1. Chapter 11-Elbow Injuries
Subtitle

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