The Elbow

Technique

• The patient sits, with the arm resting on het couch.
• The elbow is held between flexion and extension ( about 45° flexion) and in nearly full pronation. In this position the tendon overlies the head of the radius.
• The therapist sits next to the patient, takes hold of the patient's elbow with his contralateral hand and palpates with the thumb at the lateral aspect of the elbow. The other hand keeps the arm pronated.
• The tendon is now palpated
• The thumb is now brought on the medial side of the tendon and the friction is given by pulling the thumb towards the examiner.
• At nearly the end of the movement, one feels the round and dense structure slipping under thumb. This is the active movement of the friction.
• The thumb is then somewhat relaxed and brought back to the starting position ( passive movement of the friction).
• The alternating movements are conducted with a rhythm of about 60-90 movements per minute for twenty minutes.
• The treatment is always unpleasant so one should start gently