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Management of Bursitis

What Is Bursitis?

Bursitis is the inflammation or irritation of the bursa. The bursa is a sac filled with lubricating fluid, located between tissues such as bone, muscle, tendons, and skin, that decreases rubbing, friction, and irritation.

What Causes Bursitis?

Bursitis is most often caused by repetitive, minor impact on the area, or from a sudden, more serious injury. Age also plays a role. As tendons age they are able to tolerate stress less, are less elastic, and are easier to tear.

Overuse or injury to the joint at work or play can also increase a person’s risk of bursitis. Examples of high-risk activities include gardening, raking, carpentry, shoveling, painting, scrubbing, tennis, golf, skiing, throwing, and pitching. Incorrect posture at work or home and poor stretching or conditioning before exercise can also lead to bursitis.

An abnormal or poorly placed bone or joint (such as length differences in your legs or arthritis in a joint) can put added stress on a bursa sac, causing bursitis. Stress or inflammation from other conditions, such as rheumatoid arthritis, gout, psoriatic arthritis, thyroid disorders, or unusual medication reactions may also increase a person’s risk. In addition, an infection can occasionally lead to inflammation of a bursa.

Who Usually Gets Bursitis?

Bursitis is more common in adults, especially in those over 40 years of age.

 

What Parts of the Body Does Bursitis Affect?

  • Elbow
  • Shoulder
  • Hip
  • Knee
  • Achilles tendon

What Are the Symptoms of Bursitis?

The most common symptom of bursitis is pain. The pain may build up gradually or be sudden and severe, especially if calcium deposits are present. Severe loss of motion in the shoulder — called “adhesive capsulitis” or frozen shoulder — can also result from the immobility and pain associated with shoulder bursitis.

How Can I Prevent Bursitis?

If you are planning to start exercising, you will be less likely to get bursitis if you gradually build up  force and  repetitions. Stop what you are doing if unusual pain occurs.

How Is Bursitis Treated?

Bursitis can be treated in a number of ways, including:

  • Avoiding activities that aggravate the problem
  • Resting the injured area
  • Icing the area the day of the injury
  • Taking over-the-counter anti-inflammatory medicines

If the condition does not improve in a week, see your doctor.

Your doctor can also prescribe drugs to reduce the inflammation. Corticosteroids are often used because they work quickly to decrease the inflammation and pain. Steroids  can be injected directly at the site of injury.  Injections are often, but not always, effective and can be repeated . However, multiple injections in a several month period are usually avoided due to potential side effects from the injections and the possibility of masking problems that need to be treated differently.

Physical therapy is another treatment option that is often used. This includes range-of-motion exercises and splinting (thumb, forearm, or bands).

Surgery, although rarely needed, may be an option when bursitis does not respond to the other treatment options.

Warning

Consult your doctor if you have:

  • Fever (over 102 Fahrenheit) — infection is a possibility
  • Swelling, redness, and warmth
  • General illness or multiple sites of pain
  • Inability to move the affected area

These could be signs of another problem that needs more immediate attention.

Cure your Elbow Bursitis today! Call us at +65 64712744 or Email to: info@boneclinic.com.sg for Appointment

Nursemaid’s Elbow

Be peace of mind on your Child Nursemaid’s Elbow. Call us +65 6471 2744 for immediate attention (24 Hours) / SMS to: +65 9235 7641

Nursemaid’s elbow is a partial dislocation of the elbow, which occurs when the lower part of the arm (forearm) slips out of its normal position at the elbow joint.

The injury is also called radial head dislocation.

Causes of Nursemaid’s Elbow

Nursemaid’s elbow is a common condition in young children and generally affects children under age 5. The injury occurs when a child is pulled up too hard by the hand or wrist. It is often seen after someone lifts a child up by one arm up. (For example, when trying to lift the child over a curb or high step.) Swinging a young child from the arms while playing can also cause this injury.

When the injury occurs, the child usually begins crying immediately and refuses to use the arm. The child may hold the arm so that is slightly bent (flexed) at the elbow and pressed up against the belly (abdominal) area. The child will move the shoulder, but not the elbow. Some children stop crying as the immediate pain goes away, but continue to refuse to move the elbow.

