Øvelser for #tennisalbue, #golfalbue, #klatrealbue, #håndboldalbue og #musearm.

Øvelsesprogram for albuen

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Ved smerter i albuen bruges der i hverdagssprogs udtryk som: tennisalbue, golfalbue, klatre albue, håndbold albue og musearm.

Skærmbillede 2014-04-21 kl. 22.38.37Skærmbillede 2014-04-21 kl. 23.44.22Skærmbillede 2014-04-21 kl. 23.39.26

Fælles for disse skader er, at de ofte opstår  pga. gentagende overbelastnings.

Det gælder om at stoppe denne overbelastning. Det kan gøres med mange behandlingsformer såsom akupunktur, kinesiotape, ultralyd, laser, injektion ect., manuelle teknikker såsom mobiliseringer, massage osv.

Den tilgang du vil møde hos mig er en kombination af mobilisering med bevægelse (Mulligan Concept), bløddelstekniker til at nedsætte tonus og træning.

Nedenstående er en kort præsentation til diverse øvelser for albuen. Men der er nothing fits all system, så alle øvelser må individueliseres og progredieres efter behov.

Download alle øvelserne på PDF Øvelsesprogram for albuen – skal du i behandling udfyld gerne dette spørgeskema (Patient-rated Tennis Elbow Evaluation) til mig på Søernes Fysioterapi.

 

Øvelse for rotation. Du kan bruge mange forskellige redskaber men en hammer er god pga vægtstangsforholdet. 1. placer underarmen på et bord så hånden er udover. Rotere så hånden skiftevis i ind- og udafrotation.
Øvelse for rotation.
Du kan bruge mange forskellige redskaber men en hammer er god pga vægtstangsforholdet.
1. placer underarmen på et bord så hånden er udover.
Rotere så hånden skiftevis i ind- og udafrotation.
Beskrivelse af øvelse Udgangspunkt. 1 – hold hånden strakt frem for kroppen med håndfladen op. 2: grib omkring fingerne med den anden hånd. Der skal mærkes et stræk på overarmen. 3: hold strækningen et par sekunder og gentag bevægelserne dynamiske uden hvile.
Beskrivelse af øvelse
Udgangspunkt.
1 – hold hånden strakt frem for kroppen med håndfladen op.
2: grib omkring fingerne med den anden hånd. Der skal mærkes et stræk på overarmen.
3: hold strækningen et par sekunder og gentag bevægelserne dynamiske uden hvile.
Øvelsen kan udføres både siddende og stående med hånd udover en kant (fx bordkant). 1) Håndvægten / vandflaske eller vandsflaske med sand i den ene hånd 2) lad underarmen få støtte af et bord, men hånden er fri for bordkanten. 3) Undgå hurtige bevægelser eller for tung vægt i starten. 4) Gentages til udtrætning. Fx 15 x 2 gange 5) Ekstra: Evt. Tage nogle ting du bruger i din hverdag. En elastik eller pose med tunge ting.
Øvelsen kan udføres både siddende og stående med hånd udover en kant (fx bordkant).
1) Håndvægten / vandflaske eller vandsflaske med sand i den ene hånd
2) lad underarmen få støtte af et bord, men hånden er fri for bordkanten.
3) Undgå hurtige bevægelser eller for tung vægt i starten.
4) Gentages til udtrætning. Fx 15 x 2 gange
5) Ekstra: Evt. Tage nogle ting du bruger i din hverdag. En elastik eller pose med tunge ting.
Skærmbillede 2014-04-21 kl. 22.32.00
Anbring en tyk elastik omkring omkring samtlige fem fingre ved fingertipperne. Forsøg at åbne hånden med strækte fingre, så elastikkens omkreds udvider sig. Spred fingrene 20-30 gange. Øvelsen bør gentages 3 gange.
Skærmbillede 2014-04-21 kl. 22.33.19
Wave-shift: Sæt hænderne i sofabordet og skift trykket skiftevis på højre og venstre hånd.
Skærmbillede 2014-04-21 kl. 23.37.12
Sæt hånden i bordet eller læg på knæ og lænd med kroppen ind over, således at ledene får belastninger fra din egen kropsvægt. 2 – Øvelsen gentages 30 gange hver morgen med forskellige udgangspunkter
Beskrivelse af øvelse Udgangspunkt. 1 – Sæt hånden i bordet og lænd med kroppen ind over, således at ledene får belastninger fra din egen kropsvægt. 3 - Øvelsen gentages 30 gange hver morgen med forskellige placeringer.
Beskrivelse af øvelse
Udgangspunkt.
1 – Sæt hånden i bordet og lænd med kroppen ind over, således at ledene får belastninger fra din egen kropsvægt.
3 – Øvelsen gentages 30 gange hver morgen med forskellige placeringer.
Hold albue ind til væggen som vist på billedet. Kør derefter håndledet i cirklere (begge veje), vink med fingerne også videre. Bevægelsen skal være smertefri ellers skal der justures på trykket
Hold albue ind til væggen som vist på billedet. Kør derefter håndledet i cirklere (begge veje), vink med fingerne også videre. Bevægelsen skal være smertefri ellers skal der justures på trykket

