The Elbow

Sports MedicineSports Medicine

Connie Rauser, InstructorConnie Rauser, Instructor

Anatomy of Elbow and Forearm

HumerusHumerus UlnaUlna RadiusRadius

Ligaments

Joint capsule surrounds jointJoint capsule surrounds joint Ulnar collateral Ulnar collateral Radial collateral Radial collateral Annular ligamentAnnular ligament Interroseus membraneInterroseus membrane

Landmarks

Cubital fossaCubital fossa Olecranon processOlecranon process Olecranon fossaOlecranon fossa Medial and lateral epicondylesMedial and lateral epicondyles Radial headRadial head

Olecranon Bursitis

Another view?

Mechanism

Direct blowDirect blow Falling on elbowFalling on elbow May appear spontaneously without heat and May appear spontaneously without heat and

painpain

Signs & symptoms

PainPain SwellingSwelling

Treatment

ColdCold CompressionCompression Rarely will be aspirated by physicianRarely will be aspirated by physician Protect with padding when competingProtect with padding when competing May recur with repeated blowsMay recur with repeated blows

Elbow SprainsMechanism Hyperextension or a force that bends or Hyperextension or a force that bends or

twists the lower arm outward twists the lower arm outward Valgus stressValgus stress

Signs & Symptoms

PainPain Inability to throw or grasp an objectInability to throw or grasp an object

TreatmentTreatment IceIce CompressionCompression Sling for support @ 90 degreesSling for support @ 90 degrees Progress to full ROM and strengthProgress to full ROM and strength

Lateral Epicondylitis

Tennis elbowTennis elbow

Mechanism Backhand stroke involving overextending of Backhand stroke involving overextending of

wristwrist Repetitive extension of the wristRepetitive extension of the wrist

Signs & SymptomsSigns & Symptoms Pain over lateral epicondyle during and after Pain over lateral epicondyle during and after

activityactivity Pain gradually increases resulting in weakness Pain gradually increases resulting in weakness

in hand and wristin hand and wrist Pain with resistive hyperextension of wrist and Pain with resistive hyperextension of wrist and

full extension of elbowfull extension of elbow

Treatment

RICERICE NSAIDSNSAIDS AnalgesicsAnalgesics HeatHeat Deep friction massageDeep friction massage BraceBrace

Treatment (cont’d)

RehabRehab ROM exercisesROM exercises stretchingstretching strengtheningstrengthening Hand grasping while in supinationHand grasping while in supination

Thumb and finger opposition

Wrist circles Hand flips

Stretching Ex

Wrist flexor stretch

Hold for at least 15 to 30 seconds. Repeat 2 to 4 times.

Hold for at least 15 to 30 seconds. Repeat 2 to 4 times.

Hold a tennis ball in your hand.Make a fist around the ball and squeeze.Hold for about 6 seconds, then relax for up to 10 seconds.Repeat 8 to 12 times.

Sit so that your arm is supported but your hand hangs off the edge of a flat surface, such as a table.Hold your hand out like you are shaking hands with someone.Move your hand up and down.Repeat this motion 8 to 12 times. Switch arms.

Place your forearm on a table with your hand hanging over the edge of the table, palm up.Place a 1- to 2-pound weight in your hand. This may be a dumbbell, a can of food, or a filled water bottle.Slowly raise and lower the weight while keeping your forearm on the table and palm facing up.Repeat this motion 8 to 12 times. Switch arms, and do steps 1 through 4. Repeat with your hand facing down toward the floor.

Wrist curls

Sit leaning forward with your legs slightly spread and your left hand on your left thigh. Place your right elbow on your right thigh, and hold the weight with your forearm horizontal. Slowly curl the weight up and toward your chest. Repeat this motion 8 to 12 times

Biceps curls

Brace

Adhesive strap

Deep friction massage

Medial epicondylitis

Pitcher’s elbowPitcher’s elbow Racquetball elbowRacquetball elbow Golfer’s elbowGolfer’s elbow Javelin-thrower’s elbowJavelin-thrower’s elbow

Mechanism

Repeated forceful forearm flexionRepeated forceful forearm flexion Aching pain around the medial epicondyle Aching pain around the medial epicondyle

especially during forceful wrist flexionespecially during forceful wrist flexion

Pain during and after activity—progressing to Pain during and after activity—progressing to constant painconstant pain

Mild swelling Excessive throwingMild swelling Excessive throwing

Signs & Symptoms

Treatment

RICERICE NSAIDSNSAIDS UltrasoundUltrasound AnalgesicsAnalgesics BraceBrace Exercises for ROM and strengtheningExercises for ROM and strengthening

Dislocation of Elbow

Mechanism of injury

Fall on outstretched armFall on outstretched arm HyperextensionHyperextension Severe twist with elbow in flexed positionSevere twist with elbow in flexed position Blow to posterior humerus with fixed Blow to posterior humerus with fixed

radius/ulnaradius/ulna

Signs & Symptoms

Ulna and/or radius displaced posteriorly, w/ Ulna and/or radius displaced posteriorly, w/ olecranon process sitting posteriorlyolecranon process sitting posteriorly

Severe swelling/bleedingSevere swelling/bleeding DisabilityDisability LOMLOM Extreme painExtreme pain

Treatment

Immobilize in position you find itImmobilize in position you find it Treat for shockTreat for shock Immobilized after reduction for about 3 Immobilized after reduction for about 3

weeksweeks