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Chapter 11-Elbow Injuries

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1 Chapter 11-Elbow Injuries

2 Anatomy-Bones Hinge joint Humerus Radius Ulna
Medial and lateral epicondyles Radius Allows for pronation & supination Lateral or thumb side Ulna medial or pinky side Hooks to humerus

3 Anatomy-Ligaments Ulnar collateral Radial collateral Annular
Helps stabilize medially Radial collateral Lateral stabilization Annular Helps hold radius and ulna together Interossius membrane Between radius and ulna, runs length of the arm

4 Anatomy-muscles Triceps Biceps Wrist Flexors Wrist extensors
Elbow extension Biceps Elbow flexion Wrist Flexors Wrist extensors

5 Elbow Injuries Prevention Infrequent injury Mostly overuse
Most common in racket sports Stretching and strengthening important Technique important Equipment a factor (racket size, grip) Proper rest

6 Common injuries and treatments
Ulnar collateral ligament sprain Caused by overuse or direct blow (valgus stress) Possible swelling, point tender Possible joint laxity

7 Common injuries and treatments Ulnar collateral ligament strains
Treat with RICE May need to refer, rule out fractures or nerve damage Rehab should include wrist flexor strengthening

8 Common injuries and treatments
Radial collateral ligament strains Rare Pain laterally Rehab focus on extensors

9 Muscle and tendon injuries
Most often caused by excessive resistive forces or overuse Mild, moderate, severe Can occur either proximal or distal to elbow joint

10 Muscle and tendon injuries
Elbow flexor strain Injury usually caused by a loaded movement of shoulder and elbow Minimal swelling weakness and discomfort common with resisted flexion RICE, mild stretching and strengthening Complete tears or ruptures need referral

11 Muscle and tendon injuries
Elbow extensor strain Caused by excessive resistance (i.e.-attempting to break a fall) Triceps can avulse, assess carefully Pain with elbow extension Minimal swelling Treat w/RICE, mild stretching and strengthening

12 Muscle and tendon injuries
Wrist flexor strain Pain over medial epicondyle or front forearm Caused by excessive resistance during wrist flexion or overuse Treat with PRICE, modify activity Mild stretching and strengthen flexors

13 Muscle and tendon injuries
Wrist extensor strain Pain usually over lateral epicondyle Most often occur due to overuse Treat with rice, modify activity Mild stretching, reverse wrist curls for strengthening

14 Medial Epicondylitis Golfer’s elbow or little league elbow
Chronic inflammation Usually result of repetitive throwing Not as common as lateral Treat with PRICE, limit throwing, and strengthen wrist flexors Can cause compression of ulnar nerve

15 Lateral epicondylitis
Tennis elbow Chronic inflammation Causes-overuse and poor mechanics Can show minimal swelling Treat with PRICE, tendon strap Limit activity Stretch and strengthen extensors


17 Bone Injuries

18 Bone injuries Fractures to distal humerus rare
Direct impact is most common cause of fracture Immediate referral due to possible nerve damage

19 Epiphyseal and Avulsion fractures
Epiphyseal fracture Most common on medial epicondyle Suspect if there is pain, swelling, and loss of movement Young athlete more likely to injure growth plate that a fx or ligament injury Avulsion fracture Severe pain and deformity Refer immediately for either injury

20 Ulnar dislocation One of most commonly injured joints in body
Usually caused by violent hyperextension or sever blow to lateral aspect Most often dislocates posteriorly Splint immediately & refer

21 Other elbow injuries Hyperextension
Falling on outstretched arm or direct blow Can cause Sprain to ligaments of anterior elbow Strain to muscles of anterior elbow Painful bony compression of humerus by olecranon process Treat with PRICE, refer if severe

22 Bursae Bursae are fluid-filled cavities located at tissue sites where tendons or muscles pass over bony prominences near joints, such as the elbow. The function of a bursa is to facilitate movement and reduce friction between moving parts.

23 Other elbow injuries Contusions Olecranon bursitis
Common, treat with PRICE Olecranon bursitis Irritation of bursa due to direct blow to elbow… fluid build up Apply compression wrap, physician may drain Protect with padding

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