Hello, My name is _______ who is student of RMT. How are you today?
I read your file, You got injured recently,(or you got injured long time ago, As senario) then after you feel very severe pain at ________ of elbow. right? I am going to ask several questions before assessment. Can you point the location of pain? Does your pain radiate? what makes the pain worse? Are you taking medication because of this pain? Have you seen other professionals due to this pain?
Now, I am going to do assessement to figure out the problem. Let me wash my hands. During the assessment, If you feel pain or any discomfort, pleas let me know. I will stop right away. Do you understand? Do you have any question?
First, I am going to observe your arm. I found some swelling around your elbew, also it appear bruising. Next, I am going to palpation your arm. When I palpate your arem, I feel tenderness and swelling around your elbow. Also, I feel some heating sensation. Are you okay so far?
Next, I will do ROM test to see your joint movement. so, you injured the elbow, I will do ROM of your shouder, elbow, and wrist. During test, If you have any discomfort, just let me know, I will stop right away. So, could you copy my movement? ( Do AF ROM / PR ROM of shoulder ). Do you have any pain? Your AR ROM of shoulder joint looks good, Then I will AR ROM of shoulder joint. (Do AR ROM). do you have pain? your strength is good, also you don’t have any pain, which is very good. Next, I will do ROM of the elbow. Would you copy my movement? (Do AF ROM) Do you have pain? During this test, I found limited range of motion and pain. then I will move your arm without over pressure, because you have pain when AF ROM. relax, (Do PR ROM), then, I am going to give the force against your movemnet. please follow my direction. (Do AR ROM). Next, I am going to ROM test on your wrist joint. (Do AF ROM, PR ROM, AR ROM, as mentioned above). I found some limited range of motion and pain during all these ROM test, sorry about that.
Now, I will special test for your elbow. If you too much pain during the test, please let me know, I can stop right away. Perform Varus stress test and Valgus stress test to rule in. Perform Tinel’s sign, Cozen’s test, Reverse Cozen’s test to rule out.
We have finished all the tests, I got some positive result during the tests. so, my clinical impression is (lateral/medial) ligament sprain of the wrist. It means that your (lateral/medial) side of ligament is injured which may overstretched or teared because of overuse or accident (as senario). your have complaind this pain over months, it looks like chronic state which are treatable by massage therapy. Do you have any questions?