ALL CLINICAL CONDITION OF ELBOW JOINT

 

📚📚ELBOW CLINICAL ALL CONDITIONS 📚📚

• 👉Elbow joint :- it is hinge variety of synovial joint.

•👉 Lower end of humerus ,the upper ends of radius and ulna bones.

•📝 ARTICULAR SURFACES📝:-

• UPPER:-
• 👉the capitulum and trochlea of the humerus.

• LOWER :-
1. Upper surface of the head of the radius articulates with the capitulum.
2. Trochlear notch of the ulna articulates with the trochlea of the humerus
3. The superior radioulnar & humeroulnar joint are together known as cubital articulations.

• 📝LIGAMENTS📝:- 

1. Capsular ligament
2. Ulnar collateral ligament
3. Radial collateral or lateral ligament.

•📝 BLOOD SUPPLY📝:-
• From anastomosis around the elbow joint

• 📝NERVE SUPPLY📝:-
• The joint receives branches from the following nerves:-
1. Ulnar nerve
2. Median nerve
3. Radial nerve
4. Musculocutaneous nerve

• 📝MOVEMENTS📝:-
1. Flexion is brought about by:-
• Brachialis
• Biceps brachii
• Brachioradialis
2. Extension is produced by:-
• Triceps brachii
• Anconeus.

•📝 COMMON ELBOW CONDITIONS📝:-
1. TENNIS ELBOW
2. CUBITUS VARUS
3. CUBITUS VALGUS
4. DISLOCATION OF THE ELBOW
5. GOLFER'S ELBOW
6. STUDENT'S (MINER'S ) ELBOW
7. ULNAR TUNNEL SYNDROME
8. REPETITIVE STRAIN INJURY
9. SUBLUXATION
10. ELBOW EFFUSION

• 1.TENNIS ELBOW📚:-
(lateral epicondylitis)

• 👉Occurs in tennis players , tennis elbow is a type of tendinitis,---- swelling of the tendon.

• 👉Inflammation, soreness, or pain on the lateral side (outside) of the elbow.

• 👉Degeneration of the extensor carpi radialis brevis.

•👉 That causes pain in the elbow & arm.

• 👉Abrupt pronation with fully extended elbow may lead to pain & tenderness over the lateral epicondyle which gives attachment to common extensor origin.

• 👉These tendons are bands of tough tissue that connects the muscles of your lower arm to the bone.

• 👉Any repetitive gripping activities especially if they use the thumb and first two fingers ,may contribute to tennis elbow.

• 📚This is possible due to📚:-

• A. Sprain of radial collateral ligament
• B. Tearing of fibres of the extensor carpi radialis brevis.
• C. Recent researches have pointed out that it is more of a degenerative condition rather than inflammatory condition.

• 📚THE CAUSES OF TENNIS ELBOW📚 :-

• 👉Tennis elbow usually develops over time .
• 👉Repetitive motions
• 👉Like gripping a racket during a swing
• 👉Can strain the muscles and put too much stress on the tendons.
•👉 Tennis
• 👉Racquet ball
• 👉Squash
• 👉Fencing
• 👉Weight lifting
•👉 It can also affect people with jobs or hobbies that require repetitive arm movements or gripping such as :-
•👉 Carpetery
• 👉Typing
• 👉Painting
• 👉Raking
• 👉Knitting .

• 📚SYMPTOMS📚:-

•👉Tennis elbow include pain and tenderness in the bony knob on the outside of your elbow .

• 👉This knob is where the injured tendons connect to the bone.

• 👉The pain may also radiate into the upper or lower arm .

• 👉Tennis elbow may cause the most pain when you ..:-

•👉 Lift something
• 👉Make a first or grip an object ,such as a tennis racket
• 👉Open a door or shake hands
• 👉Raise your hand or straighten your wrist.

• 📚TREATMENT for TENNIS ELBOW📚 :-

• 👉Icing the elbow
• 👉Rest
• 👉Job modification
•👉 Using an elbow strap to protect the injured tendon from further strain .

• 👉Taking NSAIDs such as ibuprofen ,naproxen or aspirin

• 👉Performing range of motion exercises

•👉 Getting physical therapy 

• 2. 📚GOLFER'S ELBOW:-
(medial epicondylitis)

• 👉Golfer'S elbow is similar to tennis elbow .

• 👉It is the micro trauma of medical epicondyle of humerus, occurs commonly in golf players.

• 👉The common flexor origin undergoes repetitive strain and result in a painful condition on the medial side of the elbow

•👉 Inflammation, soreness, or pain on the medial side (inside) of the elbow.

• 👉Pain due to repetitive overuse or overload activities which is aggravated by movement of the wrist.

•📚 SYMPTOMS📚:-

• 👉Pain and tenderness
• 👉Stiffness
• 👉Weakness
• 👉Numbness and tingling
• 👉The pain of golfer's elbow can come on suddenly or gradually ,
• 👉The pain might worsen with certain movements ,such as swinging a golf club .