Once the elbow dislocates, it is likely to do so again, especially in the 3 or 4 weeks following the injury.

Nursemaid’s elbow does not usually occur after age 5. By this time, a child’s joints and surround structures are stronger, and the child is less likely to be in a situation where this injury might occur. However, in some cases, the injury can occur in older children or adults, usually from a fracture of the forearm.

Symptoms of Nursemaid’s Elbow

  • Immediate crying
  • Complaints of elbow pain
  • Refusing to use the arm that is injured
  • Holding elbow slightly bent at the elbow
  • Holding the lower part of the arm against the belly area (abdomen)
  • Moving arm at shoulder but not elbow

If you think your child has nursemaid’s elbow:

  • DO NOT move the child without first splinting the arm.
  • DO NOT try to straighten the arm or change its position.

Apply an ice pack to the elbow. Splint the injured arm in the position in which you found it. Keep the area both above and below the injured elbow from moving, including the shoulder and the wrist, if possible.

Take the child to the doctor’s office or emergency room.

Exams and Tests of Nursemaid’s Elbow

The health care provider will examine the child.

The child will be unable to rotate the arm at the elbow so that the palm is up and will have trouble bending (flexing) the elbow all the way.

Treatment of Nursemaid’s Elbow

The doctor will fix the dislocation by gently flexing the elbow and rotating the forearm so that the palm is facing upward. DO NOT try to do this yourself as you may harm the child.

In some cases of frequently recurring nursemaid’s elbow, your health care provider may teach you how to attempt to correct the problem yourself. See your health care provider for assistance.

Outlook (Prognosis) of Nursemaid’s Elbow

If nursemaid’s elbow remains untreated, it may result in permanent inability to fully move the elbow. With treatment, there is usually no permanent damage.

Possible Complications of Nursemaid’s Elbow

In some cases, the child may have problems that limit movement of the arm.

When to Contact a Medical Professional of Nursemaid’s Elbow

Call us (+65 6471 2744 – 24 Hours) if you suspect your child has a dislocated elbow or refuses to use an arm.

Prevention of Nursemaid’s Elbow

Avoid lifting a child by one arm only, either from the wrist or hand. Lift from under the arms, from the upper arm, or from both arms. Do not swing children by the hand or forearm. To swing a young child in circles, provide support under the arms and hold the upper body next to yours.

Be peace of mind on your Child Nursemaid’s Elbow. Call us +65 6471 2744 for immediate attention (24 Hours) / SMS to: +65 9235 7641

Median Nerve Injury

Injury to the median nerve at the elbow may cause symptoms to appear in the forearm, wrist and hand. Injuries to the median nerve at the elbow are either lesions – where the nerve is torn either partially or fully, or compressed due to displacement of a fracture or excess fluid following injury.

Symptoms of a Median Nerve Injury

  • Injury above the elbow may result in difficulty or even inability to turn the hand over or flex the wrist down.
  • Injuries below this may cause tingling or numbness in the forearm, thumb and the three adjacent fingers.
  • Weakness with gripping.
  • Inability to move the thumb across the palm.
  • Wasting of the muscles at the base of the thumb.

The median nerve emerges from the neck at the brachial plexus between the 5th cervical (neck) and 1th Thoracic (upper back) vertebrae. It then passes down the arm, past the elbow and splits into branches which serve the thumb and three fingers (missing just the little, pinky finger!).

At the elbow, the nerve passes to the inner side of the joint and so injuries in this area are most at risk of causing median nerve injury. It also runs alongside the brachial artery and so an acute injury to the median nerve may also cause injury to this major blood vessel.

Injuries such as a supracondylar fracture, elbow dislocation or any form of fracture should be examined for damage to the median nerve. Even relatively minor injuries, to the medial ligament for example, may result in median nerve symptoms due to increased pressure on the nerve from bleeding and swelling in the area.

Injuries to the median nerve at the elbow are either lesions – where the nerve is torn either partially or fully, or compressed due to displacement of a fracture or excess fluid following injury. Lesions are more serious, long-term injuries. Compression injuries usually resolve when swelling dissipates or when a displaced fragment of bone is removed.

