Elbow Evaluation

History•How did this injury occur?•When did you hurt your elbow?•Did you hear any sounds or feel a pop?•Have you ever hurt this elbow before?•Pain level and type of pain•Continue activity?

Observation•Carrying angle•Bilateral comparison of elbow (swelling,

deformity, discoloration)•Observes how athlete carries themselves,

or move

Boney Palpation

•Humerus▫Medial Epicondyle – the boney protrusion of the

distal humerus on the medial aspect of the arm▫Lateral Epicondyle – the boney protrusion of the

disal humerus on the later aspect of the arm▫Olecranon fossa – a hollowed fossa at the distal

end of the posterior humerus which receives the olecranon during elbow extension

•Radius (radical dude!)•Ulna

▫Olecranon – a large process at the proximal end of the ulna which forms the point of the elbow

Soft Tissue Palpation•Muscles

▫Biceps Brachii (elbow flexion; palm up)▫Triceps (elbow extension)▫Brachioradialis (elbow flexion; thumbs up)▫Brachialis (elbow flexion; palm down)▫Wrist Flexors (Medial)▫Wrist Extensors (Lateral)

•Ligaments▫Ulnar Collateral Ligament▫Radial Collateral Ligament▫Annular Ligament

•Nerves▫Ulnar Nerve▫Radial Nerve

ROM and MMT (manual muscle test)

•Flexion: 0-145 Degrees•Extension: 0-10 Degrees•Supination: 0-90 Degrees•Pronation: 0-90 Degrees•Wrist Flexion: 0-90 Degrees•Wrist Extension: 0-90 Degrees•Radial Deviation: 0-20 Degrees•Ulnar Deviation: 0-30 Degrees

Dermatomes and Myotomes•C-5•C-6•C-7•C-8•T-1

Special Tests•Valgus Stress Test•Varus Stress Test•Tinnel Sign •Forceful Hyperextension•Tennis Elbow Test•Little Leaguer’s Elbow

Injuries•Little League Elbow/ Golfer’s Elbow~

▫Strain of the Flexor-Pronator muscle group▫Often happens in younger kids

participating in little league▫Overuse injury ▫Pain on the medial epicondyle▫Tx

Increase strength by tubing exercises Wrist Flexors

Increase flexibility by stretching Wrist Extensors

Tennis Elbow•Strain of the Extensor-Supinator muscle

group•Overuse injury•Pain on lateral epicondyle•Tx:

▫Increase strength by tubing exercises Wrist Extensors Elbow Flexion (3way)

▫Increase flexibility by stretching Wrist Flexors

Olecranon Bursitis

• Causes▫Trauma▫Infection▫Prolonged Pressure▫Medical Conditions

Rheumatoid Arthritis Gout

• Sx▫Redness / swelling and pain▫Decreased ROM

• Tx▫R.I.C.E. ▫Anti-Inflammatory Drugs▫Padding of the elbow

Injuries Continued

•FX▫Olecranon Process▫Humerus▫Ulna/Radius

•Radial Collateral Ligament▫Varus Stress Test▫Pain in Lateral joint line

•Ulnar Collateral Ligament▫Valgus Stress Test▫Pain in Medial joint line