Elbow Evaluation

History How did this injury occur? When did you hurt your elbow? Did you hear any sounds or feel a pop? Have you ever hurt this elbow before? Pain level and type of pain Continue activity?

Observation Carrying angle Bilateral comparison of elbow (swelling, deformity, discoloration) Observes how athlete carries themselves, or move

Boney Palpation Humerus ▫Medial Epicondyle – the boney protrusion of the distal humerus on the medial aspect of the arm ▫Lateral Epicondyle – the boney protrusion of the disal humerus on the later aspect of the arm ▫Olecranon fossa – a hollowed fossa at the distal end of the posterior humerus which receives the olecranon during elbow extension Radius (radical dude!) Ulna ▫Olecranon – a large process at the proximal end of the ulna which forms the point of the elbow

Soft Tissue Palpation Muscles ▫Biceps Brachii (elbow flexion; palm up) ▫Triceps (elbow extension) ▫Brachioradialis (elbow flexion; thumbs up) ▫Brachialis (elbow flexion; palm down) ▫Wrist Flexors (Medial) ▫Wrist Extensors (Lateral) Ligaments ▫Ulnar Collateral Ligament ▫Radial Collateral Ligament ▫Annular Ligament Nerves ▫Ulnar Nerve ▫Radial Nerve

ROM and MMT (manual muscle test) Flexion: Degrees Extension: 0-10 Degrees Supination: 0-90 Degrees Pronation: 0-90 Degrees Wrist Flexion: 0-90 Degrees Wrist Extension: 0-90 Degrees Radial Deviation: 0-20 Degrees Ulnar Deviation: 0-30 Degrees

Dermatomes and Myotomes C-5 C-6 C-7 C-8 T-1

Special Tests Valgus Stress Test Varus Stress Test Tinnel Sign Forceful Hyperextension Tennis Elbow Test Little Leaguer’s Elbow

Injuries Little League Elbow/ Golfer’s Elbow~ ▫Strain of the Flexor-Pronator muscle group ▫Often happens in younger kids participating in little league ▫Overuse injury ▫Pain on the medial epicondyle ▫Tx  Increase strength by tubing exercises  Wrist Flexors  Increase flexibility by stretching  Wrist Extensors

Tennis Elbow Strain of the Extensor-Supinator muscle group Overuse injury Pain on lateral epicondyle Tx: ▫Increase strength by tubing exercises  Wrist Extensors  Elbow Flexion (3way) ▫Increase flexibility by stretching  Wrist Flexors

Olecranon Bursitis Causes ▫Trauma ▫Infection ▫Prolonged Pressure ▫Medical Conditions  Rheumatoid Arthritis  Gout Sx ▫Redness / swelling and pain ▫Decreased ROM Tx ▫R.I.C.E. ▫Anti-Inflammatory Drugs ▫Padding of the elbow

Injuries Continued FX ▫Olecranon Process ▫Humerus ▫Ulna/Radius Radial Collateral Ligament ▫Varus Stress Test ▫Pain in Lateral joint line Ulnar Collateral Ligament ▫Valgus Stress Test ▫Pain in Medial joint line