The most common injury involving the median nerve is Carpal Tunnel Syndrome. However this is caused by a decrease in space at the carpal tunnel in the wrist and so would not occur as a result of an elbow injury. Pronator Teres Syndrome is another entrapment neuropathy of the median nerve, this time as it passes between the two heads of the pronator teres muscle.

Treatment

As median nerve injuries at the elbow are usually caused by another acute injury, the priority is to treat the initial injury. This may be a fracture or dislocation or a soft tissue injury. But in many cases, treating the offending injury, eases the median nerve symptoms.

Applying ice, compression and elevation to a soft tissue injury will help to reduce swelling, in turn reducing pressure on the median nerve.

A displaced fracture at the elbow, which is compressing the median nerve may also be corrected by surgery to remove or realign the fragment, again easing pressure on the nerve.

Median nerve symptoms may clear up very quickly if no long term damage was sustained. However, if the nerve was damaged, the symptoms listed above may be more long-lasting.

Stop the pain and get your Elbow check, call +65 6471 2744 / Email: info@boneclinic.com.sg

What cause elbow pain?

Your elbow is a hinge joint consisting of three bones. The upper portion of the hinge is at the end of the upper arm bone (humerus), and the lower portion is the top of the two forearm bones (radius and ulna) which are side by side. All three of these bones are in contact with each other. The joint is surrounded and lined by cartilage, muscles, and tendons that provide support and stability, and make it easy for you to move.

It’s your elbow joint that lets you bend, extend, and rotate your arm. Your range of motion is dependent upon the proper articulation of this joint.

In a healthy elbow joint, the surfaces of these bones are very smooth and covered with a tough protective tissue called cartilage. Arthritis causes damage to the bone surfaces and cartilage where the three bones rub together. These damaged surfaces eventually become painful. Ligaments (another type of soft tissue) lie along the sides and back of the elbow, holding the bones of the elbow joint in place. These ligaments work with the muscles that control the bones and the tendons that connect the muscles to the bones so you can bend and straighten your elbow. Fluid-filled sacs (bursae) cushion the area where skin or tendons glide across bone. The elbow also has a lining (synovium) that secretes a clear liquid called synovial fluid. This fluid lubricates the joint, further reducing friction and making movement easier. 

As you might expect, there are many different reasons why you could be feeling elbow pain, including injury, infection, and arthritis.

Post-traumatic arthritis

Periodically, traumatic events to the elbow region result in bone fractures and severe dislocation of the joint structures. This typically can result in surgery that attempts to heal bone fragments in their proper orientation. Periodically, this attempt is not completely successful in either addressing damage to the cartilage from the injury or in precisely rebuilding your elbow as it was prior to the injury. As a result, the cartilage in your elbow may see forces differently than before the injury occurred. This can result in premature wear of the cartilage in the area of the injury and is called post-traumatic arthritis.

Rheumatoid arthritis

In rheumatoid arthritis, the synovium (lining of the joint) becomes inflamed. The inflammation causes chemicals to be released that thicken the synovium and damage the cartilage and bone of the affected joint. This inflammation of the synovium causes pain and swelling.

The good news about arthritis in the elbow is that it can be treated. Arthritis is a disease that typically worsens over the years, so it is common for treatment to involve more than one approach and to change over time. For some people, nonsurgical treatments such as lifestyle changes, medications, and physical therapy help alleviate the pain. For others, elbow replacement surgery may be a long-term solution. Together, you and your doctor can determine the best treatment options for you.

Stop the pain and Get your Elbow checked today! Call +65 6471 2744 (24 Hours) or Email: info@boneclinic.com.sg

Elbow Dislocation

Elbow dislocations are the second most common dislocations in adults, behind shoulder dislocations. The elbow is a very stable joint and so it requires a lot of force to dislocate it.

What are the symptoms?

