Rehabilitation Protocol - Medial Epicondylitis
Laith M. Jazrawi, M.D. Chief, Division of Sports Medicine Associate Professor of Orthopaedic Surgery
Tel: (646) 501-7223 option 4, option 2 Fax: (646) 501-7234 Web:
orthosurgery.med.nyu.edu/sports-medicine
Rehabilitation Protocol: Medial Epicondylitis
Patient
Name:
____________________________________________________________
Date:
___________________________________
Phase
I
?
Maximum
Protection
(0
to
10
days):
! Complete
immobilization
in
90? splint
! Sling
for
2
weeks
! Ice
and
modalities
to
control
inflammation
Phase
II
?
Intermediate
Phase
(10
days
to
4
weeks):
10
Days
to
2
Weeks:
! Discontinue
sling
at
2
weeks
! Modalities
as
needed
for
inflammation
! Begin
passive
elbow
and
wrist
range
of
motion
in
all
planes
as
tolerated
! Begin
active
shoulder
retraction/protraction
Weeks
2
to
4:
! Maintain
program
as
outlined
in
weeks
0
to
2
! Continue
modalities
to
control
inflammation
! Progress
to
active
assisted
elbow
and
wrist
range
of
motion
in
all
planes
! Initiate
rotator
cuff
and
scapular
strengthening
without
stressing
the
flexor/pronator
mass
! Initiate
terminal
range
of
motion
stretching
as
tolerated
Phase
III
?
Active
Range
of
Motion
Phase
(weeks
4
to
6):
! Modalities
as
needed
! Continue
with
end
range
stretching
of
the
wrist
flexors
and
extensors
! Begin
active
range
of
motion
of
the
elbow
and
wrist
in
all
planes
! Initiate
submaximal
isometrics
flexor/pronator
mass
! Begin
PREs
in
wrist
extension
and
supination
! Advance
rotator
cuff
and
scapular
strengthening
program
! Manual
resistance
and
PNF
patterns
Phase
IV
?
Strengthening
Phase
(weeks
6
to
8):
! Continue
with
terminal
range
stretching
! Advance
PREs
in
wrist
extension
and
supination
! Advance
rotator
cuff
and
scapular
strengthening
program
! Begin
pronator/flexor
mass
strengthening
Center for Musculoskeletal Care ? 333 East 38th Street, New York, NY 1001 ? (646) 501-7070 ? cmc.med.nyu.edu
Laith M. Jazrawi, M.D. Chief, Division of Sports Medicine Associate Professor of Orthopaedic Surgery
Tel: (646) 501-7223 option 4, option 2
Fax: (646) 501-7234
Web:
orthosurgery.med.nyu.edu/sports-medicine
Phase
V
?
Progressive
Strengthening
and
Proprioceptive
Phase
(weeks
8
to
12):
Weeks
8
to
10:
! Increase
PREs
throughout
wrist,
elbow,
and
shoulder
complex;
include
flexor/pronator
mass
! Begin
global
upper
extremity
gym
strengthening
program,
use
caution
with
pulling
and
biceps
exercises
Weeks
10
to
12:
! Initiate
closed
kinetic
chain
strengthening
Push--up
progression
Seated
serratus
push--ups
! Initiate
plyometric
program
Plyoball
wall
drills
Double
arm
rebounder
drills
progressing
to
single
arm
Phase
VI
?
Interval
Throwing
Program
(week
12):
! Follow--up
appointment
with
physician
! Initiate
return
to
sport
program
per
physician
approval
Center for Musculoskeletal Care ? 333 East 38th Street, New York, NY 1001 ? (646) 501-7070 ? cmc.med.nyu.edu
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