Elbow InjuriesElbow Injuries

OBJECTIVESOBJECTIVES

• Describe the basic anatomy of the arm Describe the basic anatomy of the arm and elbow.and elbow.

• Explain common arm and elbow Explain common arm and elbow injuries that occur with athletic injuries that occur with athletic participation.participation.

• Identify common signs and symptoms Identify common signs and symptoms of arm and elbow injuries.of arm and elbow injuries.

• Explain common treatment parameters Explain common treatment parameters performed by a CTA for elbow injuries.performed by a CTA for elbow injuries.

The elbow is prone to The elbow is prone to muscle and tendon injuries muscle and tendon injuries

because it is the site of because it is the site of many muscle attachments.many muscle attachments.

Normal ROMNormal ROM• Flexion 0-145Flexion 0-145• Extension 0-15Extension 0-15• Pronation 0-75Pronation 0-75• Supination 0-85Supination 0-85

AnatomyAnatomy

• Hinge Joint- Moves Hinge Joint- Moves in flexion and in flexion and extensionextension

• 3 Bones – 3 Bones – Humerus, radius Humerus, radius and ulnaand ulna

• Radius allows the Radius allows the forearm to pronate forearm to pronate and supinateand supinate

LigamentsLigaments

• A ligament called the joint capsule A ligament called the joint capsule surrounds the elbowsurrounds the elbow

• Ulnar Collateral Lig. (Medial Collateral Ulnar Collateral Lig. (Medial Collateral Lig.)-Helps stabilize the insideLig.)-Helps stabilize the inside

• Radial Collateral Lig. (Lateral Collateral Radial Collateral Lig. (Lateral Collateral Lig.)-Helps stabilize the outsideLig.)-Helps stabilize the outside

• Annular Ligaments- Helps to hold the Annular Ligaments- Helps to hold the radius and ulna together near the elbow radius and ulna together near the elbow joint.joint.

Ligaments of the ElbowLigaments of the Elbow

Anatomy Cont.Anatomy Cont.

MusclesMuscles• TricepsTriceps perform elbow extension perform elbow extension• BicepsBiceps perform elbow flexion perform elbow flexion• Wrist flexorsWrist flexors attach to the medial attach to the medial

epicondyle of the humerus and run toward epicondyle of the humerus and run toward the hand and perform flexion of the wristthe hand and perform flexion of the wrist

• Wrist extensorsWrist extensors attach the later attach the later epicondyle of the humerus and run toward epicondyle of the humerus and run toward the hand and perform extension of the the hand and perform extension of the wrist. wrist.

Muscles of the ElbowMuscles of the Elbow

ReviewReview

Think-Pair-ShareThink-Pair-Share

Types of Elbow InjuriesTypes of Elbow Injuries

Many of the injuries that happen to the Many of the injuries that happen to the elbow are due to overuse.elbow are due to overuse.

• Stretching and strengthening-Don’t forget Stretching and strengthening-Don’t forget about the wrist flexors and extensorsabout the wrist flexors and extensors

• Proper techniqueProper technique• Proper equipmentProper equipment• Alter activity and rest after long days of Alter activity and rest after long days of

throwing. Rules protect pitchers in throwing. Rules protect pitchers in baseball. baseball.

Treating Elbow InjuriesTreating Elbow Injuries

Ulnar Collateral Lig. SprainUlnar Collateral Lig. Sprain– More prone to sprains than other ligaments of the More prone to sprains than other ligaments of the

elbowelbow– Caused by repetitive movementsCaused by repetitive movements– Caused by a direct blowCaused by a direct blow

Signs & SymptomsSigns & Symptoms– Medial elbow painMedial elbow pain– SwellingSwelling

TreatmentTreatment– PRICEPRICE– Moderate or Severe may need to be splintedModerate or Severe may need to be splinted– Strengthen wrist flexorsStrengthen wrist flexors

Radial Collateral Lig. Radial Collateral Lig. SprainsSprains

Signs & SymptomsSigns & Symptoms• Same as ulnar except for pain is on Same as ulnar except for pain is on

the lateral sidethe lateral side

TreatmentTreatment– Same as UCLSame as UCL– Strengthen wrist extensorsStrengthen wrist extensors

Muscle and Tendon InjuriesMuscle and Tendon Injuries – Most often caused by – Most often caused by

either excessive resistive either excessive resistive forces or overuseforces or overuse

Elbow Flexor Strain Elbow Flexor Strain

Caused by a loaded movement that include the Caused by a loaded movement that include the elbow and shoulder together.elbow and shoulder together.