•📚 CAUSES📚:-

• 👉It is the damage to the muscle and tendons that control your wrist and fingers .
• 👉The damage is typically related to excess or repeated stress .
• 👉Especially forceful wrist and finger motion.
• 👉Improper lifting,throwing or hitting
• 👉As well as too little warm up or poor conditioning ,also can contribute to golfer's elbow ,
• 👉Many activities and occupations can lead to Golfer'S elbow ,including..,
• 👉Racket sports
• 👉Throwing sports
•👉 Weight training
• 👉Forceful ,repetitive occupational movement .

• 📚PREVENTION📚 :-

• 👉Strengthen your forearm muscles
• 👉Stretch before your activity
• 👉Fix your forearm
•👉 Use the right equipment
• 👉Lift properly
• 👉Know when to rest

• 📚TREATMENT📚:-

• 👉Treatment begins with avoiding activity that causes pain. To help relieve pain ,use ice .

• 📚THERAPY📚:-

• 👉Rest
• 👉Ice the affected area
• 👉Use a brace
• 👉Stretch and strengthen the affected area

•📚 SURGERY📚:-

• 👉Surgery is seldom necessary
•👉 But if your signs and symptoms don't respond to conservative treatment in six to 12 months ,surgery might be an option .

•👉 A new approach called the TENEX procedure involves, ultrasound guided removal of scar tissue in the region of the tendon pain .

• 👉More people will get better with rest ,ice ,and pain relievers.
• 👉Depending on the severity of your condition ,the pain might linger for months to years ,
•👉 Sometimes the pain returns or becomes chronic.

• 3.📚 STUDENT'S ELBOW📚:-
(miner's elbow)

• 👉Its characterised by effusion into the bursa over the subcutaneous posterior surface of the olecranon process.

• 👉Olecranon bursitis commonly known as "baker's elbow ", "student 's elbow " ,"plumber's elbow "or "popeye elbow ", involves swelling at the tip of the elbow ,on the back of the arm .

• 👉Students during lectures support their head (for sleeping)with their hands with flexed elbows .

• 👉The bursa on the olecranon process gets inflamed .

• 📚CAUSES📚:-

• 👉The condition can be painless ,or it can be painful at rest and when learned on ,as when writing with the arm pressing on a table .

• 👉Mild but repeated injury and friction

•👉 Repeated elbow movements :=
Examples = cricket or baseball players ,javelin throwers ,weight lifters.

• 👉Arthritis :=bursa may become inflamed as part of a generalised arthritis .

(Note:= most cases of olecranon bursitis are not associated with arthritis)
•👉 Infection of bursa .

• 📚SYMPTOMS📚:-

•👉 Olecranon bursa is inflamed then it causes a thickness and swelling over the back of the elbow.

• 👉The bursa may also fill with fluid and it then looks like a small soft ball .

•👉 There are two types of olecranon bursitis :-

1. Infected (septic)
2. Non–infected (aseptic)
• 👉The non –infected type is the most common .

• 📚TREATMENT📚:-

•👉 Ice
•👉 Ultrasound
•👉 Rest
• 👉Exercise
• 👉Stretching

• 4. 📚CUBITUS VARUS📚 :-

• 👉If carrying angle is less ,it is called cubitus varus.(Normal is 13°)

• 5. 📚CUBITUS VALGUS📚 :-
•👉 If carrying angle is more, the condition is CUBITUS VALGUS.

•👉 Ulnar nerve may get stretched leading to weakness of intrinsic muscles of the hand.

• 6.📚 SUBLUXATION📚:-

•👉 Nursemaid’s elbow/pulled elbow (subluxation of head of radius,)

• 👉occurs in preschool children, 1–3 years old when the forearm is suddenly pulled in pronation. 

•👉 The head of the radius slips out from the annualar ligament and the elbow is kept slightly flexed and pronated.

•👉 An attempt to supinate the forearm causes severe pain.

•👉 The reduction is easily achieved by supinating andextending the elbow and simultaneously applying direct pressure posteriorly on the head of radius. 

• 7. 📚ELBOW EFFUSION 📚:-

• 👉The distension of elbow joint due to  effusion within its cavity occurs posteriorly because here capsule is weak and the covering deep fascia is thin.

• 👉The joint is aspirated by inserting a needle on the posterolateral side, above the head of radius with elbow at the right angle.

• 8. 📚DISLOCATION OF THE ELBOW📚:-

• 👉An injury where a joint is forced out of normal position .

• 👉Posterior dislocations of elbow are more common and are often associated with fracture of the coronoid process.

• 👉The dislocation invariably occurs by falling on an outstretched hand.

• 👉The triangular relationship between the olecranon and the epicondyles of humerus is lost.

• 👉Note, in normal flexed elbow the tip of olecranon process and two epicondyles of humerus form an ‘equilateral triangle’

• 👉The reduction, if done early, is achieved fairly easily by first giving traction to overcome spasm and then flexing the forearm to lever joint back into the place.

