Elbow Injuries
Supraepicondylar fracture:
- Falling on a flexed elbow
- Spans between both epicondyles
- Damage or swelling can prevent blood supply to forearm
- Can result in uncontrolled flexion of hand and damage to nerves
The Elbow Joint
Synovial FlUiD
What Makes Up the Elbow JoinT?
Ligaments
Bones Involved
Joint Capsule
- lubricates joint to prevent friction and wear
Radial Collateral Ligament:
- Lateral side of joint
- Extends from the lateral epicondyle, and blends with the annular ligament
Hinge joint
Tendons
Surrounds joint
to provide strength
and lubrication
Ulnar Collateral Ligament:
- Originates from the medial epicondyle
- Attaches to the coronoid process and olecranon of the ulna
- Annular Ligament
- Radial Collateral Ligament
- Ulnar Collateral Ligament
- stabilize joint
- minimize mechanical stress
- connect and maintains positions
How does this joint work?
- Allows for Smooth Movement and protection
Injury caused by Tennis...
1. Keeps radius in place
2. Assists in ulna stability
3. Enables the pivoting motion of the radius
Tennis Elbow (Common)
- If wrist is bent back while hitting a backhand shot, forces are transferred through tendons of the elbow
- Having too small of a racket grip
- Strings that are too tight
- Playing with wet/heavy tennis balls
- Entrapment of the radial nerve
- Inflammation in lateral epicondyle
- Referred to as lateral epicondylitis
Three Articulatons
- medial humero-ulnar
- lateral humero-radial
- radial-ulnar
Treatments
- Ultrasound or laser treatment (helps reduce pain or inflammation and will stimulate healing)
- Prescribe pain reducing and anti-inflammatory pills to patient
- Steroid injection to reduce inflammation
- Apply cold therapy (ice) to elbow. Up to 15 minutes/ 6 times per day
- Rest is extremely important
- Tennis elbow brace to protect tendons
(P.I.E.R. Principle)
Medial humero-ulnar
- Weakness in the wrist
- Difficulty doing simple tasks, such as opening a door or shaking hands
- Pain occurs when pressure is put on the lateral epicondyle, straightening fingers or when resistance against extension occurs
- Between trochlea of the humerus and olecranon of the ulna
- Enables the arm to perform flexion and extension
Tennis Elbow Exercises
- Arm straight, wrist and hand pointing up or down, gently put pressure on tips of fingers
- Arm out to the side, and rotate inward (downwards). Wrist can be flexed for a bigger step
Golfers Elbow (common)
Lateral Humero-Radial
- Most common in the extensor carpi radialis brevis muscle (extreme tenderness)
- This type of injury can occur in various sports, not just tennis
- Referred to as medial epicondylitis
- Inflammation of tendons of the flexor/pronator muscle
- Pain is specifically on medial epicondyle - especially when hand is closed
- Located where the capitulum of the humerus meets the head of the radius
- Allows for flexion and extension
- Patient will feel weakness in the wrist
- Reproduced when anterior side of wrist is facing downward ("fighting against" resistance and resisting pronation)
radial-ulnar
- Can also occur from weight training and brick laying
- Common cause of injury due to overuse or repetitive strain from extension or bending the wrist back
- Formed between the head of the radius, ulna and annular ligament
- Enables radius to rotate slightly for supination and pronation
Causes of golfers elbow (medial epicondylitis)
- Caused by repeated wrist flexion
- Can also occur from occupations such as carpentry or working at a computer station
- Overuse of wrist flexor muscles which are found on the anterior side of the forearm
treatment For Golfers Elbow
- Ice pack 10-15 minutes every hour
- Can later be reduced to 3-4 times a day
- Golfers elbow will not heal if not rested
- After 3-4 days apply heat (helps stimulate blood flow)
- Tennis elbow brace may help to take strain off tendon
Radial Tunnel syndrome
treatment from a specialist...
- Ultrasound or laser treatment (helps reduce pain and inflammation)
- Anti-inflammatory medication
- Specific sport massages to tendons
- Nerve passing through forearm gets trapped or restricted by the tunnel it passes through
- Early stages of this symptom include extensor tendonitis
- Other symptoms include pins and needles or tingling in the outer forearm and tenderness in the lateral epicondyle
- Later symptoms include aching in the wrist and pain will also move up the arm
Treatments for Radial tunnel syndrome
- Anti- inflammatory medication
Dislocation:
- distal end of humerus is driven through the weakest part of the joint capsule
- ulnar collateral ligament is typically torn