  • Extreme pain
  • Obvious deformity (more so in complete dislocations)
  • Bruising on the inside and outside of the elbow
  • Swelling

A dislocated elbow occurs usually as a result of a fall, or a direct blow and often involves an associated fracture of the Radius, Humerus or Ulna. The most common mechanism involves falling onto an outstretched hand, with the arm away from the body and the elbow being forceably flexed on contact. There is usually also a twisting movement. This results in a posterior dislocation which accounts for up to 90% of all elbow dislocations. In a posterior dislocation the Ulna or the Radius (sometimes both!) moves backwards.

When the elbow is dislocated posteriorly this can be either partial (also known as a subluxation) or complete. With a partial dislocation the joint surfaces are separated by a small distance and usually reduce (return to their normal position) either instantly or with very little help. A complete dislocation occurs when the joint surfaces are considerably separated and can require a manual reduction (by a Doctor).

Dislocations usually involve damage to surrounding structures, most often the ligaments of the elbow joint, fractures to the Radius or Ulna or damage to the nerves or blood vessels which pass close to the elbow joint which may become trapped (pinched) by the moving bone.

Treatment

What can the athlete do?

  • Visit a Doctor or Hospital immediately
  • Apply ice or cold therapy to the elbow
  • Put the elbow in a sling to support it
  • DO NOT attempt to ‘pop it back in’ yourself! This can cause further damage

What can a professional do?

  • A Doctor will assess your arm for swelling, deformity and movement
    The lower arm and hand should also be checked for warmth and colour. A cold, white or blue tinged hand can indicate that a nerve or blood vessel has been trapped or damaged
  • An MRI or X-ray may be performed (sometimes before, sometimes after reduction)
    In a complete dislocation (or a partial dislocation which has not reduced itself) a reduction will be performed to return the elbow back to the correct position
  • This involves manipulating the elbow into a position which forces the bones back to their natural position.
  • The elbow is rested in a sling for between 1 and 3 weeks dependant on the extent of damage
    A rehabilitation program should then be followed.

Rehabilitation

  • Following a period of immobilisation, gentle mobility exercises should be commenced to increase the range of motion at the elbow joint.
  • Once range of motion is close to normal, strengthening exercises for the muscles surrounding the elbow should begin.
  • Damage to surrounding ligaments shoud also be treated as described here
    Taping or a support can be used on a return to sport

Get your Elbow Dislocation treated today, Call +65 6471 2744 for appointment / Email: info@boneclinic.com.sg

Patient education about elbow pain

Your elbow is a hinge joint consisting of three bones. The upper portion of the hinge is at the end of the upper arm bone (humerus), and the lower portion is the top of the two forearm bones (radius and ulna) which are side by side. All three of these bones are in contact with each other. The joint is surrounded and lined by cartilage, muscles, and tendons that provide support and stability, and make it easy for you to move.

It’s your elbow joint that lets you bend, extend, and rotate your arm. Your range of motion is dependent upon the proper articulation of this joint.

In a healthy elbow joint, the surfaces of these bones are very smooth and covered with a tough protective tissue called cartilage. Arthritis causes damage to the bone surfaces and cartilage where the three bones rub together. These damaged surfaces eventually become painful. Ligaments (another type of soft tissue) lie along the sides and back of the elbow, holding the bones of the elbow joint in place. These ligaments work with the muscles that control the bones and the tendons that connect the muscles to the bones so you can bend and straighten your elbow. Fluid-filled sacs (bursae) cushion the area where skin or tendons glide across bone. The elbow also has a lining (synovium) that secretes a clear liquid called synovial fluid. This fluid lubricates the joint, further reducing friction and making movement easier. 

As you might expect, there are many different reasons why you could be feeling elbow pain, including injury, infection, and arthritis.

Post-traumatic arthritis

Periodically, traumatic events to the elbow region result in bone fractures and severe dislocation of the joint structures. This typically can result in surgery that attempts to heal bone fragments in their proper orientation. Periodically, this attempt is not completely successful in either addressing damage to the cartilage from the injury or in precisely rebuilding your elbow as it was prior to the injury. As a result, the cartilage in your elbow may see forces differently than before the injury occurred. This can result in premature wear of the cartilage in the area of the injury and is called post-traumatic arthritis.