ht

Skærmbillede 2014-04-22 kl. 00.25.40
Drej håndleddet rundt. Således at du skriver enten alfabet eller tallene 1 til 10 i luften. Det vigtige er at du roterede håndleddet i alle retninger og ikke kun får vippet med fingerne
Manuel mulligan "mobilisation with movement" med "heavy slow resistance training"
Manuel mulligan “mobilisation with movement” med “heavy slow resistance training”
Vrid-en-klud øvelser
Vrid-en-klud øvelser

Skærmbillede 2015-01-28 kl. 21.18.42 Skærmbillede 2015-01-28 kl. 21.18.57 Skærmbillede 2015-01-28 kl. 21.19.07Skærmbillede 2015-01-28 kl. 21.27.33

LET-Home-Exercise-Program-Handout-Oct-2014 Skærmbillede 2015-11-12 kl. 08.29.31http://www.aleris.dk/Global/da/Download/Patientvejledninger/Sportskirurgi/traning_Tennisalbue.pdf

http://fysio.dk/fafo/Nyheder/Kronisk-tennisalbue-skal-have-traning/#.U0aNqhuKBol

http://www.sportnetdoc.dk/tennisalbue/trin1

Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial

Bilateral sensorimotor abnormalities in unilateral lateral epicondylalgia.

Assessment of functional recovery in tennis elbow.

Long-term follow-up of conservatively treated chronic tennis elbow patients. A prospective and retrospective analysis.

Chronic tendinopathy: effectiveness of eccentric exercise.

Tennisalbue

One thought on “Øvelser for #tennisalbue, #golfalbue, #klatrealbue, #håndboldalbue og #musearm.

