View Full Version : Elbow injuries and rehab care

07-19-2013, 08:33 PM
Elbow injuries and rehab care

Saw this on another board and thought it was a great read to bring over...

Although the elbow and knee share certain similar anatomical characteristics, elbows in general sustain far fewer injuries. One of the main reasons for this is that non-weightbearing joints such as the elbow are usually exposed to much lower levels of force than weightbearing joints (such as the knee). There are a few sports, however, in which the elbow joint does have to support the body's weight; gymnastics is an example of such an activity or increased loads as we use in powerlifting as well as body building.

An Integral Joint

The main duties of the elbow's joints, muscles and connective tissues are to precisely position the hand and transmit or resist a force (such as throwing a ball or spear, striking a punching bag, blocking a tackle, lifting a box, or twisting a screwdriver). The elbow joint is an integral part of the upper-extremity kinetic chain. Problems in the shoulder joint and cervicothoracic region can contribute to elbow joint dysfunction. Looking beyond the elbow itself for the source of its pain is critical, and any rehabilitation program designed for the elbow must address deficits in the scapular stabilizer and cervicothoracic extensor muscles, as well as proper head and shoulder posture.

Movement and Support

The humeroulnar and humeroradial articulations permit flexion and extension. The proximal radioulnar joint allows rotation (pronation and supination) to occur. Most normal activities of daily living can be performed even with partial limitation of any (or even all) of these elbow movements. However, compensations will tend to occur in adjacent body segments (such as the shoulder and spine), and performance levels in most sports will decrease quickly.

The elbow is an inherently stable joint; however, connective tissues do provide needed additional support. These include the annular ligament (encircling the head of the radius), the medial collateral ligament (the major stabilizer against valgus stress) and the interosseous membrane (which prevents separation of the radius and ulnar shafts). If any of these connective tissues are injured, an elbow sprain is the likely result.

Most of the muscles involved in elbow function and movement originate on the humerus and insert on either the radius (biceps, brachioradialis, and pronator teres), or the ulna (brachialis, triceps, and anconeus). Two additional muscles (supinator and pronator quadratus) form a radioulnar group. Two very important elbow muscles - the wrist extensors and flexors - primarily move the hand and wrist. Manual testing can often identify in a short period of time which of these muscles are weakened and painful on contraction, indicating an elbow strain. If there is nonpainful muscle weakness around the elbow and/or wrist, a neurological condition of the lower cervical nerves (C5-8) must be considered.

How Injuries Occur

Direct trauma or overuse (due to repetitive arm and hand movements) can cause elbow injuries. Here are several common elbow injury patterns:

"Golfer's elbow" (medial epicondylitis) - overuse tendinosis of the wrist flexors. Stockard reports overuse injuries are "more common among amateur golfers than among professional golfers."
"Little League elbow" - Repetitive pitching microtrauma can cause permanent damage.
"Nursemaid's elbow" - forced radial head dislocation in a young child (2-4 years of age).
Olecranon bursitis - acute or repetitive direct trauma to the bursa over the olecranon.
Panner's disease (osteochondrosis) - Overuse causes avascular damage to the capitellum.
"Tennis elbow" (lateral epicondylitis ) - overuse tendinosis of the wrist extensors.
Triceps tendinitis - acute or repetitive strain of the triceps insertion on the olecranon.

Elbow Sprain Rehabilitation

Damage by trauma to one or more of the connective tissues of the elbow can lead to joint instability and eventual degenerative changes. Work duties and sports activities often must be restricted to prevent further damage. Once the ligaments have undergone sufficient early repair, controlled passive motion, gentle sustained stretches, and friction massage will help to prevent the formation of adhesions. Resistance exercises are introduced to stimulate a stronger repair and assist in the remodeling process. Isometric forms progress to isotonic forms of resistance, based on the patient's tolerance for joint motion. Exercises for grip and proximal stability at the shoulder should also be included, especially for athletes.

Elbow Strain Rehabilitation

Overuse and repetitive strain are the most common sources of injury to the muscles and tendons around the elbow. For these conditions, a brief period of support and restricted activity is usually necessary. The use of a counterforce brace for the elbow should be implemented. However, controlled re-strengthening should be initiated early, with the brace on. Elastic tubing is a safe, easy method of providing progressive resistance exercises.

An effective elbow rehabilitation program starts with a consistent isotonic exercise routine, using elastic tubing to perform resisted pronation and supination. This should be performed initially within a limited, pain-free range of motion, building to full range as pain subsides. If the patient has tennis elbow, an overuse strain of the wrist extensors, special attention is given to these muscles. Sustained stretches are performed, followed immediately by full-range, progressive strengthening of wrist extension, with special focus on the eccentric phase of the exercise.

