Metrophysiotherapy

13/02/2026

13/01/2026

Elbow examination

1. Inspection

➡️ Overall: Observe the relaxed arm for symmetry, muscle wasting, scars, or skin changes, noting the normal carrying angle (slight outward tilt).

➡️ Posterior: Look for swelling, redness, or deformities around the olecranon.

➡️ Lateral/Medial: Check for swelling or nodules.

2. Palpation (Feeling for tenderness/warmth)

➡️ Bony Landmarks: Feel the olecranon, medial epicondyle, and lateral epicondyle.

➡️ Joint Line: Palpate the joint space between the epicondyles and olecranon.

➡️ Radial Head: Feel the radial head move during pronation/supination.

➡️ Soft Tissues: Palpate the triceps tendon (above olecranon) and distal biceps tendon (in front of elbow, easier with flexion).

➡️ Nerve: Gently check the ulnar nerve behind the medial epicondyle.

3. Range of Motion (Active & Passive)

☆ Flexion/Extension: Ask patient to bend and straighten the elbow; then passively move it, feeling for crepitus (grinding).

☆ Pronation/Supination: Rotate the forearm palm-up and palm-down.

4. Special Tests & Strength
★ Ligaments: Apply valgus (pushing outwards) and varus (pushing inwards) stress with the elbow slightly bent to check for laxity or pain.

★ Tennis Elbow (Lateral Epicondylitis): Resisted wrist extension, middle finger extension, or grip strength.

★ Golfer's Elbow (Medial Epicondylitis): Resisted wrist flexion with fingers flexed.

★ Biceps Tendon: Resisted elbow flexion with forearm supinated.

★ Triceps Tendon: Resisted elbow extension.

★ Nerve: Assess grip strength and finger movement for nerve compromise, e.g., the "OK" sign for Anterior Interosseous Nerve (AIN).

• For ligamentous instability:

》 Lateral pivot shift test of the elbow
》 Ligamentous valgus instability test
》 Ligamentous varus instability test
》 Milking maneuver
》 Moving valgus stress test

• For biceps rupture (third-degree strain):

》 Hook (distal biceps) test
》 Popeye sign (proximal long head of biceps)

• For lateral epicondylitis (epicondylalgia):
》 Cozen’s test
》 Mill’s test

• For plica:
》 Extension-supination plica test
》 Flexion-pronation plica test

• For posterior impingement:

》 Arm bar test
》 Extension impingement test

• For neurological dysfunction:

》 Elbow flexion test (ulnar nerve)
》 Pinch grip test (anterior interosseous branch of median nerve)
》 Tinel sign at elbow (ulnar nerve)

16/12/2025

23/11/2025

Hamstring massage involves using techniques like deep tissue massage and tools like massage guns to reduce muscle tension, increase blood flow, and promote healing. Hamstring mobilization uses hands-on techniques or specific exercises to stretch and elongate muscle fibers, improve flexibility, and increase the range of motion around the hip and knee joints. This can help reduce stiffness, break up scar tissue, and prevent injury.

Hamstring massage

Purpose: To reduce muscle tightness, increase circulation for healing, loosen scar tissue, and relieve soreness.
Techniques:
Manual: Therapists use hands, palms, and thumbs to apply pressure. This can involve using the heel of the hand, and may increase pressure to flush out lactic acid and bring in fresh blood.
Tools: Massage guns can be used to target knots and trigger points, starting slowly and gradually increasing pressure to improve blood flow and reduce soreness.

Key aspects:

It's important to start with gentle strokes to warm up the muscle, especially if the area is injured.
Massage can be combined with other techniques like flexing and extending the knee while applying pressure to stretch the hamstring.
Hamstring mobilization
Purpose: To increase flexibility, restore full range of motion, and prevent scar tissue formation.

Techniques:

Soft tissue mobilization: Pressure is applied to the muscles to increase their temperature and elasticity.
Joint mobilization: A therapist will gently move the hip, knee, and pelvic joints to relieve tension and increase the range of movement.
Stretching: Specific dynamic and static stretches are used to elongate muscle fibers and improve flexibility.
Pin and stretch: A technique where a therapist applies pressure to a tight spot and then moves the joint to stretch the muscle.

17/11/2025

16/11/2025

14/11/2025

.️He will talk about two very important terms that we hear a lot in our work with patients in our private clinics or hospitals in general. 😏

⚫️The difference between tightness and shortening muscle? 😎

1⃣First of all, tight muscle is a problem in the function of the muscle, meaning that the muscle is the nerve signals that are sent from the nervous system have a problem that is continuously communicated, and therefore this will help that it gets muscle contraction, and therefore the tone will increase in the muscle, and from here the muscle will be in a prolonged contraction state One of them is the problem of tight muscle in the function, which is the contraction of a muscle through the nerve signals that come. ✅

2⃣ Second shortening is a problem in the internal composition of the muscle that is in the muscle fibers, where muscle fibers are characterized by their ability to increase its length or shorten, and therefore the problem of shortening lies in the structure of muscle that is in muscle fibers. ✅

فيI think you understand how to differ between them, Negi, how do we deal with each clinical in our treatment? 🤔

🔵If the muscle was tight, then we need to do an inhibition of the muscle to reduce the excess tone and continuously through muscle energy techniques. For example, the trapezuis muscle, especially the upper trapezius✅

🔵If the muscle is short, then we will stretch it to do lengthening of muscle fibers, for example the pectoralis minor muscle✅

14/11/2025

Sciatica is nerve pain that radiates from your lower back, through your buttocks, and down the back of one or both legs. It is a symptom of an underlying condition that compresses or irritates the sciatic nerve.

04/11/2025