Signs & SymptomsSigns & Symptoms• Minor strainsMinor strains• Discomfort at the anterior aspect of the elbowDiscomfort at the anterior aspect of the elbow• Minimal swelling if anyMinimal swelling if any• Weakness when elbow flexion is resistedWeakness when elbow flexion is resisted• Moderate strainsModerate strains• Mild to moderate swelling Mild to moderate swelling • WeaknessWeaknessTreatmentTreatment• PRICE until swelling gonePRICE until swelling gone• Mild stretching and strengthening Mild stretching and strengthening

Elbow Extensor StrainElbow Extensor Strain

- Caused by excessive resistance to the - Caused by excessive resistance to the triceps muscletriceps muscle

- Can happen when falling and attempt to - Can happen when falling and attempt to break the fall with an outstretched armbreak the fall with an outstretched arm

Signs & SymptomsSigns & Symptoms• Same as Elbow Flexor Strains, pain at Same as Elbow Flexor Strains, pain at

posterior side of the upper arm.posterior side of the upper arm.

TreatmentTreatment • Same as Elbow Flexor StrainSame as Elbow Flexor Strain

Wrist Flexor StrainWrist Flexor Strain

• Caused by excessive resistance during wrist Caused by excessive resistance during wrist flexion movement or more commonly from flexion movement or more commonly from overuseoveruse

Signs & SymptomsSigns & Symptoms• Pain over the medial epicondyle of the Pain over the medial epicondyle of the

humerus or the front of the forearmhumerus or the front of the forearm

TreatmentTreatment• PRICEPRICE• Activity modifiedActivity modified• Mild stretching and strengthening Mild stretching and strengthening

Wrist Extensor StrainsWrist Extensor Strains • Caused by excessive resistance during wrist Caused by excessive resistance during wrist

extension movements or more commonly extension movements or more commonly from overusefrom overuse

Signs & SymptomsSigns & Symptoms• Pain over the lateral epicondyle of the Pain over the lateral epicondyle of the

humerushumerus

TreatmentTreatment• PRICEPRICE• Activity ModifiedActivity Modified• Mild stretching and strengtheningMild stretching and strengthening

Review!Review!

Lateral Epicondylitis Lateral Epicondylitis (Tennis Elbow)(Tennis Elbow)

• Caused by Poor mechanicsCaused by Poor mechanics• OveruseOveruse

Signs & SymptomsSigns & Symptoms• Pain over the lateral Pain over the lateral

epicondyle of the humerus epicondyle of the humerus • Minimal swellingMinimal swelling

TreatmentTreatment• PRICEPRICE• Limiting activityLimiting activity• Mild stretching of the Mild stretching of the

extensor tendons extensor tendons • Strengthening and Strengthening and

endurance of the muscles endurance of the muscles

Medial Epicondylitis Medial Epicondylitis (Little League Elbow) (Little League Elbow)

• Not as commonNot as common• Caused by repetitive Caused by repetitive

throwingthrowing

Signs & SymptomsSigns & Symptoms• Pain over the medial Pain over the medial

epicondyle of the epicondyle of the humerus humerus

TreatmentTreatment• Same as Lateral Same as Lateral

Epicondylitis Epicondylitis

Epiphyseal and Avulsion Epiphyseal and Avulsion FracturesFractures

• More common on the More common on the medial epicondylemedial epicondyle

• Suspect an Suspect an epiphyseal injury epiphyseal injury whenever an athlete whenever an athlete presents with presents with swelling, pain, and swelling, pain, and loss of movement.loss of movement.

• Suspect an avulsion Suspect an avulsion fracture when there fracture when there is sever pain and is sever pain and deformity.deformity.

Ulna DislocationUlna Dislocation• The elbow is one of the most The elbow is one of the most

commonly dislocated joints commonly dislocated joints in the bodyin the body

• Caused by a violent Caused by a violent hyperextension or a severe hyperextension or a severe blow to the lateral aspect of blow to the lateral aspect of the elbowthe elbow

Signs & SymptomsSigns & Symptoms• Notice an obvious deformityNotice an obvious deformity

TreatmentTreatment• Splint in the position found Splint in the position found

inin• Refer to DR. Refer to DR.

Review!Review!