Rheumatoid arthritis

In rheumatoid arthritis, the synovium (lining of the joint) becomes inflamed. The inflammation causes chemicals to be released that thicken the synovium and damage the cartilage and bone of the affected joint. This inflammation of the synovium causes pain and swelling.

The good news about arthritis in the elbow is that it can be treated. Arthritis is a disease that typically worsens over the years, so it is common for treatment to involve more than one approach and to change over time. For some people, nonsurgical treatments such as lifestyle changes, medications, and physical therapy help alleviate the pain. For others, elbow replacement surgery may be a long-term solution. Together, you and your doctor can determine the best treatment options for you.

Cure your elbow pain today and get it check, call us at +65 6471 2744 (24 Hours) / Email: info@boneclinic.com.sg

New Clinical Practice Guideline For Treating Common Elbow Fractures In Children

The American Academy of Orthopaedic Surgeons (AAOS) Board of Directors has recently approved and released an evidence-based clinical practice guideline (CPG) on “The Treatment of Supracondylar Humerus Fractures.”

Supracondylar humerus fractures are common and likely occur when children are playing, or while climbing trees, jungle gyms and other structures. When young children fall, they tend to hyperextend their arms. As a result they land on a stiff arm, often fracturing the arm, just above the elbow joint.

In addition to the broken bone, the sheer force of this type of fall, may cause “all kinds of consequences. The artery which provides blood to the forearm and hand – runs very close to the elbow, as do the three main nerves of the arm: median, radial and ulnar. As a result, elbow fractures can cause circulation problems, and in 10 to 15 percent of cases, nerve injuries.

This new guideline is the result of a robust review of more than 350 research studies on this topic and includes 14 recommendations on how to stabilize the fracture, remedy circulation problems, and ultimately, ensure the fastest and most comfortable recovery for each child.

Important findings:

  • First, the guideline recommends that surgeons stabilize the fracture with “two or three laterally introduced pins to stabilize the reduction of displaced, misaligned, supracondylar fractures of the humerus.”
  • In addition, the guideline recommends procedures to restore blood flow and circulation if the artery has been stretched, torn or severed. Orthopaedic surgeons know that the first thing to do with an arm without a pulse is to gently realign the arm. Once the fracture is put back into the proper position and established, circulation will likely recover.
  • However, sometimes there is still no pulse in the arm following realignment. This can occur with or without adequate blood flow. The guideline recommends the surgical “exploration” of the blood vessels and nerves in front of the elbow in patients with no wrist pulse, if the hand remains cold and underperfused (without adequate blood flow), to “ensure survival of the tissues in the arm and hand.” In these rare instances, further surgery may be necessary “to prevent rare, but serious, limb threatening and life threatening consequences,” according to the guideline.

The guideline states: “If the hand feels warm, has color from circulation that you can see, and the child can move the muscles of the forearm and demonstrate some motion, then there is evidence that tissues are being nourished despite the absent pulse.” The guideline does not specifically recommend surgery or observation in these cases.

“Ultimately, each physician must evaluate his or her patient’s condition and circumstance and figure out ‘how do I best treat this child.

More about supracondylar humerus fractures

The humerus is the upper arm bone that connects the shoulder to the elbow. A supracondylar fracture of the humerus occurs just above the elbow joint. Treatment may consist of both surgical and nonsurgical options, but depends on the type of fracture and the degree of displacement.

Elbow Fractures in Children

Broken elbows are common injuries in children. Many activities kids participate in make their elbows vulnerable to injury. Furthermore, there are several growth plates (areas of bone that are actively growing) around the elbow joint. These growth plates are susceptible to injury. Children who have elbow injuries should be evaluated by a physician for a fracture.
What causes an elbow fracture in children?
Many activities can cause elbow fractures in children, but jungle gyms are far and away the primary culprit! Kids falling from jungle gyms can injure their elbows as they fall to the ground. Other common activities that cause elbow injuries include gymnastics, football, jumping on beds, and rough play.

