1. Elbow Injuries

2. 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.

3. 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

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

5. 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.

6. Ligaments of the Elbow

7. 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.

8. Muscles of the Elbow

9. Review Think-Pair-Share

10. 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.

11. 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

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

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

14. 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

15. 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

16. 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

17. 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

18. Review!

19. 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

20. 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

21. 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.

22. 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.

23. Review!