Elbow dislocation..

[gcoe]

Hey Bobby

Just a couple of general comments:

• On the postive side you are really thinking through a range of therapy to treat the various impairments. Sounds like he is getting his money's worth.
• Potential negative - it is a lot in the first session. I would be concerned that if you did stir the healing tissue you would not know what was the offending mob or exercise. I think I would start off a bit more conservatively, tackling a prioritised list of problems and adding in mobs and exercises when I know he is going to tolerate them. Your patient might be fine but I even so recommend being oriened to assessing any potiential irritable response,particularly in the first 2-3 sessions. I would be inclined to do less and get him back soon to determine the response. I know you are tackling this with ice which may or may not control irritation - not sure if you can solely rely on the ice to counter irritability.
• the ROM is good - I don't think you are likely to have major poblems with restoring full extension. Just keep working at it
• with your strengthening exs are you using overload principle? - obviously need to go easy on this to start with but is this a true 15 RM (can't do any more or close to it ?) or is it a bit of number plucked out of the ether?
• Is he otherwise keeping fit? or does he need a bit of help with this - may not have been doing much so getting deconditioned?

Hope that is of help

[BobbySports]

Hey Gcoe

Thanks for you're response! You make some good points.

Following the first treatment my patient was fine with no soreness after the session or the following day which is good news I guess.

I think you are right in regards to starting off a bit more conservatively and tackling a prioritised list of problems. The patient still has a little bit of swelling on the medial aspect of his elbow so I probably should focus a bit more towards resolving that (contrast therapy?)

I was def planning on utilizing the overload principle. No its not a true 15RM, I just thought 3 x 15 with 2kg weights was a good place to start with the flexor/exentsor strengthening as the patient was able to complete 15 repetitions with relative ease. Then I was gradually going to progress to 2.5kg, 3kg, 4kg etc.. Do you think that is okay?

Also following the prescribed exercises I provided, the patient had no soreness during, after or the following day.

Once swelling was resolved and full elbow ROM was present I was going to begin with some bicep/tricep etc strengthening...

I have suggested to the patient that he is still able to maintain his cardiovascular fitness with running, cycling, lower limb exercises etc. Any other ideas?

I appriciate you're comments and look forward to you're response

Bobby