Your elbow joint is made up of bone, cartilage, ligaments and fluid. Muscles and tendons help the elbow joint move. When any of these structures is hurt or diseased, you have elbow problems. Many things can make your elbow hurt. A common cause is tendinitis, an inflammation or injury to the tendons that attach muscle to bone. Tendinitis of the elbow is a sports injury, often from playing tennis or golf. You may also get tendinitis from overuse of the elbow.
Elbow (Olecranon Bursitis)
Olecranon bursitis, a relatively common condition, is inflammation of the subcutaneous synovial-lined sac of the bursa overlying the olecranon process at the proximal aspect of the ulna (see the images below). The bursa cushions the olecranon and reduces friction between it and the skin, especially during movement. The superficial location of the bursa, between the ulna and the skin at the posterior tip of the elbow, makes it susceptible to inflammation from acute orrepetitive (cumulative) trauma. Less commonly, inflammation results from infection (septic bursitis).
When the joint surfaces of an elbow are separated, the elbow is dislocated. Elbow dislocations can be complete or partial. In a complete dislocation, the joint surfaces are completely separated. In a partial dislocation, the joint surfaces are only partly separated. A partial dislocation is also called a subluxation.
Elbow fractures may result from a fall, a direct impact to the elbow, or a twisting injury to the arm. Sprains, strains or dislocations may occur at the same time as a fracture. X-rays are used to confirm if a fracture is present and if the bones are out of place. Sometimes a CT (Computed Tomography) scan might be needed to get further detail.
Pain, swelling, bruising and stiffness in and around the elbow may be signs of a possible fracture. A snap or pop at the time of injury may be felt or heard. Visible deformity might mean that the bones are out of place or that the elbow joint is dislocated. There may be numbness or weakness in the arm, wrist and hand.
A ligament is a band of tissue that connects bone to bone. The ligaments in your elbow help connect the bones of your upper and lower arm around your elbow joint.
A sprain is an injury to the ligaments around a joint. When you sprain your elbow, you have pulled or torn one or more of the ligaments in your elbow joint.
Tendinitis is inflammation or irritation of a tendon — any one of the thick fibrous cords that attaches muscle to bone. The condition causes pain and tenderness just outside a joint.
While tendinitis can occur in any of your body’s tendons, it’s most common around your shoulders, elbows, wrists, knees and heels.
Some common names for various tendinitis problems are:
- Tennis elbow
- Golfer’s elbow
- Pitcher’s shoulder
- Swimmer’s shoulder
- Jumper’s knee
If tendinitis is severe and leads to the rupture of a tendon, you may need surgical repair. But most cases of tendinitis can be successfully treated with rest, physical therapy and medications to reduce pain.
Fractures & Fracture Care
The general aim of early fracture management is to control hemorrhage, provide pain relief, prevent ischemia-reperfusion injury, and remove potential sources of contamination (foreign body and nonviable tissues). Once these are accomplished, the fracture should be reduced and the reduction should be maintained, which will optimize the conditions for fracture union and minimize potential complications.
The goal in managing fractures is to ensure that the involved limb segment, when healed, has returned to its maximal possible function. This is accomplished by obtaining and subsequently maintaining a reduction of the fracture with an immobilization technique that allows the fracture to heal and, at the same time, provides the patient with functional aftercare. Either nonoperative or surgical means may be used.
Medial epicondylitis is commonly known as golfer’s elbow. This does not mean that only golfers have this condition. But the golf swing is a common cause of medial epicondylitis. Many other repetitive activities can also lead to golfer’s elbow: throwing, chopping wood with an ax, running a chain saw, and using many types of hand tools. Any activities that stress the same forearm muscles can cause symptoms of golfer’s elbow.
What parts of the elbow are affected?
Golfer’s elbow causes pain that starts on the inside bump of the elbow, the medial epicondyle. Wrist flexors are the muscles of the forearm that pull the hand forward. The wrist flexors are on the palm side of the forearm. Most of the wrist flexors attach to one main tendon on the medial epicondyle. This tendon is called the common flexor tendon.
Tendons connect muscle to bone. Tendons are made up of strands of a material called collagen. The collagen strands are lined up in bundles next to each other.
Because the collagen strands in tendons are lined up, tendons have high tensile strength. This means they can withstand high forces that pull against both ends of the tendon. When muscles work, they pull on one end of the tendon. The other end of the tendon pulls on the bone, causing the bone to move.
The wrist flexor muscles contract when you flex your wrist, twist your forearm down, or grip with your hand. The contracting muscles pull on the flexor tendon. The forces that pull on the tendon can build when you grip a golf club during a golf swing or do other similar actions.
Lateral Epicondylitis (Tennis Elbow)
Tennis elbow is a type of tendinitis — swelling of the tendons — that causes pain in the elbow and arm. These tendons are bands of tough tissue that connect the muscles of your lower arm to the bone. Despite its name, you can still get tennis elbow even if you’ve never been near a tennis court. Instead, any repetitive gripping activities, especially if they use the thumb and first two fingers, may contribute to tennis elbow. Tennis elbow is the most common reason that people see their doctors for elbow pain. It can pop up in people of any age, but it’s most common at about age 40.
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. That constant tugging can eventually cause microscopic tears in the tissue.
Tennis elbow might result from:
- Weight lifting