MEDIAL EPICONDLYITIS REPAIR REHABILITATION PROTOCOL
[Pages:2]Columbia University Sports Medicine Service
Christopher S. Ahmad, MD
Offices
51 West 51st Street, Ste 370 New York, NY 10019 212-326-3333 212-326-3345 (fax)
161 Ft. Washington Ave. New York, NY 212-305-5561
500 Grand Ave Englewood, NJ 07020
MEDIAL EPICONDLYITIS REPAIR REHABILITATION PROTOCOL
IMMEDIATE POSTOPERATIVE PHASE
Goals Protect healing tissue Decrease pain/inflammation Retard muscular atrophy Avoid strengthening the flexor mass muscle group during this initial phase to allow for healing at medial epicondyle
Weeks 1-2
? Brace: 90 degrees elbow flexion ? Cryotherapy: To elbow joint ? Active assisted ROM ? Brace: Elbow ROM 0-120 degrees(Gradually increase ROM ? 5
degrees, Ext/10 degrees of Flex per week) ? Continue wrist ROM exercises ? Initiate light scar mobilization incision ? Cryotherapy to elbow
INTERMEDIATE PHASE
Goals Gradual increase to full ROM Promote healing of repaired tissue Regain and improve muscular strength Restore full function of graft site
Weeks 3-4
? Brace: Elbow ROM 0-140 degrees ? Continue all exercises listed above ? Elbow ROM in brace ? Initiate active ROM Wrist and Elbow (No resistance) ? Initiate light wrist flexion stretching ? Initiate active ROM shoulder:
- ER/IR tubing - Elbow flex/extension - Lateral raises ? Initiate light scapular strengthening exercises ? May incorporate stationary bike for lower extremity
Dr. Christopher S. Ahmad POST MEDIAL EPICONDLYTIS REPAIR PROTOCOL
? D/C brace and use wrist splint ? Begin light resistance exercises for arm (1 lb)
- Wrist curls, extensions, pronation, supination - Elbow extension/flexion ? Progress shoulder program emphasize rotator cuff and scapular strengthening ? Initiate shoulder strengthening with light dumbbells
ADVANCED STRENGTHENING PHASE
Goals Increase strength, power, endurance Maintain full elbow ROM Gradually initiate sporting activities
Weeks 6-18
? ROM: Elbow ROM 0-135 degrees ? Continue all Exercises: Progress all shoulder and UE exercises ? Progress elbow strengthening exercises ? Initiate shoulder external rotation strengthening ? Initiate eccentric elbow flexion/extension ? Continue isotonic program: forearm & wrist ? Initiate plyometric exercise program (2 hand plyos close to body only)
-Chest pass -Side throw close to body ? Continue stretching calf and hamstrings ? Continue all exercises listed above ? Program plyometrics to 2 hand drills away from body -Side to side throws -Soccer throws -Side throws ? Initiate isotonic machines strengthening exercises (if desired) -Bench press (seated) -Lat pull down ? Initiate golf, swimming ? Continue strengthening program ? Emphasis on elbow and wrist strengthening and flexibility exercises ? Maintain full elbow ROM ? Initiate one hand plyometric throwing (stationary throws) ? Initiate one hand wall dribble ? Initiate one hand baseball throws into wall
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