4 The Scaphoid Bone Find your anatomical snuff box Only blood supply at one end of the boneIt has difficulty healing if the blood supply is interrupted
5 Joints of the wrist and hand There are three phalanges in each finger and two in the thumbDistal, middle and proximalJoints:Distal Interphalangeal jnt (DIP)Proximal Iinterphalangeal jnt (PIP)Metacarpal Phalangeal jnt (MCP)Carpometacarpal jnt (CMP)
6 Muscles of the hand and forearm There are two major groups of muscles at the wrist and forearmFlexors: on the dorsal side of the handExtensors: on the ventral side of the hand
7 The Thumb Testing the ulnar collateral ligament of the thumb The collateral ligaments of the thumb provide the majority of its stability
8 Preventing injuries to the hand BoxingBattingCyclingField hockey/ girls lacrosse
9 More GlovesLineman GlovesReceiver/ Running back gloves
11 Wrist Sprains Occur from twisting and overuse Injured structure depends upon the stress placed on the wristUlnar Deviation is movement towards the ulnar
12 Radial deviation is movement towards the radius
13 The LunateDislocation of the lunate bone occurs more often than any other carpal dislocationPresents as deformity, pain, swelling, and decreased range of motion
14 Ganglion Cyst A pocket of fluid within the sheath Should be referred to a physicianSometimes is removed surgically
15 Gamekeepers/Skiers Thumb Thumb is forced into abduction forcefullyPain over the joint, swelling may be presentAn x-ray may be necessary to rule out a fracture
16 A “Jammed” FingerA sprain of the collateral ligaments in the finger
17 Finger Dislocations Don’t JUST “pop” it !!!!! There could be underlying hidden issues going on at the jointThere could be a tendon rupture or a fracture!!!
18 FracturesBoxer’s fracture is most common in athletes for many reasons
19 FracturesOther fractures require the same care and treatment
20 Muscle and Tendon Injuries Repetitive stress and stretching can cause injuries to these structuresSome of these includeCarpal tunneldeQuervian’s tendinitisMallet FingerJersey fingerBoutonniere deformity
22 Carpal tunnel Most common as an overuse injury TennisField hockeyWatch for acute carpal tunnel due to poor position in slings and casts
23 deQuervian’s tendinitis Abductor pollicis longus & Extensor Pollicis brevis tendonsProlonged or repetitive radial deviation (shot putters)Swelling, crepitus and pain with abduction
24 Mallet Finger An avulsion fracture of the distal phalanx. Cannot extend the distal phalanx
25 Jersey finger Avulsion fracture of flexor tendon Unable to flex the DIP
26 Boutonniere deformity Deformity arises when there is a rupture of the central slip of the extensor mechanism.This is an uncommon sporting injury usually due to an end-on injury to the finger with sudden bending at the P.I.P. jointOften in football or basketball
33 Preventing Injuries to the Elbow Not a frequently injured jointMany of the injuries are caused by overuseMost injuries occur in racket sports such as tennis, or overhead throwing sports such as baseball and softball.Many times injuries are brought about by poor training
34 Preventing Injuries to the Elbow Athletes train the “beach muscles”Overwork the Biceps to get “ pipes” or “guns”What about the Triceps???What about the wrist flexors and extensors??
35 What about equipment?Tennis players can cause themselves injuries if the grip is too small on the racket.Throwers should have a strong tricep and lots of flexibility in the elbow to prevent injuries.
36 Sprains Radial Collateral These are rare Ulnar collateralMore common in throwersThe stress of overhead activity strains the medial aspect of the elbow.Wrestling?Pain and swelling treat as any other ligament sprainRadial CollateralThese are rareTreat the same as a ulnar collateral sprain.
37 Vascularity and Nerves There are numerous blood vessels and three major nerves that pass though t he elbow
38 Lateral Epicondylitis aka: Tennis ElbowPoor mechanics and overusePresents as pain and swelling at the lateral epicondyleTreat with PRICESMedial Epicondylitisaka: Little League ElbowRepetitive ThrowingLittle league elbow may have an avulsion fracture at the epiphysis
39 Fractures Elbow fractures are rare in athletics. Often results from a forceful blow to the area or landing on hard surface.
49 Muscles of the shoulder The Rotator CuffSITS musclesSupraspinatusInfraspiantusTeres minorSubscapularisDeltoidLays over the head of the humerusPectoralisOriginate at sternum attach to the anterior portion of the humerus
50 Muscles Triceps Biceps- two heads Originates at the Coracoid process and the HumerusDistal attachment is a the radial headRuns through the bicipital grooveACTION: elbow flexion and forearm supinationTricepsOriginates at the posterior humeral head and scapulaDistal attachment is distal humerus at the elbowACTION: Elbow extension and shoulder extension
54 Rotator Cuff Strain Characterized like any other strain 1st, 2nd, and 3rd degreeCommon in throwing athletesOccurs from excessive motion beyond the normal range
55 Impingement Syndrome Overdoing it with overhead motions Supraspinatus and Bicep run together beneath the acromion processSpace narrows because of swelling, poor posture, muscle imbalanceNot enough room for everything in the joint pain occurs with motion sometimes there is numbness along with the pain
56 Bicipital Tendonitis Pain with overhead motions Palpate crepitus Inflammation of the tendon in the groove