How is the elbow designed and what is its function? The elbow is the joint where three long bones meet in the middle portion of the arm. The bone of the upper arm (humerus) meets the inner bone of the forearm (ulna) and the outer bone of the forearm (radius) to form a hinge joint. The radius and ulna also meet in the elbow to allow for rotation of the forearm. The elbow functions to move the arm like a hinge (forward and backward) and in rotation (twisting outward and inward).

Lateral Epicondylitis (Tennis Elbow) The lateral epicondyle is the outside bony portion of the elbow where large tendons attach to the elbow from the muscles of the forearm. These tendons can be injured, especially with repetitive motions of the forearm, such as using a manual screwdriver, washing windows, or hitting a backhand in tennis play. Tennis elbow results with inflammation of the tendons causing pain over the outside of the elbow, occasionally with warmth and swelling, but always with local tenderness. The elbow maintains its full range of motion, as the inner joint is not affected, and the pain can be particularly noticed toward the end of the day. Repeated twisting motions or activities that strain the tendon typically elicit increased pain. X-rays are usually normal, but can reveal calcium deposits in the tendon or reveal other unforeseen abnormalities of the elbow joint.

Tennis Elbow

Lateral Epicondylitis (Tennis Elbow) The treatment of lateral epicondylitis includes ice packs, resting the involved elbow, and anti-inflammatory medications. Anti-inflammatory medications Bracing the elbow can help. Simple braces for tennis elbow can be found in community pharmacies and athletic goods stores. Local cortisone injections are given for persistent pain. Activity involving the elbow is resumed gradually. Ice application after activity can reduce or prevent recurrent inflammation. Occasionally, supportive straps can prevent reinjury. In severe cases, an orthopedic surgical repair is performed.

Wrist/forearm cock up splint

Tennis Elbow

Extensor Origin Syndrome

What is it?

Medial Epicondylitis (Golfer's Elbow) Medial epicondylitis is inflammation at the point where the tendons of the forearm attach to the bony prominence of the inner elbow. As an example, this tendon can become strained in a golf swing, but many other repetitive motions can injure the tendon. Golfer's elbow is characterized by local pain and tenderness over the inner elbow. The range of motion of the elbow is preserved because the inner joint of the elbow is not affected. Those activities which require twisting or straining the forearm tendon can elicit pain and worsen the condition. X-rays for epicondylitis are usually normal but can indicate calcifications of the tendons if the tendinitis has persisted for extended periods of time.

Medial Epicondylitis (Golfer's Elbow) The usual treatment involves ice packs, resting the elbow, and medications including aspirin and other NSAIDs. Severe inflammation, local corticosteroid (cortisone injections are sometimes given. Using a strap can prevent reinjury. After a gradual rehabilitation exercise program, return to usual activity is best accompanied by ice applications after use.

Flexor and Extensor Origin Syndromes

Handshake with Elbow Extension

Olecranon bursitis (inflammation of the bursa a the tip of the elbow) can occur from injury or minor trauma, as a result of systemic diseases such as gout or rheumatoid arthritis, or can be due to a local infection. Olecranon bursitis is typically associated with swelling over the tip of the elbow, while range of motion of the inner elbow joint is maintained.

Olecranon bursitis

Sprain A sprain is a stretch or tear injury to a ligament. One or more ligaments can be injured during a sprain. This might occur when the elbow is hyperextended or simply jammed, such as in a "stiffarm" collision. The severity of the injury will depend on the extent of injury to a single ligament (whether the tear is partial or complete) and the number of ligaments involved. Treatment involves rest, ice, immobilization, compression, and antiinflammation medicat ions.

Who is this?

Ulnar Nerve Entrapment The ulnar nerve is the "funny bone" nerve which travels between the tip of the elbow and the inner elbow bone. At this site it can be "pinched" by normal structures or swollen structures after injury. This pinching is referred to as entrapment. When ulnar nerve entrapment occurs, numbness and tingling of the little and ring finger of the hand may be felt. Pain may occur in the entire forearm, usually the inner side. Hand dexterity can be affected.

Ulnar Nerve Entrapment Sometimes, the numbness is reproduced by elevating the hand. Treatment consists of avoiding repeated trauma or pressure to the elbow area and resting the elbow joint. Occasionally, ice can help. In severe cases, surgical repositioning of the ulnar nerve can be required. This relocates the ulnar nerve to a position where it will not be continually compressed by the surrounding structures.