Eventually, the entire series of elbow exercises should be performed. This inexpensive rehabilitation program should initially be practiced under supervision to ensure proper performance. After proper exercise mechanics and control are demonstrated, a self-directed program of home exercises is appropriate.

Distortions and Alignments

Two additional factors to consider are the connection between elbow function and shoulder stability and the influence of cervicothoracic posture on elbow function. Specific postural distortions - such as thoracic kyphosis and cervical anterior translation (causing a "forward head") - must be addressed with corrective exercise training. An additional potential complicating postural factor is the alignment of the scapula on the thoracic cage - particularly when the shoulder is "rolled forward" (protracted). Correction of these chronic misalignments will significantly reduce the biomechanical stress during use of the arm and help prevent musculotendinous overload at the elbow.

Repair, Then Rehab

An appropriate and progressive rehab program should be started early in the treatment of patients with elbow injuries, but only after ligaments and connective tissues have repaired sufficiently. Simple, yet effective rehab techniques are available, none of which requires expensive equipment or significant time commitments. A closely monitored home exercise program using exercise tubing is recommended, since this allows the patient to attain cost-efficient, effective and specific rehabilitative care.

An important aspect of elbow rehabilitation is recognizing and addressing the biomechanical alignment problems and postural factors that can lead to substitution patterns and elbow overuse. This entails screening the patient for forward head and flexed (kyphotic) torso postures and protracted (forward) shoulders. Failure to recognize these complicating factors can result in a patient with recurring elbow complaints.

07-19-2013, 11:04 PM
154831Good post...for the past 2 years I've been dealing with nagging elbow soreness as a result of overuse..Also, owning a business I spend hours a week leaning with all my weight on my elbows on my glass desk...One of the best stretches for tennis elbow is holding your arm out straight and pullin your fingers back and then down on the top of your hands...kind of hard to explain---let me see if I can find a pic

07-20-2013, 02:37 PM
154831Good post...for the past 2 years I've been dealing with nagging elbow soreness as a result of overuse..Also, owning a business I spend hours a week leaning with all my weight on my elbows on my glass desk...One of the best stretches for tennis elbow is holding your arm out straight and pullin your fingers back and then down on the top of your hands...kind of hard to explain---let me see if I can find a pic

Thanks for the reply and the suggestion.That is a great way to stretch out your forearm muscles as well and I use it religiously during arm workouts.

Whats helped me greatly with my elbow pains is doing an exercise that im not sure what the technical name for it is but I call them windmills.Its done with dumbells and you curl each arm up one at a time and cross it over your body in front of you rotating your wrists from palms out at start to palms facing in as you cross your body.Of course a light weight is needed and as you gain strength in the tendons and muscles around the elbow,you can increase slightly.Ive given this routine to many others that have tried a of different things and this helped them out as well.

Thanks again for the reply and the feedback.

08-20-2013, 07:31 AM
Elbow injuries and rehab care...... after elbow injury we should eat good nutritious,calories food... we can eat non veg food...

11-30-2013, 05:52 AM
Human elbow is made up of bone, cartilage, ligaments and fluid, muscles and tendons help the elbow joint move. When any of these structure is hurt of diseased you have elbow problems. Elbow is serious point of matter to take notice because all our work of daily basis done on this matter.

05-04-2016, 01:26 AM
Home Treatment:

Most minor injuries will heal on their own, and home treatment is usually all that is needed to relieve your symptoms and promote healing. But if you suspect that you have a more severe injury, use first aid measures while you arrange for an evaluation by your doctor.

First aid for a suspected broken bone:

1. If a bone is sticking out of your skin, do not try to push it back into your skin. It is better to leave the bone alone and cover the area with a clean bandage.
2. Control bleeding from your injury.
3. Remove all rings, bracelets, watches, or any other jewelry from the injured arm immediately. It may be hard to remove the jewelry if swelling occurs, which in turn can cause other serious problems, such as nerve compression or restricted blood flow.
4. Splint your injured arm without trying to straighten it. Loosen the wrap around the splint if you develop signs that indicate the wrap is too tight, such as numbness, tingling, increased pain, swelling, or cool skin below the wrap. A problem called compartment syndrome can develop.

If a cast or splint is applied, it is important to keep it dry and to try to move the uninjured part of your arm as normally as possible to help maintain muscle strength and tone. Your doctor will give you instructions on how to care for your cast or splint.

04-19-2018, 10:15 AM
When a men work on his body preparing muscle , some times injury occured. Elbow injury is most common . There are many gel available for elbow injury.

04-20-2018, 07:40 AM
When a men work on his body preparing muscle , some times injury occured. Elbow injury is most common . There are many gel available for elbow injury.

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