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Elbow

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Elbow

Injuries
- Extensor tendinopathy - tennis elbow
  - Flexor tendinopathy - golfers elbow
    - MCL sprain
      - Elbow Dislocation
        Ulnar nerve entrapment
        Pin Entrapment
        buristis
Extensor tendinopathy
- symptoms
  - affects tendons
    - extensor carpi ulnaris
      - extensor digiti minimi
        extensor digitorum
        Extensor carpi radialis brevis
        most common affected
    - attach lat. epicondyle humerus
    - tendinitis/tendinosis
      - tendinitis
        single bout excessive/repetitive loading
        or one of macrotrauma to tendon
        resolves quickly
      - tendinosis
        Continued overuse
        repetitive microtrauma
        can lead to degeneration of tendon
        chronic - absense of inflammatory cells
        neovascularsation
        prolonged rehab
        of wrist extensors
      - repetitive gripping and wrist extension
        mainly 40 - 50's
        history
        change in activity - inc. volume/duration/intensity/technique
        change different grip
        Pain
        on palp tender over lat. epicondyle
        may radiate into forarm/wrist severe
        on stretch: elbow extension + wrist flexion
        on active, passive, resisted extension
        mills test
        associated muscle thickening and abnormal tension
        may irritate radial nerve
        Treatment
        active rest and inflammation control
        1 off transverse frictions
        with tendon on stretch (pain permiting)
        soft tissue work
        electrotherapy
        strength, endurance and stretching
        wrist extensors
        progressive and gradual rehab
        iso - concen - eccen - functional
        correct predisposing factors -- technique
·
- - - Elbow dislocation
      - mainly children/contact sport
        with fractures usually in cildren
        presentation
        deformity
        pain
        swelling
        unable to move joint
        treatment
        requires reduction
        immobilisation few days
        reduce pain ice, electro, nsaids
        increase ROM and strengthening
        associated fracture
        coranoid proccess
        radial head
        usually fall outstretch arm, abd, supinated, compression, forced flexion
        complication - impair vascular supply to forearm
        must assess pulse
        no pulse requires urgent reduction
        assess collateral ligaments
        long term loss of extension usual problem
        active mobilisation required immediately
        not shown to reduce stability
        simple dislo. (no fract.) return quick (3 weeks)
        surrounding muscles strengthening + tape
        some develop chronic instability
        may require lateral UCL reconstruction
        x-ray
      - posterior
    - olecranon bursitis
      - causes
        from direct blow on fall on elbow
        repetitive rubbing of bursa
        desk
      - students elbow
      - bursa fills with sirous fluid/blood
        complication: can become infected- requires immediate drainage, immobilsation, antibiotic therapy
    - rehab
      - check isometric control
        active flexion in supine, prone, mid
        depend on injury can start in ext to 90
        then 90 to flex
        RU active ROM
        Elbow at 90,
        prone to mid
        supine to mid
        shoulder strengthening exercises with elbow in ext,
        abd, add, ext, flex
        PWB
        wall pressups
        RU strengthing
        Pro/sup
        tennis ball, beans, tband, dumbell
        ""^
        pro/sup strength
        hold object both hands
        at 90
        twist right/left
        tennis ball, beach ball, medball, bean
        strengthen flexion
        1kg dumbell (more is late), tennis ball, bean bag
        in all 3 positions
        progress to curls, 21s
        strengthen extension
        same weights flexion
        tricep extension
        upright row
        bent over row
        into to press ups
        increased weighted exercises in all RU positions where possible
        elbow ROM
- MCL sprain
  - Acute tears and rupture
    - due to excessive strain/force
      - degrees of severity
    - chronic sprains
      - due to repeated valgus stresses
        throwing activities
        poor faulty technique
  - - medial joint tenderness
      - tenderness on palp. distal to medial epicondyle
        Valgus stress test cause pain and poss instability
    - - Treatement
        reduce inflammation with pricer, ice, electro, nsaids
        rest aggrevating activity
        pain free active passive movements to increase rom ROM
        muscle strength in pain free range
        functional exercises, gradual return to throwing
        incomplete tears brace
        muscle strengthening
golfers elbow/medial epicondylitis
- affects origin of wrist flexors
  - localised pain on palp/ resisted wrist flexion/forearm pronation
    - similar treatment to lateral but flexors
      - may irritate ulnar nerve
        treat with neural mobilisation
  - mainly pronator teres tendon

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Description: Mind Map on Elbow, created by Glen Chesterton on 07/05/2017.
Created by: Glen Chesterton
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Elbow

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