1. The Elbow Sports Medicine Connie Rauser, Instructor

2. Anatomy of Elbow and Forearm Humerus Humerus Ulna Ulna Radius Radius

6. Ligaments Joint capsule surrounds joint Joint capsule surrounds joint Ulnar collateral Ulnar collateral Radial collateral Radial collateral Annular ligament Annular ligament Interroseus membrane Interroseus membrane

10. Landmarks Cubital fossa Cubital fossa Olecranon process Olecranon process Olecranon fossa Olecranon fossa Medial and lateral epicondyles Medial and lateral epicondyles Radial head Radial head

11. Olecranon Bursitis

12. Another view?

13. Mechanism Direct blow Direct blow Falling on elbow Falling on elbow May appear spontaneously without heat and pain May appear spontaneously without heat and pain

14. Signs & symptoms Pain Pain Swelling Swelling

15. Treatment Cold Cold Compression Compression Rarely will be aspirated by physician Rarely will be aspirated by physician Protect with padding when competing Protect with padding when competing May recur with repeated blows May recur with repeated blows

16. Elbow Sprains Mechanism Hyperextension or a force that bends or twists the lower arm outward Hyperextension or a force that bends or twists the lower arm outward Valgus stress Valgus stress

17. Signs & Symptoms Pain Pain Inability to throw or grasp an object Inability to throw or grasp an object Treatment Treatment Ice Ice Compression Compression Sling for support @ 90 degrees Sling for support @ 90 degrees Progress to full ROM and strength Progress to full ROM and strength

18. Lateral Epicondylitis Tennis elbow Tennis elbow

19. Mechanism Backhand stroke involving overextending of wrist Backhand stroke involving overextending of wrist Repetitive extension of the wrist Repetitive extension of the wrist Signs & Symptoms Signs & Symptoms Pain over lateral epicondyle during and after activity Pain over lateral epicondyle during and after activity Pain gradually increases resulting in weakness in hand and wrist Pain gradually increases resulting in weakness in hand and wrist Pain with resistive hyperextension of wrist and full extension of elbow Pain with resistive hyperextension of wrist and full extension of elbow

20. Treatment RICE RICE NSAIDS NSAIDS Analgesics Analgesics Heat Heat Deep friction massage Deep friction massage Brace Brace

21. Treatment (cont’d) Rehab Rehab  ROM exercises  stretching  strengthening  Hand grasping while in supination

22. Thumb and finger opposition

23. Wrist circles Hand flips

24. Stretching Ex

25. Wrist flexor stretch Hold for at least 15 to 30 seconds. Repeat 2 to 4 times.

27. Hold a tennis ball in your hand. Make a fist around the ball and squeeze. Hold for about 6 seconds, then relax for up to 10 seconds. Repeat 8 to 12 times.

28. Sit so that your arm is supported but your hand hangs off the edge of a flat surface, such as a table. Hold your hand out like you are shaking hands with someone. Move your hand up and down. Repeat this motion 8 to 12 times. Switch arms.

29. Place your forearm on a table with your hand hanging over the edge of the table, palm up. Place a 1- to 2-pound weight in your hand. This may be a dumbbell, a can of food, or a filled water bottle. Slowly raise and lower the weight while keeping your forearm on the table and palm facing up. Repeat this motion 8 to 12 times. Switch arms, and do steps 1 through 4. Repeat with your hand facing down toward the floor. Wrist curls

30. Sit leaning forward with your legs slightly spread and your left hand on your left thigh. Place your right elbow on your right thigh, and hold the weight with your forearm horizontal. Slowly curl the weight up and toward your chest. Repeat this motion 8 to 12 times Biceps curls

31. Brace

32. Adhesive strap Deep friction massage

33. Medial epicondylitis Pitcher’s elbow Pitcher’s elbow Racquetball elbow Racquetball elbow Golfer’s elbow Golfer’s elbow Javelin-thrower’s elbow Javelin-thrower’s elbow

34. Mechanism Repeated forceful forearm flexion Repeated forceful forearm flexion Aching pain around the medial epicondyle especially during forceful wrist flexion Aching pain around the medial epicondyle especially during forceful wrist flexion Pain during and after activity—progressing to constant pain Pain during and after activity—progressing to constant pain Mild swelling Excessive throwing Mild swelling Excessive throwing Signs & Symptoms

35. Treatment RICE RICE NSAIDS NSAIDS Ultrasound Ultrasound Analgesics Analgesics Brace Brace Exercises for ROM and strengthening Exercises for ROM and strengthening

36. Dislocation of Elbow

37. Mechanism of injury Fall on outstretched arm Fall on outstretched arm Hyperextension Hyperextension Severe twist with elbow in flexed position Severe twist with elbow in flexed position Blow to posterior humerus with fixed radius/ulna Blow to posterior humerus with fixed radius/ulna

40. Signs & Symptoms Ulna and/or radius displaced posteriorly, w/ olecranon process sitting posteriorly Ulna and/or radius displaced posteriorly, w/ olecranon process sitting posteriorly Severe swelling/bleeding Severe swelling/bleeding Disability Disability LOM LOM Extreme pain Extreme pain

43. Treatment Immobilize in position you find it Immobilize in position you find it Treat for shock Treat for shock Immobilized after reduction for about 3 weeks Immobilized after reduction for about 3 weeks