Elbow

Ryan LaCorte Treatments

The elbow is a complex joint consisting of not only the articulation of the ulna and the humerus (upper arm,) but also that of the radius and humerus as well as proximal radius and ulna (forearm bones.)  These 3 joints work together to allow the elbow to not only flex and extend, but also to allow the forearm to pronate and supinate (turn palm up and down.)  The primary joint allowing for bending of the elbow involves the distal humerus articulation with the proximal ulna (humeroulnar joint.)  Due to the anatomical structure of this joint, it is a very sturdy and stable joint allowing for elbow flexion and extension.  When the arm is straightened fully, it provides a very stable articulation between the two bones.  As the joint bends however, this becomes much less stable and allows for some joint laxity (looseness).

Due to the multiple muscle attachments as well as the instability in the elbow when in a flexed position, it is a common site for injury.  Most injuries are considered overuse injuries due to repetitive strain on the elbow joint as well as the muscles, tendons and ligaments supporting the elbow and controlling motion.  Below we have listed a number of common injuries.

Lateral Epicondylitis (Tennis Elbow)

Lateral Epicondylitis, commonly known as Tennis Elbow refers to inflammation of the proximal wrist extensor tendons as they attach to the lateral epicondyle (bony prominence on the outside of the elbow) and supracondylar ridge.  There are a number of mechanisms behind lateral epicondylitis, however the most consistent is repetitive wrist extension.  With lateral epicondylitis, one will develop pain along the lateral (outside) part of the elbow with point tenderness to touch.  Frequently one will have weakened grip strength with pain.  Symptoms are frequently exacerbated with grasping objects or shaking hands.  As an inflammatory condition, non-steroidal anti-inflammatories are the most common course of action.  However if symptoms persist, other interventions may be necessary.  Most cases of lateral epicondylitis are treated through non-surgical interventions.  Physical therapy is considered the most appropriate non-invasive treatment.  Through a thorough evaluation and patient history, your therapist will assess the underlying cause of your symptoms.  The first step is controlling the inflammation frequently with the application of modalities as well as manual techniques.  Once under control, your therapists will address the mechanism leading to your lateral epicondylitis and focus on preventing any future episodes.  At times bracing is also necessary to control symptoms and reduce future incidence.  Your therapist will assess your needs and help to expedite your recovery.   All of our facilities are equipped with state of the art modalities and equipment to meet your needs.   Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

**For more information, please see the article “Elbow Pain and How Physical Therapy Can Help:  Epicondylitis (Golfer’s Elbow or Tennis Elbow”) written by Katherine Zaborowski in our publications.

Medial Epicondylitis (Golfer’s Elbow)

Medial Epicondylitis, commonly known as Golfer’s Elbow, refers to inflammation of the proximal wrist flexor tendons as they attach to the medial epicondyle (bony prominence on the medial of the elbow) and supracondylar ridge.  There are number of mechanisms behind medial epicondylitis, however the most common is repetitive wrist flexion.  With medial epicondylitis, one will develop pain along the medial (inside) part of the elbow with point tenderness to touch with symptoms frequently radiating down the palm side of the forearm to the wrist.  Weakened grip strength with pain is common.  Symptoms are frequently exacerbated with grasping objects.  Treatment of medial epicondylitis includes eliminating the action producing the symptoms.  As an inflammatory condition, a non-steroidal anti-inflammatory is the most common treatment along with non-surgical interventions.  As a soft tissue inflammatory condition, physical therapy is generally thought of as the most appropriate intervention when symptoms persist. Your therapist will assess the underlying mechanism behind your condition.  The use of modalities as well as manual intervention and therapeutic activities will help to expedite your recovery and prevent future incidence of injury.  All of our facilities are equipped with state of the art modalities and equipment to meet your needs.   Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

**For more information, please see the article “Elbow Pain and How Physical Therapy Can Help:  Epicondylitis (Golfer’s Elbow or Tennis Elbow”) written by Katherine Zaborowski in our publications.

Ulnar Collateral Ligament; Sprains or Tears

The Ulnar Collateral Ligament helps to provide stability to the elbow joint and runs along the inside portion of your elbow from the distal humerus to the proximal ulna.  This ligament limits or prevents valgus stresses placed on the elbow.  The most common injuries to the Ulnar Collateral Ligament involve acute trauma or overuse mechanisms.  In traumatic cases, the arm is usually supporting body weight as a force is applied to the outside of the elbow pushing inward.  Overuse injuries generally involve repetitive throwing commonly seen in baseball pitchers as well as track and field events.  Injuries most commonly occur when poor throwing motions are employed.  Pain will present with palpation of the medial aspect of the elbow with possible swelling or bruising.  Additionally, there will be discomfort with valgus stresses placed on the elbow and possible pain with resisted elbow flexion.  Treatment of an Ulnar Collateral Ligament Sprain is dependent upon the severity of the injury.  Initially, the focus is to control the inflammatory response through modalities and manual techniques as well as avoiding aggravating activities.  Frequently, soft tissue mobilization and cross friction massage is employed to help to break up scar tissue formation and increase blood flow.  Additionally an elbow support brace may be employed to prevent valgus stresses placed on the elbow.  As symptoms subside, your therapists will devise a program to restore elbow and forearm strength and range of motion as well as help to analyze the mechanism of injury and assess any changes in form that will help prevent future injury.   In severe cases, a surgical procedure is performed to reconstruct the Ulnar Collateral Ligament known as Tommy John Surgery.  Due to the structures involved, Tommy John Surgeries will frequently involve a long rehabilitation period focusing on improving throwing form as well as building forearm and elbow strength.   Your physical therapist will perform a thorough evaluation to assess your condition and devise a treatment plan to best address your symptoms.   All of our facilities are equipped with state of the art modalities and equipment to meet your needs.   Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

Cubital Tunnel Syndrome-(Ulnar Nerve Entrapment)

The ulnar nerve runs along the inside part of the elbow and passes into the forearm.   As the ulnar nerve travels along the inside of the elbow, there is a small space known as the cubital tunnel where the nerve sits.  This ulnar nerve sits superficially (close to the skin) in this area and can commonly be irritated here.  This area is frequently termed the “funny bone.”  Due to the nerve positioning, entrapment can occur.  Cubital Tunnel Syndrome will present with numbness and tingling running along the pinky side of the forearm into the hand, pinky and ring finger and in severe cases weakness.  In most cases, symptoms can be controlled through conservative treatments such as physical therapy.  Through a thorough evaluation, your therapist will discover the underlying mechanism creating entrapment of the ulnar nerve.  They will employ manual interventions, modalities and appropriate exercise prescription, to alleviate your symptoms and restore your prior level of function.   All of our facilities are equipped with state of the art modalities and equipment to meet your needs.   Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

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