Beginner Elbow Acute Injury Rehabilitation

Pain at rest <3/10 on VAS scale,No reproducible pain with gentle valgus/varus stress to medial/lateral epicondyle,Absence of ulnar nerve paresthesia in forearm and digits 4-5,No active joint effusion at humero-ulnar joint,Protected elbow ROM: flexion 90-110°, extension within 20° of full,Tolerance to static isometric contraction of wrist flexor/extensor groups without epicondyle flare

→ Advance to: Early Range of Motion

Pain with passive elbow flexion/extension <2/10,Full pronation and supination without radioulnar joint pain,No reproduction of ulnar nerve symptoms with elbow flexion beyond 90°,Active elbow flexion to 115° with minimal compensation,No increase in joint swelling following session,Tolerates wrist and finger active range of motion without medial/lateral epicondyle pain

→ Advance to: Early Strengthening

Pain-free resisted wrist extension with forearm in pronation (lateral epicondyle tolerance),Pain-free resisted wrist flexion with forearm in supination (medial epicondyle tolerance),Grip strength >50% of contralateral side,No ulnar nerve dysesthesia with elbow flexion-extension arcs,Full pain-free elbow extension within 10° of contralateral side,Tolerates isometric forearm supination/pronation against resistance

→ Advance to: Progressive Strengthening

Full pain-free elbow flexion and extension range of motion,Grip strength >70% of contralateral side,Lateral epicondyle tolerance to resisted wrist extension with elbow extended,Medial epicondyle tolerance to resisted wrist flexion with elbow extended,No ulnar nerve provocation with sustained elbow flexion at 90°,Pinch grip (key and tip) >60% of contralateral side

→ Advance to: Advanced Strengthening

Grip strength >85% of contralateral side,Full pain-free functional range in all planes including valgus stress tolerance,Tolerates resistance training with loads up to 70% 1RM for wrist flexion/extension,No reproduction of medial elbow pain with throwing motion simulation,Negative elbow valgus stress test at 30° flexion,Normal ulnar nerve conduction velocity at cubital tunnel

→ Advance to: Return to Activity

Pain-free full elbow range of motion including hyperextension if pre-injury status,Grip and pinch strength 100% or equal to contralateral side,No medial/lateral epicondyle tenderness to palpation,No ulnar nerve symptoms with sustained elbow flexion or repetitive motion,Functional movement patterns without compensation,Patient-reported return to pre-injury activity level without limitations

→ Advance to: Discharge