When should I have my child see a doctor about an elbow injury?
If you are unsure of the diagnosis it is always safest to have your child seen by their pediatrician or in the emergency room. Signs that should tip you off to a problem include:

  • Inability to straighten or bend the elbow
  • Swelling or discoloration (bruising) around the elbow
  • Pain around the elbow joint
How is an elbow fracture diagnosed?
Your doctor will first evaluate your child’s arm for signs of damage to the nerves and blood vessels around the elbow joint. While damage to these structures are uncommon, it is important to know if there is a problem. Injuries to blood supply of the arm may necessitate early surgical intervention.

X-rays are used to diagnose elbow fractures. In more severe injuries, the fracture will be easily seen on x-ray, but it is not uncommon to have some types of elbow fractures that do not show up on x-ray. The reason is that growth plate fractures may not show up on x-ray like normal broken bones. Therefore, your doctor may request an x-ray of the opposite elbow (your child’s uninjured side) to compare the two for differences. Often the only sign of a broken elbow in a child is swelling seen on x-ray (the so-called ‘fat-pad sign’). In this case, the elbow should be treated as having a break.

What is the treatment of an elbow fracture in a child?
Treatment of elbow fractures depends on several factors including:

    • Location of the fracture
    • Amount of displacement of the fracture
    • Age of the patient
    • Damage to nerves and blood vessels

Some common types of elbow fractures include:

  • Supracondylar Humerus Fracture: The supracondylar fractures are the most common type of elbow fracture. They occur through the growth plate of the humerus (above the elbow joint). The most common cause of these injuries is a fall onto an outstretched arm–often a jungle gym. These injuries most commonly occur in children between the ages of 5 and 7 years old.
  • Condylar Fractures: Condylar fractures also occur just above the elbow joint. When a child sustains a condylar fracture he or she has broken off just one side of the elbow joint.
  • Radial Neck Fractures: Radial neck fractures are uncommon in adults, but often occur in children. The treatment of a radial neck fracture depends on the angulation of the fracture. Treatment may consist of casting, manipulation, or possibly placing pins across the fracture.
  • Radial Head Subluxation: While not a broken bone, a radial head subluxation is a common injury in a young child’s elbow. When a radial head subluxation occurs, the elbow joint slides out of position. These injuries are usually placed back into position quite easily.
  • Olecranon Fractures: Olecranon fractures are injuries to the prominent bone over the back of the elbow. Injuries to this bone can be difficult to differentiate from normal growth plate appearances, so often x-rays of both elbows are obtained for comparison.
  • Splints
    Splinting is the treatment for many elbow fractures, especially those that have minimal displacement (are not out of place). A splint is also commonly used when there is suspicion of an elbow fracture but with normal x-rays.In the case of normal x-rays, a splint will be placed and your child will have new x-rays about a week after injury. The repeat x-rays often show signs of healing of the fracture.

    • Casts
      Casts are often used to treat elbow fractures, but not after the initial injury. More commonly the elbow will be splinted for a week, and a cast may be placed after the swelling has had time to subside.
    • Surgery
      Surgical options include:

      • Pins
        Pins are often used to stabilize the fracture in proper position. The pins are placed by an orthopedic surgery with your child under general anesthesia. The pins hold the fracture in proper position until sufficient healing has taken place, usually about 3 to 6 weeks. A small incision may be necessary to reposition the fracture and to protect the nerves around the elbow joint.
      • Screws
        In older children, sometimes a screw is used to hold the fracture in proper position. Pins are usually used in younger children, but in children who are approaching skeletal maturity a screw may be used instead.

    What are the long term complications of elbow fractures in children?
    Because the fractures are often around the growth plate, there is always a change of injury to the growth plate. This may cause early closure of the growth plate. This is uncommon, and the only way to tell is the growth plate is permanently injured is to watch the child over time.Other potential complications include restriction of motion of the elbow joint, damage to nerves and blood vessels around the elbow, and infection of the pins that are place into the elbow.

    Complications are unusual, but they do occur in a small percentage of patients. Your doctor will follow your child until fracture healing is complete, and then may ask for a follow-up to ensure growth and motion around the elbow is normal. The parent can also monitor the elbow joint and alert the doctor if there is suspicion of a problem after a fracture.

