Fix the arm to the table with your proximal hand and apply some compression to the medial side of the elbow. Apply a stretching force with the other hand by pulling the forearm into your side. Keep your arms against your sides and rotate away from the table.
Tips: Try varying the pronation and supination during the technique to reach different parts of the muscles.
26.5 • (bottom left) Stretching of intra-osseous membrane supine Grip the forearm between your hands and apply opposite movements with each hand of traction and compression as well as antero-posterior shearing.
Tips: Try varying the angle of flexion before applying the other levers.
26.6 • (bottom right) Traction supine Fix in the ante-cubital fossa with your pronated proximal hand and grip the forearm with the other. Compress the forearm against your abdomen and turn away from the table to pivot round the fixing hand to apply traction.
Tips: Most useful where there has been a longitudinal compression force injury and it is necessary to disengage the joints.
26.7 • Traction to ulna supine Fix the upper arm to the table with the pronated proximal hand. Grip the ulna with the other hand and compress the forearm against your abdomen. Pivot around your fixing hand to apply a specific traction to the ulna.
Tips: Try adding a small circumduction force to the traction.
26.8 • Traction to radius supine Fix the upper arm to the table with your pronated hand and reach around the forearm with the distal hand to grip the radius. Apply traction and mobilize in pronation and supination.
Tips: Most useful in cases of 'tennis elbow' where there tends to be an element of compression in the radio-humeral joint. Least useful where the forearm is very large and it would be difficult to reach around the ulna to the radius.
26.11 • Thrust to radio-humeral joint supine The patient is lying supine but slightly turned toward the affected arm. Apply your hands to the slightly flexed arm. Contact the shafts of the radius and ulna and the upper part of the humerus. Compress with both hands toward the table and apply a gentle rocking force from side to side until tension accumulates in the radio-humeral joint. The thrust is applied without releasing this preliminary tension by dropping some weight onto both hands.
Tips: If preferred, use crossed arms to apply the hold.
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