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Elbow Injuries 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. 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 Anatomy • Hinge Joint- Moves in flexion and extension • 3 Bones – Humerus, radius and ulna • Radius allows the forearm to pronate and supinate 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. Ligaments of the Elbow 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. Muscles of the Elbow Review Think-Pair-Share 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. 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 Radial Collateral Lig. Sprains Signs & Symptoms • Same as ulnar except for pain is on the lateral side Treatment – Same as UCL – Strengthen wrist extensors Muscle and Tendon Injuries – Most often caused by either excessive resistive forces or overuse 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 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 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 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 Review! 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 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 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. 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. Review!
