Download Elbow Injuries

The Elbow
Sports Medicine
John Hardin, Instructor
Anatomy of Elbow and Forearm
Humerus
 Ulna
 Radius

Humerus
Medial & lateral epicondyles
 Olecranon fossa
 Trochlea
 Capitulum

Ulna
Olecranon process
 Articulates with trochlea and olecranon
fossa of humerus

Radius
Head of radius
 Articulates w/ the capitulum of the humerus

Joints
Humeroulnar joint
 Flexion/extension
 Humeroradial joint
 Flexion/extension
 Radioulnar joint
 Supination/pronation
 3 articulations—superior, middle, distal

Ligaments
Joint capsule surrounds joint
 Ulnar collateral
 Radial collateral
 Annular ligament
 Interroseus membrane

Muscles

Flexors of the elbow
 Biceps brachii
 Brachialis
 Brachioradialis
 Forearm flexors
 Forearm extensors
Extensors of the elbow

Triceps brachii
 Long head
 Lateral head
 Medial head
Pronators
Pronator teres
 Pronator quadratus

Supinators
Biceps brachii
 Supinator

Forearm muscles
Forearm flexors attach to the medial
epicondyle
 Forearm extensors attach to the lateral
epicondyle

Other structures

Nerves
 Ulnar, radial, median
Landmarks
Cubital fossa
 Olecranon process
 Olecranon fossa
 Medial and lateral epicondyles
 Radial head

Olecranon Bursitis
Another view?
Mechanism
Direct blow
 Falling on elbow
 May appear spontaneously without heat and
pain

Signs & symptoms
Pain
 Swelling
 POT
 Heat

Treatment
Cold
 Compression
 Rarely will be aspirated by physician
 Protect with padding when competing
 May recur with repeated blows

Elbow Sprains
Mechanism
Hyperextension or a force that bends or
twists the lower arm outward
 Valgus stress

Signs & Symptoms
Pain
 Inability to throw or grasp an object
 POT (usually over UCL)

Treatment
Ice
 Compression
 Sling for support @ 90 degrees
 Progress to full ROM and strength

Lateral Epicondylitis

Tennis elbow
Mechanism
Backhand stroke involving overextending
of wrist
 Repetitive extension of the wrist

Signs & Symptoms
POT over lateral epicondyle
 Pain over lateral epicondyle during and
after activity
 Pain gradually increases resulting in
weakness in hand and wrist
 Pain with resistive hyperextension of wrist
and full extension of elbow

Treatment
RICE
 NSAIDS
 Analgesics
 Heat
 Deep friction massage

Treatment (cont’d)

Rehab
 ROM exercises
 stretching
 PRE’s
 strengthening
 Hand grasping while in supination
 Avoid pronation movements
Medial epicondylitis
Pitcher’s elbow
 Racquetball elbow
 Golfer’s elbow
 Javelin-thrower’s elbow

Mechanism
Repeated forceful forearm flexion
 Excessive throwing

Signs & Symptoms
Aching pain around the medial epicondyle
especially during forceful wrist flexion
 Pain during and after activity—progressing
to constant pain
 POT
 Mild swelling

Treatment
RICE
 NSAIDS
 Ultrasound
 Analgesics
 Brace
 Exercises for ROM and strengthening

Dislocation of Elbow
Mechanism of injury
Fall on outstretched arm
 Hyperextension
 Severe twist with elbow in flexed position
 Blow to posterior humerus with fixed
radius/ulna

Signs & Symptoms
Ulna and/or radius displaced posteriorly, w/
olecranon process sitting posteriorly
 Severe swelling/bleeding
 Disability
 LOM
 Extreme pain

Treatment
Immobilize in position you find it
 ER
 Treat for shock
 Immobilized after reduction for about 3
weeks

Fracture of elbow
Mechanism
Fall on outstretched arm
 Direct blow to elbow

Signs & symptoms
Possible deformity
 Swelling/bleeding
 Muscle spasm
 Pain
 POT

Treatment
Immobilize
 Ice
 ER

Injuries to forearm
Contusions
 Forearm strain
 fractures

Contusion
Mechanism
Direct blow to forearm
 Repeated blows to forearm

Signs & Symptoms
Pain
 Swelling
 Discoloration
 Hematoma

Treatment
RICE
 Protective padding
 Modify activity if necessary

Forearm strain
Mechanism
Hyperextension or hyperflexion
 Fall on outstretched hand

Signs & Symptoms
Pain along extensors or flexors
 POT
 Pain with motion
 Inability to grip
 swelling

Treatment
RICE
 Modify activity
 Restore ROM and strength
 Tape for protection

Fractures
Radius
 Ulna
 Both bones

Mechanism
Direct blow
 Fall on outstretched arm

Signs & Symptoms
Possible deformity
 Pain
 POT
 Swelling
 Unable to use arm
 “+” compression/percussion test

Treatment
Immobilize
 Ice
 ER
