1. Elbow, Wrist, & Hand Injuries

2. Elbow Anatomy Hinge Joint- Moves in flexion and extensionHinge Joint- Moves in flexion and extension 3 Bones – Humerus, radius and ulna3 Bones – Humerus, radius and ulna Radius allows the forearm to pronate and supinateRadius allows the forearm to pronate and supinate

3. Ligaments of the Elbow Radial Collateral Ligament Ulnar Collateral Ligament

4. Anatomy Cont. Muscles Triceps perform elbow extensionTriceps perform elbow extension Biceps perform elbow flexionBiceps perform elbow flexion Wrist flexors attach to the medial epicondyle of the humerus and run toward the hand and perform flexion of the wristWrist flexors attach to the medial epicondyle of the humerus and run toward the hand and perform flexion of the wrist Wrist extensors attach the lateral epicondyle of the humerus and run toward the hand and perform extension of the wrist.Wrist extensors attach the lateral epicondyle of the humerus and run toward the hand and perform extension of the wrist.

5. Muscles of the Elbow

6. Treating Elbow Injuries Ulnar Collateral Lig. Sprain –More prone to sprains than other ligaments of the elbow –Caused by repetitive movements –Caused by a direct blow Signs & Symptoms –Medial elbow pain –Swelling Treatment –RICE –Moderate or Severe may need to be splinted –Strengthen wrist flexors

7. Radial Collateral Lig. Sprains Signs & Symptoms Same as ulnar except for pain is on the lateral sideSame as ulnar except for pain is on the lateral sideTreatment –Same as UCL –Strengthen wrist extensors Treating Elbow Injuries

8. Muscle and Tendon Injuries – Most often caused by either excessive resistive forces or overuse

9. Common Injuries Mechanism of Injury Signs and SymptomsTreatmentPrevention Strategies Repetitive extension of the wrist. Aching pain in lateral elbow during and after activity. RICE, anti- inflammatory medications, strengthening exercises. Proper technique, progressive increase in frequency/intensity of training. Lateral epicondylitis – “Tennis Elbow”

10. Common Injuries Mechanism of Injury Signs and SymptomsTreatmentPrevention Strategies Repetitive flexion of the wrist. Pain in medial elbow, could radiate down arm; point tenderness, mild swelling. RICE, anti- inflammatory medications, strengthening exercises Proper technique, progressive increase in frequency/intensity of training. Medial epicondylitis – “Little Leaguer’s or Golfer’s Elbow”

11. Review!

12. Wrist and Hand Anatomy RadiusRadius UlnaUlna 8 Carpal bones8 Carpal bones 5 Metacarpal bones5 Metacarpal bones 14 Phalanges14 Phalanges

13. Wrist and Hand Joints Metacarpal Phalengeal MCP Thumb Interphalengeal PIP DIP

14. Common Injuries Mechanism of Injury Signs and SymptomsTreatment Blow to the tip of the finger. Pain, deformity, no ROM. Splint in position found, immediate referral to a physician. Interphalengeal Dislocation

15. Taping Injuries of Wrist & Hand

16. Prophylactic Wrist Taping (Circular) 1.First apply pre-wrap below the wrist joint, around the wrist, and the heel of the hand. 2.Make sure that you keep the fingers spread and hand flat while applying the tape. 3.Place the first strip of tape just below the wrist joint, pulling the tape in a circle around the wrist, from the outside toward the inside of the arm. 3.Place the first strip of tape just below the wrist joint, pulling the tape in a circle around the wrist, from the outside toward the inside of the arm. 4.Apply 3 – 4 additional strips moving up the wrist toward the hand. Each strip should overlap about half of the strip before it. 5.For additional support, continue back down the wrist in the same pattern.

17. Prophylactic Wrist Taping (Figure 8 – Through the hand) 1.Complete steps 1-4 of “Prophylactic Wrist taping (Circular)”. “Prophylactic Wrist taping (Circular)”“Prophylactic Wrist taping (Circular)” 2.The next strip should start on the first strip, and cross over the back of the hand, then continue through the space between the thumb and finger, the across the palm. It may help to fold the tape when it crosses the thumb web to make it more comfortable. 2.The next strip should start on the first strip, and cross over the back of the hand, then continue through the space between the thumb and finger, the across the palm. It may help to fold the tape when it crosses the thumb web to make it more comfortable. 3.Continue pulling the same strip of tape back across the back of the hand and back to the point of the wrist where the strip started. 3.Continue pulling the same strip of tape back across the back of the hand and back to the point of the wrist where the strip started. 4.Repeat this pattern 3 or 4 times, making the next strip of tape overlaps half of the previous strip. This tape job can provide slightly more support than the basic circular, and also provides more of a limit on the wrists range of motion. It works well for mild sprains and provides extra support.

18. Prophylactic Wrist Taping (Figure 8 – Through the hand) 5.Apply 3 – 4 additional strips moving up and down the wrist toward the hand. Each strip should overlap about half of the strip before it. 6.The addition of a fan or checkrein may provide additional support and limitation of movement. 7.The tape should allow the thumb and fingers to move freely, and only restrict movement of the wrist. 7.The tape should allow the thumb and fingers to move freely, and only restrict movement of the wrist.

19. Prophylactic Thumb Taping 1. 1.The athlete should fully extend and adduct the fingers while keeping the thumb in a relaxed, neutral position (as if holding a can). The taper should stand in front of the athlete’s thumb 2. 2.Apply pre-wrap to the hand and wrist. 3. 3.Place an anchor strip around the base of the wrist. Add another 2/3 strip anchor attaching from the wrist anchor to the back of the hand between the thumb and pointer finger to the palm side attaching to the wrist anchor.

20. 4.Add a series of three “spica” strips. The first spica is started on the radial side at the base of the thumb and carried under the thumb, completely encircling it, and then crossing to the starting point. The strip should continue around the wrist and finish at the starting point. Each of the following spica strips should overlap the preceding strip by at least 2/3 inch and move downward on the thumb. Prophylactic Thumb Taping

21. 5. 5.Apply C-strips; starting at base of thumb, apply tape from dorsal side of hand around the base of thumb to the palmer side to the hand. Each of the following strips should overlap the preceding strip by at least 2/3 and move upward on the thumb. 6. 6.Secure the open ends of the “C” strips by the single strip of tape through the hand. Apply anchor strip around the wrist. Prophylactic Thumb Taping

22. Questions? Everyone Practice * Remember to have partners sign-off your lab skill sheets