Elbow Injuries

OBJECTIVES Describe the basic anatomy of the arm and elbow. Explain common arm and elbow injuries that occur with athletic participation. Identify common signs and symptoms of arm and elbow injuries. Explain common treatment parameters performed by a CTA for elbow injuries.

The elbow is prone to muscle and tendon injuries because it is the site of many muscle attachments. Normal ROM Flexion 0-145 Extension 0-15 Pronation 0-75 Supination 0-85

Anatomy Hinge Joint- Moves in flexion and extension 3 Bones – Humerus, radius and ulna Radius allows the forearm to pronate and supinate

Ligaments A ligament called the joint capsule surrounds the elbow Ulnar Collateral Lig. (Medial Collateral Lig.)-Helps stabilize the inside Radial Collateral Lig. (Lateral Collateral Lig.)-Helps stabilize the outside Annular Ligaments- Helps to hold the radius and ulna together near the elbow joint.

Ligaments of the Elbow

Anatomy Cont. Muscles Triceps perform elbow extension Biceps perform elbow flexion Wrist flexors attach to the medial epicondyle of the humerus and run toward the hand and perform flexion of the wrist Wrist extensors attach the later epicondyle of the humerus and run toward the hand and perform extension of the wrist.

Muscles of the Elbow

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Types of Elbow Injuries Many of the injuries that happen to the elbow are due to overuse. Stretching and strengthening-Don’t forget about the wrist flexors and extensors Proper technique Proper equipment Alter activity and rest after long days of throwing. Rules protect pitchers in baseball.

Treating Elbow Injuries Ulnar Collateral Lig. Sprain More prone to sprains than other ligaments of the elbow Caused by repetitive movements Caused by a direct blow Signs & Symptoms Medial elbow pain Swelling Treatment PRICE Moderate or Severe may need to be splinted Strengthen wrist flexors

Radial Collateral Lig. Sprains Signs & Symptoms Same as ulnar except for pain is on the lateral side Treatment Same as UCL Strengthen wrist extensors

Muscle and Tendon Injuries – Most often caused by either excessive resistive forces or overuse

Elbow Flexor Strain Caused by a loaded movement that include the elbow and shoulder together. Signs & Symptoms Minor strains Discomfort at the anterior aspect of the elbow Minimal swelling if any Weakness when elbow flexion is resisted Moderate strains Mild to moderate swelling Weakness Treatment PRICE until swelling gone Mild stretching and strengthening

Elbow Extensor Strain - Caused by excessive resistance to the triceps muscle - Can happen when falling and attempt to break the fall with an outstretched arm Signs & Symptoms Same as Elbow Flexor Strains, pain at posterior side of the upper arm. Treatment Same as Elbow Flexor Strain

Wrist Flexor Strain Caused by excessive resistance during wrist flexion movement or more commonly from overuse Signs & Symptoms Pain over the medial epicondyle of the humerus or the front of the forearm Treatment PRICE Activity modified Mild stretching and strengthening

Wrist Extensor Strains Caused by excessive resistance during wrist extension movements or more commonly from overuse Signs & Symptoms Pain over the lateral epicondyle of the humerus Treatment PRICE Activity Modified Mild stretching and strengthening

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Lateral Epicondylitis (Tennis Elbow) Caused by Poor mechanics Overuse Signs & Symptoms Pain over the lateral epicondyle of the humerus Minimal swelling Treatment PRICE Limiting activity Mild stretching of the extensor tendons Strengthening and endurance of the muscles

Medial Epicondylitis (Little League Elbow) Not as common Caused by repetitive throwing Signs & Symptoms Pain over the medial epicondyle of the humerus Treatment Same as Lateral Epicondylitis

Epiphyseal and Avulsion Fractures More common on the medial epicondyle Suspect an epiphyseal injury whenever an athlete presents with swelling, pain, and loss of movement. Suspect an avulsion fracture when there is sever pain and deformity.

Ulna Dislocation The elbow is one of the most commonly dislocated joints in the body Caused by a violent hyperextension or a severe blow to the lateral aspect of the elbow Signs & Symptoms Notice an obvious deformity Treatment Splint in the position found in Refer to DR.

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