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Elbow Sports Medicine.

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Presentation on theme: "Elbow Sports Medicine."— Presentation transcript:

1 Elbow Sports Medicine

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

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

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

11 Elbow Dislocation MOI S/S TX 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 S/S TX FOOSHA, or direct blow
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 S/S TX 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 Positive Test
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 Positive test
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 Positive Test
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

19 Epicondylitis MOI S/S TX 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 Positive Test
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 S/S TX Direct blow
Pain, severe swelling, point tenderness TX Acute= ice, compression Chronic = compression, modalities, aspiration Padding for play

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