Chapter 11-Elbow Injuries Subtitle

Anatomy-Bones Hinge joint Humerus Radius Ulna Medial and lateral epicondyles Radius Allows for pronation & supination Lateral or thumb side Ulna medial or pinky side Hooks to humerus

Anatomy-Ligaments Ulnar collateral Radial collateral Annular Helps stabilize medially Radial collateral Lateral stabilization Annular Helps hold radius and ulna together Interossius membrane Between radius and ulna, runs length of the arm

Anatomy-muscles Triceps Biceps Wrist Flexors Wrist extensors Elbow extension Biceps Elbow flexion Wrist Flexors Wrist extensors

Elbow Injuries Prevention Infrequent injury Mostly overuse Most common in racket sports Stretching and strengthening important Technique important Equipment a factor (racket size, grip) Proper rest

Common injuries and treatments Ulnar collateral ligament sprain Caused by overuse or direct blow (valgus stress) Possible swelling, point tender Possible joint laxity

Common injuries and treatments Ulnar collateral ligament strains Treat with RICE May need to refer, rule out fractures or nerve damage Rehab should include wrist flexor strengthening

Common injuries and treatments Radial collateral ligament strains Rare Pain laterally Rehab focus on extensors

Muscle and tendon injuries Most often caused by excessive resistive forces or overuse Mild, moderate, severe Can occur either proximal or distal to elbow joint

Muscle and tendon injuries Elbow flexor strain Injury usually caused by a loaded movement of shoulder and elbow Minimal swelling weakness and discomfort common with resisted flexion RICE, mild stretching and strengthening Complete tears or ruptures need referral

Muscle and tendon injuries Elbow extensor strain Caused by excessive resistance (i.e.-attempting to break a fall) Triceps can avulse, assess carefully Pain with elbow extension Minimal swelling Treat w/RICE, mild stretching and strengthening

Muscle and tendon injuries Wrist flexor strain Pain over medial epicondyle or front forearm Caused by excessive resistance during wrist flexion or overuse Treat with PRICE, modify activity Mild stretching and strengthen flexors

Muscle and tendon injuries Wrist extensor strain Pain usually over lateral epicondyle Most often occur due to overuse Treat with rice, modify activity Mild stretching, reverse wrist curls for strengthening

Medial Epicondylitis Golfer’s elbow or little league elbow Chronic inflammation Usually result of repetitive throwing Not as common as lateral Treat with PRICE, limit throwing, and strengthen wrist flexors Can cause compression of ulnar nerve

Lateral epicondylitis Tennis elbow Chronic inflammation Causes-overuse and poor mechanics Can show minimal swelling Treat with PRICE, tendon strap Limit activity Stretch and strengthen extensors

Bone Injuries

Bone injuries Fractures to distal humerus rare Direct impact is most common cause of fracture Immediate referral due to possible nerve damage

Epiphyseal and Avulsion fractures Epiphyseal fracture Most common on medial epicondyle Suspect if there is pain, swelling, and loss of movement Young athlete more likely to injure growth plate that a fx or ligament injury Avulsion fracture Severe pain and deformity Refer immediately for either injury

Ulnar dislocation One of most commonly injured joints in body Usually caused by violent hyperextension or sever blow to lateral aspect Most often dislocates posteriorly Splint immediately & refer

Other elbow injuries Hyperextension Falling on outstretched arm or direct blow Can cause Sprain to ligaments of anterior elbow Strain to muscles of anterior elbow Painful bony compression of humerus by olecranon process Treat with PRICE, refer if severe

Bursae Bursae are fluid-filled cavities located at tissue sites where tendons or muscles pass over bony prominences near joints, such as the elbow. The function of a bursa is to facilitate movement and reduce friction between moving parts.

Other elbow injuries Contusions Olecranon bursitis Common, treat with PRICE Olecranon bursitis Irritation of bursa due to direct blow to elbow… fluid build up Apply compression wrap, physician may drain Protect with padding