Elbow injuries can occur in most sports, especially those involving throwing or swinging (volleyball, golf, tennis and baseball, for example). The elbow also can be injured in contact sports such as hockey and football, and from falls sustained during gymnastics and wrestling. This article looks at the elbow and common injuries.
Anatomy. The elbow is a hinge joint between the radius and ulna of the forearm, and the humerus of the upper arm. The bones are held together by ligaments. The primary ligament of the elbow is the medial collateral ligament (MCL) on the inside of the elbow and the lateral collateral ligament (LCL) on the outside. Several muscles surrounding the joint are responsible for movement. The tendons attach the muscle to the bone, the cartilage covers and protects the ends of the bones, and bursa sacs provide lubrication and protection of the joint.
Fractures of the elbow joint can occur in any sport. Signs of fracture may include pain, swelling, deformity and loss of motion. The ability to move a joint does not always mean the absence of a fracture. A suspected fracture should be immobilized, and the patient should see a physician.
A dislocation is usually the result of a fall on an outstretched arm. Most elbow dislocations are posterior, where the forearm is displaced back beyond the humerus. Signs include obvious deformity, pain and swelling. The joint should be immobilized in the position in which it is found: Do not attempt to put it back in the socket. The athlete should see a physician.
A sprain is an injury to a ligament and a strain is an injury to a muscle. Sprains are commonly seen in athletes who throw. Signs of a sprain include point tenderness, joint laxity, general joint pain and swelling. Treatment includes rest, ice, anti-inflammatory medication, and gentle stretching and strengthening when the athlete is pain-free (see figures). Strains are treated similarly to sprains.
Muscle-Strengthening Exercises for Elbow and Upper Arm
Tendonitis is inflammation of the muscle tendon. Common forms of tendonitis are tennis elbow, golfers elbow or little league elbow. Tennis elbow is an overuse injury often caused by a bad backhand technique or grip that is too small. Signs of tennis elbow include pain on the outside of the elbow, weakness in the wrist, pain with extension of the wrist or fingers against a resistance, and tenderness on the bone of the outside of the joint. Treatment includes ice, rest, bracing for support, and gentle stretching and strengthening exercises. Tips for prevention include correcting any problems with technique, proper warm-up before play and proper strengthening. Golfer’s elbow or little league elbow affects the inside of the elbow. Signs include pain on the inside of the elbow, weakness in the wrist, and pain on the inside of the elbow when the athlete uses a strong grip. Treatment includes rest, ice, bracing, and stretching and strengthening exercises. A gradual return to throwing/golfing is recommended.
Bursa sac injuries are common in sports where there is risk of falling on the tip of the elbow. The bursa is a fluid-filled thin sack over the end of a bone. Bursa injuries can be chronic or acute. Acute bursitis is usually the result of direct trauma. Signs include pain, immediate swelling, and limited motion. Treatment includes ice, compression wrap, and possible aspiration if the swelling does not subside. Chronic bursitis results from repetitive trauma and build-up of fluid. The area around the bursa may feel thick to the touch. Treatment includes rest, ice, and anti-inflammatory medication.