Index of Day 2 Upper Extremity Lecture 2
Summary
• Golfer's Elbow and Nerve Entrapments Overview (0:03)
◦ Dr. Richard Hazel explains that the treatment for golfer's elbow, median nerve, and ulnar nerve entrapments is similar, using the golfer's elbow treatment to learn the muscles needed for all three.
◦ He emphasizes that once the muscles are learned, the key is to recognize the specific nerve issue and apply the appropriate protocol.
◦ Dr. Hazel reassures new practitioners that treatment success is not always about visible muscle movement, especially in older or larger patients.
◦ He advises not to judge treatments based on immediate results and to rely on patient feedback for improvement assessment.
• Muscle Involvement in Nerve Entrapments (5:39)
◦ Dr. Hazel discusses the muscles involved in golfer's elbow, including the flexor digitorum superficialis, flexor digitorum profundus, pronator teres, and palmaris longus.
◦ He highlights the importance of the pronator teres in golfer's elbow and mentions the flexor carpi ulnaris, deep flexors, and medial head of the triceps as additional considerations.
◦ The flexor carpi radialis is mentioned but not a primary focus due to its proximity to the palmaris longus.
◦ Dr. Hazel explains the anatomy of the median nerve pathway, including its origin, travel through the thoracic outlet, and its passage through the carpal tunnel.
• Carpal Tunnel Syndrome and Treatment (10:29)
◦ Dr. Hazel describes carpal tunnel syndrome, its symptoms, and the importance of ruling out thoracic outlet syndrome and cervical spine compression.
◦ He explains the Phalanx test and the reverse Phalanx test for diagnosing carpal tunnel syndrome.
◦ The treatment for carpal tunnel syndrome includes the pronator quadratus, palmaris longus, flexor digitorum superficialis, and flexor digitorum profundus.
◦ Dr. Hazel mentions the abductor pollicis as a motor point for neurofunctional treatment to stimulate sensation in numb areas.
• Pronator Teres Syndrome and Its Treatment (23:27)
◦ Dr. Hazel explains pronator teres syndrome, its symptoms, and the importance of recognizing it as a median nerve entrapment.
◦ He describes the pronator quadratus as a last resort treatment for median nerve entrapment.
◦ The treatment for pronator teres syndrome includes the pronator teres, palmaris longus, flexor digitorum superficialis, and flexor digitorum profundus.
◦ Dr. Hazel emphasizes the importance of treating the pronator teres and palmaris longus to relieve median nerve compression.
• Ulnar Nerve Entrapment and Cubital Tunnel Syndrome (24:45)
◦ Dr. Hazel discusses the ulnar nerve entrapment at the medial head of the triceps and the arcade of Struthers.
◦ He explains the cubital tunnel syndrome, its symptoms, and the importance of treating the flexor carpi ulnaris and flexor digitorum profundus.
◦ Dr. Hazel describes the treatment for cubital tunnel syndrome, including the flexor carpi ulnaris and flexor digitorum profundus motor points.
◦ He mentions the importance of treating the medial head of the triceps for ulnar nerve entrapment.
• Assessment and Treatment of Golfer's Elbow (35:39)
◦ Dr. Hazel outlines the assessment for golfer's elbow, including flexion, supination, and straightening the arm to check for pain at the medial epicondyle.
◦ He explains the importance of treating the flexor digitorum superficialis and flexor digitorum profundus for golfer's elbow.
◦ Dr. Hazel describes the treatment points for golfer's elbow, including the flexor carpi ulnaris and the medial head of the triceps.
◦ He emphasizes the importance of treating the pronator teres and palmaris longus for median nerve entrapment.
• Treatment of Ulnar Nerve Entrapment (35:56)
◦ Dr. Hazel discusses the treatment for ulnar nerve entrapment, including the flexor carpi ulnaris and flexor digitorum profundus.
◦ He explains the importance of treating the medial head of the triceps for ulnar nerve entrapment.
◦ Dr. Hazel describes the treatment points for ulnar nerve entrapment, including the flexor carpi ulnaris and flexor digitorum profundus motor points.
◦ He mentions the importance of treating the pronator teres and palmaris longus for median nerve entrapment.
• Muscle Testing and Assessment (36:18)
◦ Dr. Hazel explains the importance of muscle testing and assessment for diagnosing nerve entrapments.
◦ He describes the flexor carpi ulnaris test and the flexor digitorum profundus test for ulnar nerve entrapment.
◦ Dr. Hazel mentions the importance of treating the pronator teres and palmaris longus for median nerve entrapment.
◦ He emphasizes the importance of treating the flexor carpi ulnaris and flexor digitorum profundus for ulnar nerve entrapment.
• Patient Feedback and Treatment Success (36:43)
◦ Dr. Hazel advises practitioners to rely on patient feedback for assessing treatment success.
◦ He emphasizes the importance of not judging treatments based on immediate results and to trust the patient's feedback.
◦ Dr. Hazel mentions the importance of treating the pronator teres and palmaris longus for median nerve entrapment.
◦ He describes the treatment points for ulnar nerve entrapment, including the flexor carpi ulnaris and flexor digitorum profundus motor points.
• Final Remarks and Break (37:04)
◦ Dr. Hazel concludes the lecture by summarizing the key points discussed.
◦ He advises practitioners to keep practicing and not to give up.
◦ Dr. Hazel mentions the importance of treating the pronator teres and palmaris longus for median nerve entrapment.
◦ He offers a 10-minute break for participants to se
t up and prepare for the next part of the lecture.