Elbow joint functional exercise method

  The elbow joint consists of the brachioradialis, brachioradialis, and proximal ulnar radius joints, and is an important structure for the proper function of the upper extremity. Injuries to the elbow joint and its surrounding soft tissues, as well as to adjacent joints (distal ulnar radial joint, shoulder joint), can affect elbow function to varying degrees. Successful rehabilitation is based on a comprehensive understanding of the anatomical and physiological factors of a particular patient’s elbow disorder and requires close collaboration between the patient, the surgeon and the rehabilitation team. To meet the needs of daily living, elbow joint angulation should strive to achieve: active flexion >130°, active extension limitation <40°, active posterior rotation >60°, and active anterior rotation >60°. The main methods of elbow joint functional exercise are briefly described. Figure 1 Normal elbow joint range of motion I. Flexion of the elbow joint (bending the arm) In the early stages of injury, while the joint is still under braking, isometric active muscle contraction training should be started. After removal of the external immobilization device, passive extension and flexion mobility exercises can be started with the assistance of a rehabilitator (Figure 2). Patients can also exercise on their own by holding the affected wrist with the healthy hand and pulling it forcefully toward themselves. Note that the exercise should be suspended when there is significant pain, and the angle should be increased after the tissue has adjusted to the pain. Resistance exercises can be performed with the aid of rubber stretching bands or dumbbells and other equipment. Figure 2: Passive elbow flexion (A) and extension exercises (B) II. Elbow extension (straightening the arm) Elbow extension can also be practiced by the patient himself by taking a seated position with the elbow extended and the fist up, with the elbow supported and fixed on the table and the small arm and hand hanging off the table. The muscles are completely relaxed, so that the elbow is slowly straightened by dropping down under its own weight or by holding a heavy object such as a dumbbell. Elbow extension exercises mainly help to stretch the soft tissues in front of the elbow joint, care should be taken to avoid violence and to master the principles of low load (dumbbell weight from light to heavy, slowly increasing) and longer duration. Figure 3 Passive elbow extension exercises with the help of heavy weights III. Forearm rotation anterior Forearm rotation anterior and posterior rotation involves the linkage of the proximal and distal ulnar radial joints, which is easily neglected in the early rehabilitation phase and may affect the later hand function. Exercises are generally performed in a seated position with the shoulder joint relaxed and the forearm flat on the table with the elbow flexed, holding a long-handled weight in the hand and tilting it inward with the gentle and continuous traction force of its gravity, gradually increasing the joint activity. Figure 4 forearm passive rotation exercise four, forearm rotation as shown in the figure, the movement and rotation before the exercise is similar, the direction is the opposite, the rest of the requirements are identical. The elbow joint is a part of the body prone to stiffness and ossifying myositis. Early exercises should be performed under the guidance of a physician, following the principles of active muscle stretching, then passive pulling, and finally resistance exercises. In accordance with the rehabilitation process, the frequency of exercises should be increased first (10-15 minutes each time in the early stage, 2-3 times a day), and then the intensity of exercises should be increased; attention should be paid to the combination of continuous static training (joint inactivity) and short duration of power resistance training.