1. BIOMECHANICS OF ELBOW COMPLEX
U.RADHAKRISHNAN.M.P.T

2. INTRODUCTION Elbow complex is designed to serve hand.
They provide MOBILITY for Hand in space by apparent shortening and Lengthening of upper extremity.
They provide Stability for skillful and forceful movements

3. ELBOW JOINT

4. HUMERO ULNAR JOINT ARTICULATIONS OF HUMEROULNAR JOINT
The articulating surface on the Humerus is Hour glass shaped TROCHLEA
The articulating surface on Ulna is a semicircular shaped concave surface called TROCHLEAR NOTCH

5. HUMERO RADIAL JOINT ARTICULATION OF HUMERORADIAL JOINT
The articulating surface on the Humerus is spherical – shaped CAPITULUM
The articulating surface on the RADIUS is the cup shaped Radial head surrounded by a rim

6. ARTICULATIONS OF JOINT
IN EXTENSION
The OLECRANON PROCESS enter the olecranon fossa in Humeroulnar Joint
There is no contact between the articulating surfaces in Humeroradial Joint.

7. ARTICULATIONS OF JOINT
IN FLEXION
The Trochlear ridge of Ulna slides along the Trochlear groove until the Coronoid process reaches the Coronoid fossa in Humeroulnar joint
The radial head slides over capitulum and reaches Radial fossa in Full Flexion.

8. JOINT CAPSULE
The Humeroulnar , Humeroradial and Superior Radioulnar Joint are enclosed in a single Joint capsule.The capsule is fairly loose .
Anteriorly, it is attached above coronoid and radial fossa
Posteriorly ,it is attached above Olecranon fossa.

9. LIGAMENTS MEDIAL COLLATERAL LIGAMENT
Extends from Medial epicondyle of Humerus to Coronoid and
Olecranon process of Ulna
LATERAL COLATERAL LIGAMENT
Extends from Lateral Epicondyle of Humerus to Annular Ligament and Olecranon process.
ANNULAR LIGAMENT
It encircles the head of Radius

10. LIGAMENTS OF ELBOW

11. Movements of Elbow Joint
FLEXION-EXTENSION ( degree)
AXIS Medio Lateral Axis (Passess through Trochlea)
PLANE------Saggital plane
MUSCLES:
FLEXORS OF ELBOW
Biceps Brachi---Powerful flexor when elbow is in 90 degree Flexion.
Brachialis----Flexor of elbow in all position
Brachioradialis---Flexor of elbow in midprone position

12. BICEPS BRACHI

13. EXTENSORS OF ELBOW TRICEPS is the powerful extensor of the Shoulder
Long head of Triceps depends on Shoulder Position
Medial head of Triceps is active in unresisted Elbow
extension
All three Heads of Triceps are active when heavy resistance is given to Extension.

15. CARRYING ANGLE
The angle formed between the axis of Humerus and the Longitudinal axis of Forearm
Normal angle: In MEN=5 degree ,
In WOMEN=10 degree
The angle is more in Women due to Wider Pelvis
CUBITUS VALGUS: Increase in Carrying Angle
CUBITUS VARUS: Decrease in Carrying Angle

16. CARRYING ANGLE

17. SUPERIOR RADIOULNAR JOINT
ARTICULATION
The Radial notch on Ulna articulate with Head of Radius along with Annular Ligament & Capitulum.
LIGAMENTS
Annular Ligament-----circle the head of Radius and keeps the Ulna together.
Quadrate Ligament----extends from the Inferior edge of radial notch to Neck of Radius
Oblique cord------attached to inferior part of Radial notch on Ulna to just below Radial Tuberosity

18. INFERIOR RADIOULNAR JOINT
ARTICULATION
The Ulnar notch of Radius articulates with head of Ulna along with Articular Disc.
LIGAMENTS
Anterior Radio Ulnar Ligament----attached to anterior aspect just above the Ulnar head to above Ulnar notch.
Posterior Radio Ulnar Ligament---attached to posterior part of Ulnar head to above Ulnar notch.
Interosseous Membrane---binds the shaft of Radius and Ulna together.

19. MUSCLES
PRONATOR TERES----- helps in Pronation,it acts in all position of Elbow, helps in Stabilization of Superio Radio Ulnar Joint. Active during rapid and resisted Pronation.
PRONATOR QUADRATUS---- helps in Pronation in all position of Elbow
SUPINATOR helps in Supination in all position of Elbow
BICEPS BRACHI helps in Supination when Elbow is flexed to 90 degree

20. MOVEMENTS Pronation & Supination
Axis of movement extends from radial head to Ulnar head
Pronation and Supination movement is good when Elbow is Flexed to 90 degree
In Elbow extended position Pronation is limited due to passive tension in Biceps Brachi. Supination is limited due to passive tension in Interosseous Membrane.

21. PROBLEMS OF ELBOW TENNIS ELBOW or LATERAL EPICONDYLITIS:
Inflammation at origin of Extensors of Wrist at Lateral Epicondyle.
It is caused due to repeated forceful contraction of Wrist Extensors.
Extensor carpi radialis brevis is affected
GOLFER’S ELBOW or MEDIAL EPICONDYLITIS:
Inflammation at origin of Flexors of Wrist at Medial Epicondyle.
Repetitive contractions of Pronator Teres,Flexor Carpi Ulnaris

22. PROBLEMS OF ELBOW NURSEMAID’S ELBOW or PULLED ELBOW
In small children the radial head is not fully developed ,lifting small child up in to by one hand may cause the RADIAL HEAD to slip out of Annular Ligament.
CUBITAL TUNNEL SYNDROME
Repetitive forceful contractions of Flexor carpi Ulnaris may compress Ulnar Nerve as it passess through the cubital tunnel between Medial Epicondyle of Humerus and Olecranon process of Ulna.