ANATOMY OF THE ELBOW JOINT
Bones
Composed of three bones:
Humorous, radius, ulna
Distal end of the humerus forms the medial and lateral epicondyles
The olecranon process of the ulna articulates with the trochlea and the olecranon fossa on the posterior humerus
Three joints form the elbow
Humeroulnar, humeroradial, and the radioulnar
Humeroulnar and humeroradial have flexion and extension
Radioulnar has pronation (inward) and supination (outward)
Ligaments
The ulnar (medial) collateral ligament is the most important for stability
The annular ligament extend from the ulna forming a sling around the radial head (allows free rotation of the radius while providing stability and preventing radial head luxation)
The radial (lateral) collateral ligament provides stability to a varus force and extends from the lateral epicondyle
Muscles
Biceps brachii, brachialis, and brachioradialis (flexors of elbow)
Brachialis: primary elbow flexor
Triceps brachii control extension
Biceps brachii and supinator muscles allow supination of the forearm
Pronator teres and pronator quadratus act as pronators
ASSESING ELBOW INJURIES
Palpation
Epicondyles, olecranon process, distal aspect of humerus, proximal aspect of the ulna, and the proximal radial head
Soft tissue to be palpated includes: the muscles and muscle tendons, joint capsule, and ligaments surrounding the joint
PREVENTION OF ELBOW, FOREARM, AND WRIST INJURIES
Acute injuries usually occur either from a direct blow or falling out an outstretched hand
Wearing padding can minimize injury
Chronic overuse injuries usually occur in the in the elbow or in the wrist may be reduced by several strategies
The athlete should limit the amount of repetitions
Make sure mechanics are correct
Correct equipment
Athlete should maintain certain level of strength and endurance
Stretch routinely
RECOGNITION AND MANAGEMENT OF ELBOW INJURIES
Olecranon Bursitis
Cause: most frequently injured bursa in the elbow
Signs: inflamed bursa produces pain, swelling, and tenderness
Care: if acute: ice and compression should be applied for 20 minutes. If chronic: program of protective therapy.
Elbow Sprain
Cause: usually caused by hyperextension or a force that bends or twists outward
Signs: athletes complain of pain and the inability to throw or grasp object. Point tenderness over the medial collateral ligament
Care: cold and pressure bandages for at least 24 hours. Apply sling in fixed position of about 90 degrees of flexion. Progressively aid the elbow in regaining a full range of motion, followed by active exercises. If elbow is unstable, surgical procedure called a “Tommy John” is used to repair the medial collateral ligament in the joint capsule.
Lateral Epicondylitis
Cause: most common problems of the elbow in sports, also called tennis elbow; overextending the wrist which causes irritation and inflammation to the insertion of the extensor muscle of the lateral epicondyle.
Signs: pain at the lateral epicondyle and pain on the resisted extension of the wrist and full extension of the elbow.
Care: immediate use of PRICE, drugs. Can wear a brace for 1-3 months
Medial Epicondylitis
Cause: Irritation and inflammation of the medial epicondyle. Result of sports activities that require repeated forceful flexions of the wrist. “Little League Elbow,” “pitchers elbow”
Signs: occurs around the medial epicondyle of the humerous during forceful wrist flextion and may radiate down the arm.
Care: rest, cryotherapy, or heat through the application of ultrasound. Elbow splinting and rest for 7-10 days.
Elbow Osteochondritis Dissecans
Cause: The cause of osteochondritis is unknown; however, impairment of the blood supply can lead to fragmentation and separation of a portion of the articular cartilage and bone, creating loose bodies within the joint.
Signs: Complains of sudden
