ESS 303 – Biomechanics
Elbow & Wrist
Anterior View
3
2
Middle
phalanx
1
Posterior View
4
5
The Elbow Joint
Articulation between humerus and ulna
Flexion: limited by coronoid fossa and
coronoid process contact
Extension: limited by olecranon fossa
and olecranon process contact
Stable compared to shoulder – bony
structure
Head of radius moves along capitulum
Radioulnar Joint
3 articulations
Proximal or superior (by the elbow joint)
Middle
Distal or inferior (by the wrist joint)
Bony arrangements give virtually no
stability – ligament support
Movements: pronation and supination
The Wrist Joint
Technically 2 joints
Proximal or radiocarpal
Ellipsoidal
 Flexion
 Extension
 Abduction (radial flexion or
radial deviation)
 Adduction (ulnar flexion or
ulnar deviation)
 Circumduction
Distal radiocarpal or
midcarpal joint
The Wrist Joint
The primary function of
the wrist muscles is to
provide a stable base for
the hand, while
permitting postural
adjustments that provide
optimal length-tension in
the long finger muscles
Tennis Elbow and Carpal Tunnel
Syndrome (CTS)
Tennis Elbow
Tennis Elbow
 Lateral epicondylitis
 Wrist extensors attach to a single tendon at
the lateral epicondyle of the humerus
 May be caused by any activity in which you
grasp an object while your wrist is extended or
by lifting heavy objects with your elbow locked
and your arm extended
 Common in people over 30. Most common in
Caucasian men 30 to 60 years old who work
with their hands
Tennis Elbow – RX
Rest (or stop) until the pain disappears
Massage
Exercise to strengthen and prevent reinjury
Warm up & stretching before activity
Take frequent breaks
Medical: Anti-inflammatory drugs and
surgery
CTS
Median Nerve
Transverse
Carpal Ligament
CTS Basics
 The carpal tunnel is a bony canal within the
palm side aspect of the wrist that allows for the
passage of the median nerve to the hand
 Pinching or compression of the median nerve
(compression neuropathy) by the transverse
carpal ligament sets into motion a
progressively crippling disorder which
eventually results in wrist pain, numbness and
tingling in the hand, pain consisting of a “pins
and needles” feeling at night, weakness in grip
and loss of coordination
Who Gets CTS?
Women more than men – ratio of 3 to 1
Usually between the ages of 30 and 50
Seen more frequently in people who tend
to do forceful repetitive types of work,
such as grocery store checkers,
assembly line workers, meat packers,
typist, accountants, writers, etc.
CTS - RX
 Early stage: modification in activities, a
removable wrist brace, and anti-inflammatory
medicines
 Moderate stages, especially if numbness
and pain continues: cortisone injection into
the carpal tunnel or surgery (if other
treatments have failed)
 Advanced stages, especially with profound
weakness or muscle atrophy: surgery
 Untreated can cause permanent nerve
damage
Movements and Major Muscles
Elbow
Flexion: biceps brachii, brachialis &
brachioradialis
Extension: triceps brachii & anoneus
Radioulnar
Pronation: pronator quadratus
Supination: supinator
Movements and Major Muscles
 Wrist
 Flexion: flexor carpi radialis, flexor carpi unlaris,
pulmaris longus, flexor digitorum superficialis &
flexor digitorum profundus
 Extension: extensor carpi radialis longus, extensor
carpi radialis brevis & extensor carpi unlaris
 Abduction (also called radial deviation or radial
flexion): flexor carpi radialis
 Adduction (also called ulnar deviation or ulnar
flexion): flexor carpi unlaris
 Circumduction: combination of above