Case Studies of the Upper Quarter: Elbow and Wrist

Presented by Eric Robertson and Jodi Young

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In these case studies we'll assess two different patients referred to physical therapy for elbow and wrist pain. The first patient is a 39-year-old right handed male who has returned to school for his PhD in microbiology. The patient is referred to physical therapy for right achy elbow pain that started six months ago, which was three weeks into his new program. The second is A 27-year-old left handed female with a newborn (six weeks old) infant, who is referred to physical therapy for left radial wrist pain that started when she was eight months pregnant. Our panel will review the anatomy and differential diagnosis related to each condition. Furthermore, our panel will assess proper examination procedures and identify interventions to properly manage each patient's progress through physical therapy.

Meet your instructors

Eric Robertson

Eric Robertson is an associate professor at the University of Utah in Salt Lake City, Utah, and an associate professor of clinical physical therapy at the University of Southern California in Los Angeles, California. Previously, he served as director of graduate physical therapy education for Kaiser Permanente of Northern…

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Jodi Young

Jodi Young, PT, DPT, PhD is the Director of Research for the Bellin College Doctor of Science in Physical Therapy program. She is also a fellow of the American Academy of Orthopaedic Manual Physical Therapy. Jodi completed her PhD through the University of Newcastle in Australia where she researched physical therapy dosing in…

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Chapters & learning objectives

Elbow

1. Elbow

A 39-year-old right handed male who has returned to school for his PhD in microbiology is referred to physical therapy for right achy elbow pain that started six months ago, which was three weeks into his new program. He notes that pain increases with a lot of computer time or lab work where he is using pipettes to run experiments. This requires him to grip and grasp a pipette for up to three hours at one time. Pain at rest is 1/10 and with computer or lab work, it increases to 6/10 and starts burning. He has continued to do his work because as a new grad student, he feels he has no other choice, but it usually takes about 1-2 hours after stopping using the computer or pipettes before the pain goes back to a 1/10. He wakes three nights per week due to the pain, and if his arm is “in an awkward position” (described as wrist flexion), the pain will definitely wake him.

Radial Wrist Pain

2. Radial Wrist Pain

A 27-year-old left handed female with a newborn (six week old) infant is referred to physical therapy for left radial wrist pain that started when she was eight months pregnant. She works at Target as a customer service representative part time, but has had to take time off due to having her baby, plus the pain in her wrist has increased significantly over the last month. This has increased her stress significantly, and she feels like her wrist pain increases even more when she is stressed. She describes the pain as dull and achy at the base of her left hand, but it will radiate up to the elbow after a long day at work or if she has to lift/hold her baby. The pain is a 2/10 at rest and 7/10 with any lifting/holding her baby.