THE ELBOW

1
THE ELBOW

• Ms.Herrera
• Care Prevention of Athletic Injuries

2
BONY ANATOMY

• Elbow is made of the
• Humerus
• Radius
• Ulna
• Articulations to REMEMBER
• Lateral Epicondyle
• Medial Epicondyle
• Olecranon
• Radial Head

3
SOFT TISSUE ANATOMY

• MUSCLES
• Biceps brachii (flexes)
• Triceps brachii (extends)
• BURSAE
• Olecranon bursae
• Between skin and olecranon process
• LIGAMENTS
• Ulnar collateral
• Radial collateral
• Annular

4
Injuries/Pathologies of the Elbow

• Contusions
• Strains
• Fractures
• Olecranon Bursitis
• UCL Injuries
• Lateral Epicondylitis
• Medial Epicondylitis
• Little League Elbow
• Dislocation

5
Olecranon Bursitis

• MOI Direct Blow
• Signs/Symptoms
• Severe swelling
• Pain
• TTP
• If infected Hot and red
• Management
• Cold pack
• Compression
• Anti-inflammatories
• Severe cases aspiration

6
Ulnar Collateral Ligament (UCL) Injuries

• MOI
• Excessive valgus force
• Repetitive valgus force
• Overuse
• Improper mechanics in sports
• Examples?
• Signs/Symptoms
• TTP over medial elbow
• Swelling
• Sometimes Parathesia
• Why?

7
UCL MANAGEMENT

• Conservative
• Rest
• Anti-inflammatories
• Rehab to strengthen flexors and extensors
• Review athletes biomechanics
• Invasive
• Reconstruct ligaments/Insert replacement
• Tommy John Surgery (22-26)

8
Lateral Epicondylitis/Tennis Elbow

• MOI
• Repetitive trauma of extensors
• Overuse of extensors
• Repetitive heavy lifting
• Symptoms/Signs
• Aching/dull pain during/after activity
• TTP and swelling
• Weakness in wrist/elbow extension
• Decreased ROM
• Management
• Rest, Anti-inflammatories, Pain relievers
• Cross friction massage (why?)
• Rehabilitation
• Education (mechanics/proper use of equipment)

9
Medial Epicondylitis/Golfers/Pitchers Elbow

• MOI
• Forceful, repetitive, flexion movements
• Extreme valgus forces
• I.e. forehandstroke in tennis, pitchers throwing
  a curveball and screwball
• Signs/Symptoms
• TTP over medial elbow
• Pain radiates down arm
• Swelling
• Management
• Sling rest, ice, anti-inflammatories, analgesics
• Brace to reduce valgus stress

10
Little League Elbow

• MOI
• Repetitve trauma from throwing
• Exceeding pitch count as a young pitcher
• Can cause.
• Fx of medial epicondyle
• Damage to growth plate
• Growth of bony fragments
• Stress fx

11
Little League Elbow Contd

• Signs/Symptoms
• Elbow stays slightly flexed all the time
• Due to tight triceps and tight anterior capsule
• Decrease ROM
• Locking/catching sensation
• Management
• RICE, anti-inflammatories, pain relievers
• Stretch and triceps strengthening
• SX to remove loose bony fragments
• Maintain pitch count and have good technique

12
Dislocation of Elbow

• MOI
• FOOSH, Hyperextension
• Signs/Symptoms
• Ligament tears
• Hemorrhage/swelling
• Pain, loss of ROM
• Possible radial head fx, tear of nerves and blood
  vessels
• Management
• Cold compression
• Place in sling
• Refer to ER to reduce dislocation
• Rehab

13
ANY QUESTIONS???