3 joints
Amount of elbow joints
Names of 3 elbow joints
Humeroulnar, humeroradial, proximal radioulnar
How many major elbow muscles are there?
7 major muscles
Elbow muscles
Biceps brachii, brachioradialis, brachialis, triceps brachii, anconeus, supinator, pronator
Movements of elbow muscles
Biceps brachii - flexion + supination
brachioradialis - Flexion + pronation (from full supination) & supination (from full pronation)
brachialis - flexion
triceps brachii - Extension
anconeus - Extension
supinator - Supination
pronator - Pronation
Active flexion
~145 degrees & limited by the biceps
Passive flexion
~160 degrees & limited by ulna, radial head and coracoid fossa
Limitations to extension
Tight biceps and olecranon process
Carrying angle
The measurement between the humerus and ulna & radius when elbow is fully extended
Carrying angle in men
~ 5-10 degrees
Carrying angle in women
~ 10-15 degrees
Causes of dislocation
FOOSH or hyperextension
Types of dislocations
Complete (torn UCL and RCL + brachialis)
Perched
What can too much aggressive exercises cause
Instability
What can too much conservative exercises cause
Contractures
Stable dislocation rehab basics
Splint at 90 degrees, gripping exercises, avoiding passive rehab, isometrics and eccentric ex. as tolerated, gentle ROM
Unstable dislocation rehab basics
Splint at 30-90 degrees, increase extension by 5-10 degrees weekly until full ROM, grip and wrist ex., PREs isotonic at 4 weeks
Other names for medial epicondylitis
Little league, swimmer’s, racquet ball, golfer’s elbow
Other names for lateral epicondylitis
Tennis elbow
Cause of medial epicondylitis
Repetitive pronation and wrist flexion
Cause of lateral epicondylitis
Repetitive wrist exercises
Two epicondylitis rehab approaches
Reduce pain and inflammation
(chronic only) increase inflammation
UCL Sprains causation
Throwing/overhand actions
Treatment for full UCL sprain
Tommy John Surgery (9-12 months recovery time) or internal bracing
Rehab goal for partial UCL sprains
Reduce pain and inflammation
Return for UCL sprains
Full ROM
Equal bilateral strength
No pain while throwing
Complete interval throwing program
Symptoms of UCL sprains
Pain and paresthesia (tingling) on medial side of hand
Where ulnar nerve passes through
Cubital tunnel
Ulnar nerve entrapment causes
Hypertrophy (repetitive throwing), dislocations, direct hit, often associated with medial epicondylitis
Symptoms of ulnar nerve entrapment
Numbness and tingling on medial side of the elbow to 4th and 5th fingers, wrist weakness + ulnar deviation, loss of finger movement
Where the radial nerve passes through
Radial tunnel
Radial nerve entrapment causes
Repetitive throwing and overhand activities
COmmonly mistaken for lateral epicondylitis
Radial nerve entrapement
Radial nerve entrapment symptoms
Weakness with resisted supination, pain with resisted extension of middle finger, radiating pain to wrist, weakness with wrist and middle finger extension
Median nerve entrapment causes
Hypertrophy of pronator teres, repetitive grip activities, pronation, forearm extension
Another name for median nerve entrapment
Pronator teres syndrome
Symptoms of pronator teres syndrome (median nerve entrapment)
Tingling alongside anterior forearm, thumb, index, middle finger + increased pain while sleeping + weakness with wrist pronation and flexion& finger flexion and radial deviation
Fossas of the elbow
Olecranon fossa, radial fossa, coranoid fossa
Bones attached to the 3 fossas
Olecranon fossa - olecranon process
radial fossa - radial head
coranoid fossa - coranoid process
Specific cause of tennis elbow
Wrist flicking movement during backhands
Basic criteria to return for elbow dislocation
Full ROM, default strength, endurance, neuromuscular control, no sports specific activity limitations
Sports commonly associated with medial epicondylitis
Little league, swimming, racquet ball, golfing
Movements compromised with ulnar nerve injury
Wrist flexion and ulnar deviation
Movements compromised with median nerve injury
Wrist flexion, radial deviation, pronation, finger flexion
Movements compromised with radial nerve injury
Resisted supination, middle finger extension, wrist extension, supination, finger extension
Medial condyle of the humerus
Trochlea
Between the lateral epicondyle and olecranon process
Radial tunnel
Ligament attached to both ends of the ulna, surrounding neck of radius
annular ligament
Portion of humerus that allows space for ulna during elbow flexion
coronoid fossa
Ligament connecting humerus and ulna on the lateral side of the elbow
Radial collateral ligament
Muscle whose single function is wrist flexion
Brachialis
Name for lateral condyle of humerus
Capitulum
Term for numbness or tingling
Paresthesia