Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with insidious onset of medial-sided left elbow pain, exacerbated by repetitive wrist flexion and forearm pronation. Reports localized tenderness, occasional radiation to the proximal forearm, and weakness with gripping activities. Denies history of acute trauma, numbness, or paresthesia in the ulnar nerve distribution.
Clinical Examination Findings
Left elbow inspection reveals no erythema, edema, or deformity. Palpation demonstrates focal tenderness directly over the medial epicondyle. Pain is reproduced with resisted wrist flexion and forearm pronation. Passive wrist extension elicits discomfort at the medial epicondyle. Ulnar nerve is stable in the cubital tunnel; Tinelโs sign at the elbow is negative. Distal neurovascular status is intact.
Treatment Protocol
Conservative management initiated: activity modification to avoid aggravating repetitive motions, application of ice packs for 15 minutes TID, and non-steroidal anti-inflammatory drugs (NSAIDs) as directed. Prescribed physical therapy for eccentric strengthening and stretching of the wrist flexor-pronator mass. Use of a counterforce brace recommended during strenuous activity.