    For Appointment, please call +65 6471 2744 (24 Hours) or Email to: info@boneclinic.com.sg

Elbow Pain Tips and Prevention

Overuse or repeated pressure on the elbow joint can cause small tears to form in the soft tissue, particularly where the tendon anchors to bone. If a number of these tears occur over a period of time, they can cause pain and reduced movement of the elbow joint. Depending on the location and severity of the injury, full recovery can take months.

The most common type of elbow pain is known as ‘tennis elbow’. ‘Golfer’s elbow’ is a less common but similar overuse injury. Despite their names, these injuries can occur as a result of a range of physical activities – racquet sports, rowing, canoeing, weightlifting, hockey, wrestling, swimming – as well as repetitive work tasks undertaken in a variety of occupations.

The elbow joint
If you bend your arm, you can feel three bumps at your elbow joint. Injury to the tendons that anchor muscles to the two bumps on either side of the elbow are a common cause of elbow pain:

  • Lateral epicondyle (‘tennis elbow’) – the bump on the outer side of the elbow. The muscles on the back of your forearm, responsible for curling your wrist backwards, are anchored to this bony point. Pain in this bump is called lateral epicondylitis. This area is particularly susceptible to tennis elbow because it has a poor blood supply.
  • Medial epicondyle (‘golfer’s elbow’) – the bump on the inner side of the elbow. The muscles on the front of your forearm, responsible for curling your wrist up, are anchored to this bony point. Pain in this bump is called medial epicondylitis.

Symptoms
Some of the symptoms of elbow pain include:

  • Pain in the elbow joint, especially when straightening the arm
  • Dull ache when at rest
  • Pain when making a fist (medial epicondylitis)
  • Pain when opening the fingers (lateral epicondylitis)
  • Soreness around the affected elbow bump
  • Weak grip
  • Difficulties and pain when trying to grasp objects, especially with the arm stretched out.

A range of causes
Some of the many conditions and events that may contribute to elbow injuries include:

  • Lack of strength or flexibility in the forearm muscles
  • Lack of strength in the shoulder muscles
  • Instability of the elbow joint
  • Poor technique during sporting activities (especially tennis and golf) that puts too much strain on the elbow joint
  • Inappropriate sporting equipment, such as using a heavy tennis racquet or having the wrong sized grip on a tennis racquet or golf club
  • Repetitive movements of the hands and arms, such as working on an assembly line
  • Continuously making the muscles and joint take heavy loads
  • Other factors such as neck symptoms or nerve irritation.

First aid
Suggestions for first aid to elbow injuries include:

  • Stop whatever you are doing.
  • Rest your elbow for a few days.
  • Use icepacks every two hours, applied for 15 minutes.
  • Massage and stretch the muscles after 48 hours to relieve stress and tension.
  • See your doctor or physiotherapist for diagnosis and further treatment, if necessary
Prevention strategies
Ways to reduce the risk of elbow injury include:

  • Always warm up and cool down thoroughly when playing sport.
  • Make sure you use good technique and proper equipment when playing your chosen sports.
  • Do strengthening exercises with hand weights – your physiotherapist can prescribe the correct exercises for you.
  • Regularly stretch relevant muscles before beginning any potentially stressful activity. Your physiotherapist can prescribe the correct exercises for you.
  • Avoid or modify work tasks that put excessive pressure on muscles of the forearm or that include the use of fingers, wrists and forearms in repetitive work involving forceful movement, awkward postures and lack of rest.

Inflammation and rupture of the triceps tendon

What is the triceps tendon?

The triceps tendon is the one at the back of the upper arm – as shown opposite. It inserts into the back of the elbow. If you fall onto your hands you can rupture this tendon. If you over-do the weights or try to push something too heavy you can also rupture the tendon or it could become inflamed through over use.

Symptoms include:

  • Elbow pain at rest and during exercise.
  • A painful swelling on the back of the elbow.
  • Limited mobility in the elbow.

Treatment

  • Rest
  • Apply ice or cold therapyto the injury in the first two days.
  • See a sports injury professional for advice on treatment and rehabilitation.
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