  1. Lateral Elbow pain
    Created as a free resource by David Pope, Physiotherapist, Clinical Edge
    Get your free trial of online Physio education now by clicking here
    Based on Physio Edge podcast episode 44 with Dr Leanne Bisset
    Why is Lateral Epicondylalgia (LE) difficult to treat?
    What seems a relatively simple presentation has complex underlying factors.
    Pathology
    • There is a local tendon degeneration with LE, with focal change on Ultrasound,
    with some degeneration of the LCL. This is also seen on asymptomatic individuals,
    with 50% of asymptomatic people having tendon changes on US, thus may be a
    normal part of aging.
    • Normally affects Common Extensor Tendon, and in particular ECRB – function is to
    hold the wrist still during gripping and hand function, which is an isometric
    function.
    • LE does not involve any of the joints around the elbow.
    Pain pattern and current history
    • Pain with LE is localised just to the lateral epicondyle, without any radiation to any
    other area.
    • Pain with gripping or picking items up
    • There is often a history of overload/overuse, with a gradual onset. If they are a
    manual worker, the overload has to be quite high, but if the person is sedentary,
    low levels of activity may overload the tissues. Occasionally there is an onset of
    pain without a definable history of overload.
    • More prevalent in manual workers and people that use their arms a lot eg factory
    workers
    Communication – What are the important things to communicate with your patients
    regarding their LE?
    • Dont tell them their pain is because they have a black hole in their tendon on US.
    This can be very counterproductive.
    • Improvements in pain and function don’t relate to changes in tendon. Their pain
    and function will improve regardless of whether the scan changes
    • Calling it “degenerative” can have negative connotations for patients, but can be
    described as normal aging changes in tendons.
    • The tendon changes have been there for a long time, it is not acute like a sprained
    ankle. The patient has only had pain for eg a few weeks or months etc, which
    1 of 3
    started when you loaded these elbow eg did some gardening, triggered a cascade
    of pain.
    • We can tell if it is getting better by how the patient feels, their pain free grip
    strength (PFGS), and how the patient is able to use their arm.
    • The pain is coming from the tendon, and how they loaded it.
    • The evidence tells us that exercise is the most effective way of treating LE, with
    adjuncts of manual therapy.
    • They do NOT need long term Physiotherapy, and exercises SHOULD NOT be
    painful.
    Ask them how confident they are that they will perform the exercises, we want them to be
    100%
    Advice for patients
    • Avoid aggravating activities or positions
    • Carry things with the palm up
    • Carry things close to the body
    • Load the tendon with exercises, but reduce manual labour
    • There should be no pain when performing exercises
    When should your patient rest?
    If pain has just developed, give 6–8 weeks rest. If it is not better after 6–8 weeks, then it is
    time to exercise and strengthen the tendons.
    How is tendinopathy in the UL different to the LL?
    • Patients do not get better if exercises are taken into pain in the UL.
    • UL pain may be associated with more of a threat and the risk of inability to work.
    This may have more emotional meaning for patients than a lower limb
    tendinopathy.
    • Patients will very often not comply if exercises are painful, especially in the early
    stages of rehabilitation.
    How can you assess patients with LE?
    Use Painfree Grip strength (PFGS) as the measure of improvement rather than maximal
    grip strength. There is no point in measuring maximal grip strength, as this will
    demonstrate no deficit and will not change. Ask them to grip just to the onset of pain.
    2 of 3
    Commencing treatment
    • The main priority in your first treatment is to reduce or settle pain and improve
    function.
    • Utilise manual therapy including Mobilisation with Movement (MWM) to change pain
    during gripping task to get immediate patient buy in and compliance.
    • Perform a maximum of 5–6 repetitions.
    • If your positive response to the glide starts to diminish, stop performing MWM’s.
    • Teach self MWM – “Get you to hold here so you take away the pain”, no need to
    explain how it works. This is their Panadol/pain reliever
    • Manual therapy – PA glide on the radial head, Lateral glide of the Ulnar and Radius on
    the Humerus.
    • Most times the arm is not completely painfree after the first session
    • A “Rebound effect” often happens after MWM’s. The first time they go to move their
    elbow it will be very stiff and sore. To avoid this response, perform the same MWM
    with elbow Flexion and Extension for as many repetitions as it takes to settle it down.
    Maintain the MWM and get them moving.
    • After the MWW with gripping – get them to drop whatever they are using to apply
    resistance, but don’t move, then get them to move their flex and extend the elbow
    with the same MWM.
    Exercises
    • Isometric contraction affects descending inhibitory pathway.
    • Should not be performed with any pain
    • Make the exercise functional eg gripping
    • Elbow bent 90 degrees, neutral pronation/supination
    • Apply your MWM
    • Use a theraband for resistance down towards the floor.
    • Hold isometric elbow flexion for up to 1 minute with no pain
    • See if they can perform full pronation with light resistance without pain
    • If they can do this without pain, see how far they can extend the elbow into
    extension/pronation pain free
    • Only work in the range of pronation/elbow extension that is pain free
    • See how many 1 minute holds they can perform before any pain comes on, and
    make sure they do less than this at home
    • Perform a max of 3 x 1’ holds, with a minute in between
    • If they get pain or fatigue half way through eg third repetition, stop them there and
    do only 2 repetitions
    • Only once/day, to assist compliance
    • If they have stirred it up with work, activity or bumping the elbow, they can use the
    self-MWM’s.
    For more information on LE, listen to Physio Edge podcast Episode 45 with Dr Leanne
    Bisset, out soon on https://www.clinicaledge.co
    3 of 3

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