• 📚TYPES OF FRACTURES 📚

👉Physeal fractures:
👉Monteggia fractures
👉Epicondylar
👉Condylar fracture:
👉Supracondylar fracture:

• 📚SYMPTOMS📚 :-

•👉 Joint pain
•👉 Elbow pain
• 👉Tenderness

• 📚TREATMENT 📚

📝Nonsurgical treatment📝:-

• 👉Simple elbow dislocations are treated by keeping the elbow immobile in a splint or sling for 1 to 3 weeks, followed by early motion exercises

• 👉Physical therapy can be helpful during this period of recovery.

•👉 the doctor or physical therapist may add a strengthening program. X-rays may be taken periodically while the elbow recovers to ensure that the bones of the elbow joint remains well aligned.

📝Surgical Treatment📝:-

• 👉In a complex elbow dislocation, surgery may be necessary to restore bone alignment and repair ligaments.

•👉 It can be difficult to realign a complex elbow dislocation and to keep the joint in line.

• 👉After surgery, the elbow may be protected with an external hinge. This device protects the elbow from dislocating again.

• 👉If blood vessel or nerve injuries are associated with the elbow dislocation, additional surgery may be needed to repair the blood vessels and nerves and repair bone and ligament injuries.

9.📚Repetitive strain injury📚

• 👉a combination of chronic exhaustion and irritation in the muscles and tendons on the back of the arm and the outside of the elbow.

• 👉Repetitive strain injury has been around since people first began repeating motions and carrying out manual labor.

• 📝SYMPTOMS 📝

•👉 tenderness or pain in the affected muscle or jointa throbbing or pulsating sensation in the affected area

• 👉tingling, especially the hand or arm

•👉 loss of sensation

•👉 loss of strength

•👉 Other symptoms depend on which part of the body is affected.

• 📖Examples of RSIs📖:-

1. Bursitis.

2. Tendonitis: A tendon becomes inflamed.

3. Tendinosis: Cellular degeneration of collagen results within the tendons, due to overuse. This is different from tendinitis.

4. Carpal tunnel syndrome: Painful compression of a nerve across the front of the wrist.

5. De Quervain syndrome: This painful condition affects the tendons on the thumb side of the wrist.

6. Medial epicondylitis, or golfer’s elbow: This affects the inside of the lower arm, near the elbow. Frequently playing certain sports or repetitive twisting motions can lead to this condition.

7. Lateral epicondylitis, or tennis elbow: This affects the outer part of the elbow.

8. Radial tunnel syndrome: There is a dull ache at the top of the forearm. Overuse of the arm to push or pull, or overuse of the hand and wrist can irritate the nerve and cause pain.

• 📚CAUSES📚 :-

• 👉Here are some activities and equipment that can increase the risk:

• 👉overuse of a particular muscle or group of muscles

• 👉vibrating equipment
• 👉working in cold temperatures
• 👉poor posture or a non-ergonomically designed workspace
• 👉forceful activities
• 👉holding the same posture for prolonged periods
• 👉direct pressure to particular areas
• 👉carrying heavy loads
•👉 fatigue

📚TREATMENT📚:-

• 👉Types of treatment that are commonly used include:-

1. Medication:-Anti-inflammatory painkillers (such as aspirin or ibuprofen),
muscle relaxants, and antidepressants may help. Sleeping tablets may be suitable.

2. Heat or cold :- Avoid excessive heat or applying ice directly to the skin, as these can burn.

3.Splints: Some people use an elastic support or splint.

4.Surgery: : As a last resort, surgery can correct problems with specific tendons and nerves

5.Physical therapy: This Includes exercises, manual therapy, bracing or splinting, and advice on adapting activities to cope with tasks or reduce the risk of worsening the injury.

10.📚Ulnar tunnel syndrome 📚

• 👉Ulnar tunnel syndrome is a condition that affects the wrist.

• 👉It happens when the ulnar nerve is compressed going from the wrist into the hand through a space referred to as Guyon’s canal.

• 👉You may have weakness, tingling, numbness, or pain because of the nerve compression.

• 📚SYMPTOMS📚

• 👉The ulnar nerve is a large nerve that runs from your neck to your hand. It’s responsible for some hand movements and function.

•👉 Common symptoms

•👉 The symptoms of ulnar tunnel syndrome can take time to develop. They can also get progressively worse over time.

• 👉Common symptoms of ulnar tunnel syndrome affecting the hand, wrist, and little finger include:

• 👉weakness

• 👉numbness, especially in the little and ring fingers

• 👉tingling, especially in the little and ring finger

•👉 pain

• 👉inability to do daily tasks such as typing

•👉 problems holding things with the affected hand

• 👉hand and fingers forming a “claw”

• 📚CAUSES 📚

• 👉work with vibrating tools

• 👉have hand trauma

• 👉do tasks with repetitive pressure on the hands

• 👉cycle or lift weights

• 📚TREATMENT 📚

•👉 Nonsurgical options:-Physical, occupational, and massage therapies may help relieve symptoms.

• 👉Surgery

• 👉Surgery is necessary to remove the ganglion or cyst that’s causing the pressure on your wrist. 

Regard 

LOSER PHYSIO TEAM