Transcript Elbow Injuries

FYI
Functions with any upper extremity
movement.
 Prone to muscle and tendon injuries
because it is the sight of many muscle
attachments.

Anatomy
Hinge joint
 3 major bones: humerus, radius, and
ulna.
 Ulna is hooked to the end of the
humerus and forms a tight joint.
 Radius is on the thumb side of the
forearm.

 Able to rotate, causing supination and
pronation of the forearm.
Ligaments
Joint capsule (a ligament) surrounds the
elbow and gives some general stability to
the joint.
 Other primary ligaments that provide
stability:

 Ulnar collateral-stabilize the medial aspect
 Radial collateral-stabilize the lateral aspect
 Annular collateral-helps hold the radius and ulna
together near the elbow joint
○ Interosseus membrane-tissue that joins the radius
and ulna from the elbow to wrist and keeps the
two bones from separating.
Muscles
Triceps-primarily performs elbow
extension
 Biceps-primarily performs elbow flexion.
 Wrist flexors-attach to the medial
epicondyle of humerus
 Wrist extensors-attach to the lateral
epicondyle of humerus
**epicondyle-rounded articular area.
**both muscles help stabilize the elbow.
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Preventing Elbow Injuries
Not a frequently injured joint.
 Most injuries seen at the elbow joint are
caused by overuse.
 Most athletes pay more attention to
strengthening the biceps and triceps,
and they fail to properly condition some
of the smaller muscles of the wrist (vital
to preventing overuse injuries).

Ligament Injuries
Sprains classified as first, second, or
third degree.
 Ulnar collateral seem to be more prone
to sprains than the other ligaments

 Especially in athletes who throw, due to the
amount of stress placed on the medial
aspect of the elbow.
Valgus Stress
Forcing the medial aspect of the joint to
separate or spread apart as the forearm
moves laterally
 Characterized by medial elbow pain and
swelling.
 Joint laxity may be present.
 Treated using PRICE
 Rehab: strengthening the wrist flexors

Radial Collateral Injuries
Very rare
 Same characteristics of ulnar collateral
injuries except the pain and swelling
would be on the lateral side.
 Rehab: strengthening the wrist
extensors

Muscle and Tendon Injuries
Strains often caused by either excessive
resistive forces or overuse.
 Can occur to elbow flexors or extensors,
as well as to the wrist flexors and wrist
extensors

Elbow Flexor Strain
Often caused by a loaded movement
that includes the elbow and shoulder
together.
 “two-joint muscles” are very prone to
strains.

 Muscles involved with creating movement at
more than one joint
 Ex. Biceps-flexes elbow and shoulder
Degrees of a Flexor Strain
Minor-characterized by discomfort at the
anterior aspect of the elbow and minimal
swelling. Some weakness when elbow
flexion is resisted.
 Moderate-mild to moderate amounts of
swelling and marked weakness.
**treated with PRICE
 Complete rupture needs to be referred
to team physician

Elbow Extensor Strain
Excessive resistance to the triceps
muscle will often cause tissue damage
to the elbow extensors.
 Needs to be assessed carefully because
the triceps tendon can often pull a bit of
bone away from the ulna.
 Characteristics are the same as a flexor
strain except the pain will be at the
posterior aspect.
 Treatment: PRICE

Wrist Flexor Strains
Caused by excessive resistance during
wrist flexion movements or from
overuse.
 Result in pain over the medial
epicondyle of the humerus or the front of
the forearm.
 Treated with PRICE and activity should
be modified

Wrist Extensor Strains
Caused by excessive resistance during
wrist extension movements or overuse
 Result in pain over the lateral epicondyle
of the humerus.
 Treated with PRICE and activity should
be modified.

Lateral Epicondylitis
Caused by poor mechanics and
continual use over a long period of time.
 Racquet sports are the most common
cause

 Aka Tennis Elbow
Characterized by pain over the lateral
epicondyle of the humerus and minimal
swelling.
 Treatment: PRICE, a support, and
limiting activity

Medial Epicondylitis
Not as common as lateral epicondylitis.
 Often a result of repetitive throwing.
 Aka “Little League elbow”
 Treatment: PRICE and limiting
activities.

Bone Injuries
Fractures to the distal end of the humerus
are not common.
 If they do occur, it is often due to a very
powerful mechanism

 Ex. Hand being planted on the ground and
someone forcing the arm into excessive side
bending.

ATC must consider any type of elbow
fracture an emergency because they can
result in compression of an artery or nerve
Epiphyseal and Avulsion
Fractures

More common on the medial eipcondyle or
olecranon aspect
 Olecranon-process of the ulna projecting behind
the elbow joint.
Epiphyseal injury suspected whenever
there is swelling, pain, and loss of
movement.
 Severe pain and deformity indicate an
avulsion fracture.
 Either injury should be referred to a team
physician

Ulna Dislocation
Elbow is one of the most commonly
dislocated joints in the body.
 Takes a very traumatic injury to dislocate
the ulna from the humerus.

 Violent hyperextension or a severe blow to the
lateral aspect of the elbow
Obvious deformity
 Should be immediately splinted in the
position in which it is found
 Needs to be reduced by a physician

Olecranon Bursitis

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Happens when the olecranon process is
contused.
Olecranon bursa becomes irritated
Causes a lot of fluid to build up at the “tip”
of the elbow
Rarely disabling, but build up can become
the size of a golf ball.
Treatment: compression wrap or may
need to be drained.
Padding may need to be applied to protect
the elbow from further bruising.
Pics of olecranon bursitis