow, Forearm, Wrist, and Hand Objectives of Lab: • Identify common injuries and overuse conditions that occur to the elbow, forearm, wrist, and hand. • Demonstrate the application of tapes, wraps, braces, and pads to the elbow, forearm, wrist, and hand for the purpose of preventing, treating, and rehabilitating injuries. Lab Activity 1: Anatomy 1. Look at the model and show your partner the bones of the elbow, forearm, and wrist. 2. Identify and palpate the following muscles on your partner. a. Biceps b. Triceps c. Brachioradialis d. Pronator teres e. Flexor carpi radialis longus/brevis f. Palmaris longus g. Flexor carpi ulnaris longus/brevis h. Extensor carpi radialis longus/brevis i. Extensor carpi ulnaris longus/brevis 3. Locate the following ligaments on a model and briefly describe their function in the space provided. a. Ulnar collateral ligament: Stabilizes the elbow through its various motions such as throwing b. Annular ligament: Stabilizes the elbow joint by preventing a dislocation of the radial head c. Radial collateral ligament: Stabilizes the lateral side of the elbow joint prevents medial flexion and lateral translation of the elbow joint Stabilizes the elbow during flexion Lab Activity 2: Prevention of Common Conditions 1. Identify three effective prevention strategies and the associated common elbow, forearm, wrist, and hand conditions. a. Finger sprain (Buddy tape) b. TFCC injury (“X” tape wrist) c. Fracture (Fan Tape Wrist) Lab Activity 3: Application of Taping, Wrapping, Bracing, and Padding Practice and demonstrate your ability to appropriately apply these techniques with a partner as demonstrated and instructed in class. List one common condition that each of these techniques would be useful with during treatment and rehabilitation. 1. Taping a. Elbow hyperextension Used when treating sprains to limit hyperextension of the elbow and stretch on the soft tissues b. Lateral epicondylitis strap Used to treat lateral epicondylitis to reduce the tension of the wrist extensor musculature at its origin on the lateral epicondylitis c. Fan tape Used when preventing sprains d. “X” tape Used when treating fractures e. Buddy tape Provides mild to moderate support to the collateral ligaments of the fingers following sprains and post dislocations and post fractures f. Thumb spica Provides mild to moderate support and limits excessive abduction and extension of the MCP joint 2. Wrapping a. Hand, wrist, and forearm compression wrap Used to provide compression when treating contusions b. Elbow compression wrap Used to provide compression when treating tendon ruptures 2 3. Bracing a. Rehabilitative Used when treating elbow sprains b. Functional Used when treating elbow dislocations c. Epicondylitis strap Lessens the tension on the wrist extensor or flexor musculature when treating lateral or medial epicondylitis 4. Padding Provides shock absorption and protection Lab Activity 4: Case Scenarios 1. Theresa is a 17-year-old female softball player who came to the athletic training room with complaints of localized right medial elbow pain and discomfort persisting for 7 days. She has no memory of an acute mechanism, nor does she complain of pain into the extremity. After examination, she was diagnosed with right elbow medial epicondylitis. a. What type of force is associated with the cause of this injury? Excessive force that is used to bend the wrist toward the palm is associated with the cause of this injury b. Describe what proper management of this injury at this time would likely include. Ice should be applied immediately and possible NSAIDs depending on the severity of the epicondylitis. Long term treatments are using an epicondylitis strap, exercises to strengthen the area, and possible corticosteroid injections. c. Which techniques, as demonstrated in class, are most appropriate for managing this injury at the time of evaluation and why? Some strength training techniques may be used to evaluate this patient. These include isometric wrist strengthening, resisted wrist extension, and various ergonomic positions. When the patient raises or bends their wrist against resistance, there can be pain found in the medial area 2. While playing a game of flag football, Alifonzo suffered a fall which produced a valgus force on the first metacarpophalangeal joint of his right hand. He reported significant pain and an inability to return to the game. The athletic trainer on site evaluated the injury and diagnosed him with a first-degree sprain of the thumb, commonly referred to as “gamekeeper’s thumb.” a. Which ligament is most likely involved with this injury? Ulnar Collateral Ligament and Right Collateral ligament b. Describe what proper initial management of this injury would likely include. 3 The initial treatment is to ice, elevate the hand to minimize swelling, and medicate to help with the pain c. What technique learned in class would be most beneficial for limiting range of motion at the first metacarpophalangeal joint? Thumb brace d. After 4 weeks of rehabilitation, the athletic trainer clears Alifonzo for participation. Which taping technique would be most appropriate for limiting range of motion about the first metacarpophalangeal joint? Thumb Spica tape version 1 References Prentice, W. E. (2017). Principles of athletic training: a guide to evidence-based clinical practice. New York, NY: McGraw-Hill Education. 4