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Elbow Sports Medicine. Movements Carrying angle – Females 10-15 degrees, Males 5 degrees Flexion – 145 degrees Extension Pronation – 90 degrees Supination.

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Presentation on theme: "Elbow Sports Medicine. Movements Carrying angle – Females 10-15 degrees, Males 5 degrees Flexion – 145 degrees Extension Pronation – 90 degrees Supination."— Presentation transcript:

1 Elbow Sports Medicine

2 Movements Carrying angle – Females degrees, Males 5 degrees Flexion – 145 degrees Extension Pronation – 90 degrees Supination – 90 degrees

3 Articulations Consists of 3 separate joints – Humeroulnar – Humeroradial – Proximal radioulnar

4 Ligaments and Bursae Ulnar collateral ligament – Prevents valgus forces Radial collateral ligament – Prevents varus forces (uncommon) Annular ligament – Stabilizes head and neck of radius (strong) Olecranon bursa – Between olecranon process and skin

5 Musculature Biceps Brachii, Brachialis, brachioradialis – Elbow flexion Triceps brachii, anconeus – Elbow extension Pronator teres, supinator – Pronation and supination

6 Nerve/Blood Supply Median Nerve Radial Nerve Ulnar Nerve – Funny bone Radial Artery Ulnar Artery

7 Assessment History – Land on tip of bent elbow? (most common MOI) – Overuse from throwing? – Over extension? – Location and duration of pain? – Positions that increase or decrease pain? – Previous elbow injuries? – Locking or crepitation w/movement?

8 Assessment Observations – Deformities, swelling – Carrying angle Too great or little could = epiphyseal fx – Decreased flexion or extension – 45 degree angle, posterior observation of epicondyles and olecranon process to make isosceles triangle

9 Assessment Bony Palpations – Medial epicondyle – Lateral epicondyle – Olecranon process – Radial head – Radius – ulna Soft tissue palpations – Anterior Biceps brachii Brachialis Brachioradialis Pronater teres – Posterior Triceps supinator – Medial Ulnar collateral ligament – Lateral Radial collateral ligament Annular ligament

10 Strains MOI – FOOSHA = hyperextension S/S – AROM or RROM= pain – Point tender TX – RICE possibly a sling – Cryotherapy, US, rehab – X-ray if severe

11 Elbow Dislocation MOI – FOOSHA, or severe twist with flexion – Ulna and radius are pushed posterior (most common) S/S – Severe pain, swelling and disability – Deformity – Probable radial head fx TX – Ice, sling, check circulation – Refer for x-ray and reduction

12 Elbow Fractures MOI – FOOSHA, or direct blow S/S – Possible visible deformity – Hemorrhage, muscle spasm, and swelling TX – Stabilize, monitor distal pulse – Refer for x-ray, splint 6-8 weeks

13 Elbow MMTs Flexion Extension Pronation Supination

14 UCL sprain MOI – Valgus force from repetitive trauma – Tennis, golfing, throwing S/S – Pn. On medial aspect of elbow – Parasthesia, and laxity TX – Rest, NSAIDs, strengthening, correct form

15 Valgus Test Procedure – Athlete sits with elbow flexed at 20 degrees. Evaluator grasps athletes wrist and lateral elbow applying a valgus force. Positive Test – Pn at the medial aspect of elbow, laxity – Ulnar (medial) collateral ligament sprain

16 Varus Test Procedure – Athlete sits with elbow flexed at 20 degrees. Evaluator grasps athletes wrist and medial elbow applying a varus force. Positive test – Lateral elbow pn, and laxity – Radial (lateral) collateral ligament sprain

17 Volkmann’s Contracture MOI – Complication of serious elbow injury – Muscle spasm, swelling, or bone pressure on the brachial artery S/S – Pn. In the forearm that is worse when fingers are passively extended – Decreased or absent brachial and radial pulses TX – Removal of constricting casts, wraps or braces, elevation – Can become permanent

18 Tinel’s sign Procedure – Patient is seated, elbow in flexion – Evaluator grasps wrist and taps the ulnar notch with reflex hammer Positive Test – Athlete complains of tingling sensation along forearm, hand and fingers – Indicates ulnar nerve compromise 2O8ON

19 Epicondylitis MOI – Lateral (tennis elbow) Tennis, baseball, swimming, golfing Repeated forearm flexion and extension – Medial (pitchers or golfers elbow) Repetitive wrist flexion, valgus stress on elbow S/S – Aching pn. During and after activity – decreased ROM – hand weakness TX – RICE, NSAIDS – ROM, PRE, Deep friction massage – Elbow sleeve or band just below the bend of the elbow

20 Epicondylitis Tests Procedure – Elbow is flexed to 45 degrees – Wrist extension is resisted, increases pn at lateral epicondyle – Wrist flexion is resisted, increases pn at medial epicondyle Positive Test – Pn at either epicondyle

21 Olecranon Bursitis MOI – Direct blow S/S – Pain, severe swelling, point tenderness TX – Acute= ice, compression – Chronic = compression, modalities, aspiration – Padding for play


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