Chapter 23: The Elbow

Anatomy of the Elbow

Functional Anatomy

Observations

Special Tests

Valgus/Varus Stress Test

Medial and Lateral Epicondylitis Tests

Pronator Teres Syndrome Test

Contusion

Olecranon
Bursitis

Strains

Lateral Epicondylitis (Tennis Elbow)

Medial Epicondylitis

Little League Elbow

Dislocation of the Elbow

Management

Cold and pressure immediately w/ sling

Refer for reduction

Neurological and vascular fxn must be assessed prior to and following reduction

Physician should reduce - immediately

Immobilization following reduction in flexion for 3 weeks

Hand grip and shoulder exercises should be used while immobilized

Following initial healing, heat and passive exercise can be used to regain full ROM

Massage and joint movement that are too strenuous should be avoided before complete healing due to high probability of myositis ossificans

ROM and strengthening should be performed and initiated by athlete (forced stretching should be avoided

Myositis Ossificans

Fractured Humerus

Fixation after fracture

Elbow Dislocation

Dislocated Elbow/Fracture

Elbow Fractures (continued)

Rehabilitation of the Elbow

General Body Conditioning

Must maintain pre-injury fitness levels - cardiovascular and strength (lower body)

Flexibility

Restoring ROM is critical in elbow rehab

Variety of approaches can be used as long as they donπt force the joint

Joint Mobilizations

Loss of proper arthrokinematics following immobilization is expected

Joint mobilization and traction can be very useful to increase mobility and decrease pain through restoration of accessory motions

Strengthening

Functional Progressions

Return should progress with use of restrictions in an effort to objectively measure activity progression

Protective Taping and Bracing

Should be continued until full strength and flexibility have been restored

Chronic conditions usually cause gradual debilitation of surrounding soft tissue

Must restore maximum state of conditioning w/out encouraging post-injury aggravation