How is the elbow designed and what is its function?

• The elbow is the joint where three long bones meet in the middle portion of the arm.

• The bone of the upper arm (humerus) meets the inner bone of the forearm (ulna) and the outer bone of the forearm (radius) to form a hinge joint.

• The radius and ulna also meet in the elbow to allow for rotation of the forearm. The elbow functions to move the arm like a hinge (forward and backward) and in rotation (twisting outward and inward).

Lateral Epicondylitis (Tennis Elbow)

• The lateral epicondyle is the outside bony portion of the elbow where large tendons attach to the elbow from the muscles of the forearm.

• These tendons can be injured, especially with repetitive motions of the forearm, such as using a manual screwdriver, washing windows, or hitting a backhand in tennis play.

• Tennis elbow results with inflammation of the tendons causing pain over the outside of the elbow, occasionally with warmth and swelling, but always with local tenderness.

• The elbow maintains its full range of motion, as the inner joint is not affected, and the pain can be particularly noticed toward the end of the day.

• Repeated twisting motions or activities that strain the tendon typically elicit increased pain.

• X-rays are usually normal, but can reveal calcium deposits in the tendon or reveal other unforeseen abnormalities of the elbow joint.

Tennis Elbow

Lateral Epicondylitis (Tennis Elbow)

• The treatment of lateral epicondylitis includes ice packs, resting the involved elbow, and anti-inflammatory medications.

• Anti-inflammatory medications• Bracing the elbow can help. • Simple braces for tennis elbow can be found in community pharmacies

and athletic goods stores. • Local cortisone injections are given for persistent pain.• Activity involving the elbow is resumed gradually. Ice application after

activity can reduce or prevent recurrent inflammation. • Occasionally, supportive straps can prevent reinjury.• In severe cases, an orthopedic surgical repair is performed.

Wrist/forearm cock up splint

Tennis Elbow

Extensor Origin Syndrome

What is it?

Medial Epicondylitis (Golfer's Elbow)

• Medial epicondylitis is inflammation at the point where the tendons of the forearm attach to the bony prominence of the inner elbow.

• As an example, this tendon can become strained in a golf swing, but many other repetitive motions can injure the tendon.

• Golfer's elbow is characterized by local pain and tenderness over the inner elbow.

• The range of motion of the elbow is preserved because the inner joint of the elbow is not affected.

• Those activities which require twisting or straining the forearm tendon can elicit pain and worsen the condition.

• X-rays for epicondylitis are usually normal but can indicate calcifications of the tendons if the tendinitis has persisted for extended periods of time.

Medial Epicondylitis (Golfer's Elbow)

• The usual treatment involves ice packs, resting the elbow, and medications including aspirin and other NSAIDs.

• Severe inflammation, local corticosteroid (cortisone injections are sometimes given.

• Using a strap can prevent reinjury.• • After a gradual rehabilitation exercise

program, return to usual activity is best accompanied by ice applications after use.

Flexor and Extensor Origin Syndromes

Handshake with Elbow Extension

Olecranon bursitis

• (inflammation of the bursa a the tip of the elbow) can occur from injury or minor trauma, as a result of systemic diseases such as gout or rheumatoid arthritis, or can be due to a local infection.

• Olecranon bursitis is typically associated with swelling over the tip of the elbow, while range of motion of the inner elbow joint is maintained.

Olecranon bursitis

Sprain

• A sprain is a stretch or tear injury to a ligament.

• One or more ligaments can be injured during a sprain.

• This might occur when the elbow is hyperextended or simply jammed, such as in a "stiffarm" collision.

• The severity of the injury will depend on the extent of injury to a single ligament (whether the tear is partial or complete) and the number of ligaments involved.

• Treatment involves rest, ice, immobilization, compression, and antiinflammation medications.

Who is this?

Ulnar Nerve Entrapment

• The ulnar nerve is the "funny bone" nerve which travels between the tip of the elbow and the inner elbow bone.

• At this site it can be "pinched" by normal structures or swollen structures after injury.

• This pinching is referred to as entrapment. When ulnar nerve entrapment occurs, numbness and tingling of the little and ring finger of the hand may be felt.

• Pain may occur in the entire forearm, usually the inner side. Hand dexterity can be affected.

Ulnar Nerve Entrapment

• Sometimes, the numbness is reproduced by elevating the hand. Treatment consists of avoiding repeated trauma or pressure to the elbow area and resting the elbow joint.

• Occasionally, ice can help. In severe cases, surgical repositioning of the ulnar nerve can be required.

• This relocates the ulnar nerve to a position where it will not be continually compressed by the surrounding structures.