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The Elbow, Forearm, Wrist and HandPE 236Juan Cuevas, ATC? 2007 McGraw-Hill Higher Education. All rights reserved.? 2007 McGraw-Hill Higher Education. All rights reserved.Prevention of Elbow, Forearm and Wrist InjuriesVulnerable to a variety of acute and chronic injuriesProtective gear is always recommended to reduce severity of injuryChronic injury reductionLimit repetitions (baseball, tennis)Utilize proper mechanicsUse equipment that is appropriate for skill levelMaintain appropriate levels of strength, flexibility, and endurance for activityRecognition and Management of Injuries to the ElbowOlecranon BursitisCause of InjurySuperficial location makes it extremely susceptible to injury (acute or chronic) --direct blowSigns of InjuryPain, swelling, and point tendernessSwelling will appear almost spontaneously and w/out usual pain and heatContusionCause of InjuryVulnerable area due to lack of paddingResult of direct blow or repetitive blowsSigns of InjurySwelling (rapidly after irritation of bursa or synovial membrane)CareTreat w/ RICE immediately for at least 24 hoursIf severe, refer for X-ray to determine presence of fractureElbow SprainsCause of InjuryElbow hyperextension or a valgus force (often seen in the cocking phase of throwingSigns of InjuryPain along medial aspect of elbowInability to grasp objectsPoint tenderness over the MCLCareConservative treatment begins w/ RICE elbow fixed at 90 degrees in a sling for at least 24 hoursCoach should be concerned with gradually regaining elbow full ROMAthlete should modify activityGradual progression involving an increase in number of throws while range and strength returnLigament InjuriesUlnar Collateral Ligament tearOveruse injuryBaseball pitchersSigns and SymptomsMedial elbow painPop sensationMedial elbow swelling TreatmentSURGERY – “Tommy John”Elbow ligament reconstructionLateral Epicondylitis (Tennis Elbow)Cause of InjuryRepetitive microtrauma to insertion of extensor muscles of lateral epicondyleSigns of Injury