I ANATOMY A BONES Humerus Medial and Lateral

I ANATOMY A. BONES * Humerus- Medial and Lateral Epicondyle, and Olecranon fossa *Radius- Head of radius- allows for supination (“spins” on ulna) * Ulna- Olecranon process (bump) allows elbow to go to 180 degrees

Elbow Anatomy

OLECRANON PROCESS AND FOSSA

B. Muscles Bicep Brachii Tricep Brachii

B. MUSCLES * ELBOW MUSCLES B R FLEXOR ACHIORA DIALIS CORACOBRACHIALIS/ BRACHIALIS

* WRIST FLEXORS/EXTENSORS Extensor Digitorum

C. LIGAMENTS Medial Collateral Ligament (Ulna Collateral) Lateral Collateral (Radial Collateral) Annual Ligament

Lateral Collateral Ligament Medial Collateral Ligament

Ligaments

D. NERVES

II INJURIES 1. Medial Epicondylitis Mech. Symptoms. TX- 2. Lateral Epicondylitis Mech. Symptoms. TX- 3. MCL Sprain Mech. Symptoms. TX-

Tennis Elbow Brace

MCL Sprain

Wind-up Early Cocking Late Cocking -Anterior Instability -RTC -SLAP -Quadrilateral Space Syndrome -Medial Elbow instability -Capitellar OCD Acceleration -Internal Impingement -RTC -Scapulothoracic bursitis -Medial Elbow instability -Olecranon apophysitis / stress fx Deceleration -RTC -SLAP -Subacromial impingement -Posteromedial Elbow impingement Follow-through -Olecranon apophysitis / stress fx

III. ASSESSMENT History- Age? Sport? How long? Technique questions? Training? Observation- Bilateral, Anatomical position and ‘natural’, atrophy/hypertrophy Palpations- Swelling, PT, crepitus, pulse, insertions and origins of muscles

ASSESSMENT- SPECIAL TESTS 1) PROM, AROM, and RROM all for flex, ext, pronation and supination 2) Valgus and Varus test. Valgus for Ulna Collateral ligament Varus for Radial Collateral ligament * Perform test at full ext and 30 degrees flexion 3) Lateral and Medial Epicondylitis testa) Lateral- RROM of wrist extensor and pain on lateral epicondyle b) Medial- RROM of wrist flexors and pain on medial epicondyle

IV. REHAB Phase 1 - Ice or heat but be careful of ulna nerve Phase 2 - Regain ROM in elbow joint (could be a problem if immobilized) Stretching all muscles in wrist, elbow and shoulder Phase 3 - Start with Isometric, then isotonic Concentrate on wrist, elbow and shoulder movement

PHASE 3 EXERCISES http: //www. marianjoylibrary. org/residency/documents/s 51 ref 16 rehabilitationofthrowerselbo Putty/grip strengthening Wrist curls Pronation/supination AIAAROM elbow extension/flexion Broomstick roll-up

ELBOW REHAB

Pronation and Supination with theraband Bicep curl with theraband

THROWER’S TEN http: //www. ballcharts. com/teams/files/N/nd bluejays/photos/throwerstenexercises 1. pdf

You think you have problems!

COLLES FRACTURE