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Elbow Injuries Critical link in kinetic chain of upper extremityCritical link in kinetic chain of upper extremity Extremely susceptible to injuryExtremely.

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Presentation on theme: "Elbow Injuries Critical link in kinetic chain of upper extremityCritical link in kinetic chain of upper extremity Extremely susceptible to injuryExtremely."— Presentation transcript:

1 Elbow Injuries Critical link in kinetic chain of upper extremityCritical link in kinetic chain of upper extremity Extremely susceptible to injuryExtremely susceptible to injury –Big range of motion –Weak lateral bone structure –Boney anatomy prominent causing soft tissue damage –Excessive stress on joint from sports –Locking motion of some activities –Use of implements –Throwing motion

2 Olecranon Head of radius Neck of radius Styloid Process Neck of radius Head of radius Olecranon Radial notch Tuberosity of radius Styloid Process Ulna Radius Interosseous Membrane Styloid Process Anterior View Posterior View

3 Posterior Alignment Extended Elbow Straight line formed Flexed ElbowFlexed Elbow IsoscolesTriangleIsoscolesTriangle

4 Elbow ROM SupinationPronation PronationSupination Extension 0º Flexion 150º Supination 90º Pronation 90º Carrying Angle of Elbow Normal Angle Normal Angle –Females º –Males 5 º Hyperextended Elbow

5 Humerus Triceps Tendon Joint Capsule Olecrenon Bursa Coronoid Process Medial View Annular Ligament Biceps Tendon (cut) Radius Ulna Ulnar Collateral Ligament

6 Valgus Stress Test Ulnar Collateral Ligament Radial Collateral Ligament Varus Stress Test Valgus Stress Stabilize Apply Stress

7 EtiologyEtiology –Valgus force –Repetitive trauma –Related injuries Ulnar nerve inflammationUlnar nerve inflammation Wrist flexor tendinitisWrist flexor tendinitis Overuse flexor/pronator strainOveruse flexor/pronator strain Elbow flexion contracturesElbow flexion contractures InstabilityInstability Ulnar Collateral Ligament Sprains

8 Signs and Symptoms –Pain Medial aspect of elbow UCL Valgus stress test at 20 degrees –End-point laxity –Paresthesia Positive Tinel’s sign Signs and Symptoms (con’t)Signs and Symptoms (con’t) –Positive X-ray Bone spursBone spurs Calcification w/in UCLCalcification w/in UCL Loose bodiesLoose bodies Posterior impingementPosterior impingement

9 ManagementManagement –Conservative treatment RICERICE NSAID’sNSAID’s –W/ resolution StrengtheningStrengthening Analysis of the throwing motionAnalysis of the throwing motion –Surgical intervention ReconstructionReconstruction (Tommy John procedure)(Tommy John procedure) Return to activity weeks post opReturn to activity weeks post op

10 Lateral Epicondylitis Tennis Elbow –Etiology Repetitive microtraumaRepetitive microtrauma Insertion of extensor/supinator muscle/sInsertion of extensor/supinator muscle/s Lateral epicondyleLateral epicondyle –Signs and Symptoms Aching pain after activityAching pain after activity Pain w/ resistive wrist extensionPain w/ resistive wrist extension Weakness in wrist and handWeakness in wrist and hand Elbow decreased ROMElbow decreased ROM

11 Resisted Eccentric Contraction RICERICE NSAID’sNSAID’s AnalgesicsAnalgesics RehabilitationRehabilitation –ROM exercises –PRE –Deep friction massage –Stretching in pain free ROM Mechanics trainingMechanics training BracingBracing –Counter force brace –Neoprene sleeve AssessmentManagement

12 Olecrenon Bursitis Superficial locationSuperficial location Extremely susceptible to injuryExtremely susceptible to injury EtiologyEtiology –Direct blow –Irritation to bursa Chronic irritationChronic irritation –Production of fluid –Increased capillary permeability –Fluids and exudates flow into the bursa –Bursal wall thickens over time –May have irregular areas of scar tissue Feels like loose joint cartilage (joint mice)Feels like loose joint cartilage (joint mice) Calcium depositsCalcium deposits –Acutely injured joint Blood may fill the bursaBlood may fill the bursa Risk of infectionRisk of infection


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