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Elbow Injuries

Common Complaints in Throwing Athletes


• Medial elbow pain  from ulnar collateral ligament (UCL) valgus overload
(UCL injury) may present withan acute "pop" or progressive medial elbow
discomfort after heavy throwing. Ulnar nerve signs (including numbness
and paresthesias radiating into the ulnar two fingers)

• Posterior elbow pain  often is present with valgus extension overload


syndrome.

• Lateral elbow pain in throwers  produced by compression and


subsequent lesions of the radial head or capitellum or resultant loose
bodies.
Tennis elbow
• Lateral epicondylitis  repetitive use of the extensor tendons at the elbow
where it insert into lateral epicondyle of humerus, originating from the Extensor
Carpi Radialis (ECRB) tendon. Mechanism  microscopic tears of wrist extensor
• Symptom  pain by wrist extension with pronation or supination, finger
extension and forceful gripping
Golfer Elbow
• Medial epicondylitis  repetitive use of the flexor tendons at the elbow
that insert into the medial epicondyle.
• Symptom  tenderness over the medial epicondyle and pain on resisted
wrist flexion
• Symptoms  pain
aggravated by motion,
limited motion, clicking, and
swelling.

• Osteochondral fragment
may:
1. remain in situ,
2. be slightly displaced
3. be loose within the joint
cavity
• Strength athletes,
bodybuilders and heavy
manual workers.
• Generally, males over the age
of 35 years.
• a pop in the elbow and pain
• Muscle retract up the upper
arm crating a prominent
bump  known as the
'Popeye' sign
• Olecranon tip is
repeatedly jammed
into the fossa at the
back of the elbow 
inflammation of the
joint lining
(synovium),
proceeding to injury
to the cartilage and
bone
Elbow Dislocations
• Occur when great deal of
force is applied to elbow in
a slightly flexed position.

• Cause ulna slide posterior


to the distal end of
humerus
Supracondylar fracture
• Supracondylar fractures are among the most common fractures in
children and are caused by falling on the outstretched hand.
• The distal end of the humerus fractures just above the condyles.
• The great danger of this fracture as well as the elbow dislocation is
the potential damage to the brachial artery because of the close
proximity.
• This can lead to Volkmann’s ischemic contracture,a rare but
potentially devastating ischemic necrosis of the forearm muscle
Volkmann’s ischemic contracture
Pulled elbow or nursemaid’s elbow
• young children under the age of 5
years  experienced a sudden
strong traction force on the arm.
• often occurs when an adult
suddenly pulls on the child’s arm, or
the child falls away from an adult
while being held by the arm.
• This force causes the radial head to
sublux out from under the annular
ligament
Little League Elbow
• Little League elbow is an overuse
injury of the medial epicondyle,
usually caused by a repetitive throwing
motion.
• It is seen in young baseball players
who have not reached skeletal
maturity.
• The throwing motion places a valgus
stress on the elbow, causing lateral
compression and medial distraction on
the joint.
Ulnar Nerve Injury at the
Elbow (Cubital Tunnel)
• Repetitive valgus stresses to the elbow
during throwing often produce medial
traction on the ulnar nerve.
• Ulnar nerve injury results from
repetitive traction combined with
elbow ligament laxity, recurrent
subluxation or dislocation of the nerve
outside of the ulnar groove,
compression of the nerve, or direct
trauma.
• Throwers often have a hypertrophied
forearm flexor mass (attaching to the
medial epicondyle) that compresses
the nerve during muscle contraction.
Radial nerve pain and palsy