Elbow Injuries Critical link in kinetic chain of upper extremity Extremely susceptible to injury Big range of motion Weak lateral bone structure Boney anatomy prominent causing soft tissue damage Excessive stress on joint from sports Locking motion of some activities Use of implements Throwing motion

Interosseous Membrane Olecranon Olecranon Radial notch Head of radius Head of radius Neck of radius Neck of radius Tuberosity of radius Ulna Radius Interosseous Membrane Styloid Process Styloid Process Styloid Process Styloid Process Anterior View Posterior View

Posterior Alignment Extended Elbow Flexed Elbow Straight line formed IsoscolesTriangle

Carrying Angle of Elbow Normal Angle Females 10-15 º Males 5 º Extension 0º Flexion 150º Pronation Supination Elbow ROM Supination 90º Pronation 90º Hyperextended Elbow Supination Pronation

Ulnar Collateral Ligament Medial View Humerus Annular Ligament Biceps Tendon (cut) Joint Capsule Triceps Tendon Radius Ulnar Collateral Ligament Olecrenon Bursa Ulna Coronoid Process

Valgus Stress Test Varus Stress Test Valgus Stress Stabilize Ulnar Collateral Ligament Varus Stress Test Apply Stress Radial Collateral Ligament

Ulnar Collateral Ligament Sprains Etiology Valgus force Repetitive trauma Related injuries Ulnar nerve inflammation Wrist flexor tendinitis Overuse flexor/pronator strain Elbow flexion contractures Instability

Ulnar Collateral Ligament Sprains Signs and Symptoms Pain Medial aspect of elbow UCL Valgus stress test at 20 degrees End-point laxity Paresthesia Positive Tinel’s sign Signs and Symptoms (con’t) Positive X-ray Bone spurs Calcification w/in UCL Loose bodies Posterior impingement

Management Conservative treatment W/ resolution Surgical intervention RICE NSAID’s W/ resolution Strengthening Analysis of the throwing motion Surgical intervention Reconstruction (Tommy John procedure) Return to activity 22-26 weeks post op

Lateral Epicondylitis Tennis Elbow Etiology Repetitive microtrauma Insertion of extensor/supinator muscle/s Lateral epicondyle Signs and Symptoms Aching pain after activity Pain w/ resistive wrist extension Weakness in wrist and hand Elbow decreased ROM

Assessment Management RICE NSAID’s Analgesics Rehabilitation ROM exercises PRE Deep friction massage Stretching in pain free ROM Mechanics training Bracing Counter force brace Neoprene sleeve Resisted Eccentric Contraction

Olecrenon Bursitis Superficial location Extremely susceptible to injury Etiology Direct blow Irritation to bursa Chronic irritation Production of fluid Increased capillary permeability Fluids and exudates flow into the bursa Bursal wall thickens over time May have irregular areas of scar tissue Feels like loose joint cartilage (joint mice) Calcium deposits Acutely injured joint Blood may fill the bursa Risk of infection