Elbow

*If you are experiencing persistent pain, diminished function, loss of strength, range of motion, and/or sensation, BCPT recommends that you contact your physician, as a serious underlying physical condition may be present.

Fractures and Dislocations

The elbow joint is a unique multifaceted articulation between three bones: the distal humerus (upper arm bone) and the bones of the forearm (the radius and ulna). Because of the congruence of the joint, the relationship of the ligaments and muscles, and the sensitivity of the joint to trauma, fractures of the elbow complex can be difficult to treat. There are several types of elbow fractures, which may or may not be associated with dislocation. Regardless of the specific injury, restoring normal anatomical alignment is imperative in order to make optimal recovery, and prevent nerve and blood vessel damage. Depending on the severity and type of injury, either a closed or open reduction will be required to restore proper alignment. Whereas a closed reduction does not require surgical intervention, an open reduction involves a surgical procedure to align the fracture. Often, an open reduction procedure requires internal fixation (ORIF) to maintain anatomical alignment. Following the reduction, a period of immobilization is required to allow appropriate healing to take place. Progressive physical therapy after immobilization is then needed to help restore maximal range of motion, strength, and functional independence.

Lateral Epicondylitis (Tennis Elbow)

This condition is a common form of tendonitis involving the wrist extensor muscles. The attachment of these muscles at the elbow makes it susceptible to chronic inflammation during times of repetitive muscle contraction. This overloading of the tendon leads to fatigue and microtrauma, and is more prevalent in those over 35 years of age. The chronic inflammation is an attempt to increase tissue healing to compensate for the micro damage. If rehabilitation is not initiated early, treatment is more difficult and return to sport or activity is delayed. The goals of treatment are to restore normal, pain-free use and prevent recurrence. Physical therapy uses various types of healing modalities to resolve the inflammatory process, followed by exercise to restore normal strength and flexibility.

Medial Epicondylitis (Golfer's Elbow)

This condition is also a form of tendonitis, but is less common than lateral epicondylitis, It occurs characteristically with wrist flexion activity and active pronation, as in baseball pitching, the golf swing, or the pull-through phase of a swimming stroke. As in lateral epicondylitis, the muscles to strengthen, once the inflammatory phase is under control, are the elbow flexors and extensors, forearm pronators, supinators, and wrist flexors in particular.

References: Norkin, CC and Levangie, PK: Joint Structure and Function, A Comprehensive Analysis Magee, DJ: Orthopedic Physical Assessment Richardson, JK and Iglarsh ZA: Clinical Orthopaedic Physical Therapy