Movement System Impairment Approach - Based Evaluation and Treatment of Elbow Extension Syndrome: A Case Report of Posterior Elbow Pain and Overuse

Abstract

Introduction: In non-athletic occupational groups, posterior elbow discomfort is rare and often goes unrecognised, especially if the symptoms are caused by kinetic chain dysfunction and recurrent end-range extension rather than tissue failure. Tailors and textile workers are at risk of extension-based overuse injuries because they frequently execute thousands of repeated sewing and fabric-handling operations each day. The Movement System Impairment (MSI) model has never been adequately articulated for treating posterior elbow discomfort, particularly in non-athletic, vocational clients. This case provides a beginning description of how to apply an MSI-based diagnostic paradigm to identify the movement defects that are producing significant elbow discomfort in a sewing industry worker.

Materials and Methodology: Over a span of six months, a 47-year-old right-handed female tailor had increasingly significant right posterior elbow discomfort. An MSI-guided examination indicated bothersome elbow extension, triceps overuse, biceps weakness (3+/5), decreased scapular upward rotation, and abnormal movement patterns. Despite three months off work and medication, her problems did not improve. She was diagnosed with Elbow Extension Syndrome as an MSI and began a 6-week intervention program focused on pain treatment, muscle rebalancing, movement correction, and job adaptations.

Results: At the beginning of the treatment, the patient reported a NPRS pain score of 6/10, limited functional ability, PREE-Q - reduced functional score and uncomfortable full extension. After 6 weeks of MSI-based therapy, pain was reduced to 1/10, PREE-Q improved to high and near normal function, and biceps strength increased to 4+/5. Full, painless elbow range of motion was restored. The patient recovered to no restriction on sewing and fabric handling and resumed work without symptoms.

Conclusions: The follow-up time was short, making it hard to determine long-term recovery. Advanced imaging procedures such as ultrasonography or MRI were not judged to be required, but they may have provided information about tendon health. Furthermore, the lack of electromyographic examination limits the capacity to objectively analyse muscle activation and detect mobility deficits associated with musculoskeletal injuries. Nevertheless, the instance demonstrates that movement-based rehabilitation is an effective treatment for persistent posterior elbow discomfort in repetitive-use occupations.