Elbow Evaluation
History
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How did this injury occur?
When did you hurt your elbow?
Did you hear any sounds or feel a pop?
Have you ever hurt this elbow before?
Pain level and type of pain
Continue activity?
Observation
• Carrying angle
• Bilateral comparison of elbow (swelling,
deformity, discoloration)
• Observes how athlete carries themselves, or
move
Boney Palpation
• Humerus
▫ Medial Epicondyle – the boney protrusion of the distal
humerus on the medial aspect of the arm
▫ Lateral Epicondyle – the boney protrusion of the disal
humerus on the later aspect of the arm
▫ Olecranon fossa – a hollowed fossa at the distal end of
the posterior humerus which receives the olecranon
during elbow extension
• Radius (radical dude!)
• Ulna
▫ Olecranon – a large process at the proximal end of the
ulna which forms the point of the elbow
Soft Tissue Palpation
• Muscles
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Biceps Brachii (elbow flexion; palm up)
Triceps (elbow extension)
Brachioradialis (elbow flexion; thumbs up)
Brachialis (elbow flexion; palm down)
Wrist Flexors (Medial)
Wrist Extensors (Lateral)
• Ligaments
▫ Ulnar Collateral Ligament
▫ Radial Collateral Ligament
▫ Annular Ligament
• Nerves
▫ Ulnar Nerve
▫ Radial Nerve
ROM and MMT (manual muscle test)
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Flexion: 0-145 Degrees
Extension: 0-10 Degrees
Supination: 0-90 Degrees
Pronation: 0-90 Degrees
Wrist Flexion: 0-90 Degrees
Wrist Extension: 0-90 Degrees
Radial Deviation: 0-20 Degrees
Ulnar Deviation: 0-30 Degrees
Dermatomes and Myotomes
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C-5
C-6
C-7
C-8
T-1
Special Tests
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Valgus Stress Test
Varus Stress Test
Tinnel Sign
Forceful Hyperextension
Tennis Elbow Test
Little Leaguer’s Elbow
Injuries
• Little League Elbow/ Golfer’s Elbow~
▫ Strain of the Flexor-Pronator muscle group
▫ Often happens in younger kids participating in
little league
▫ Overuse injury
▫ Pain on the medial epicondyle
▫ Tx
 Increase strength by tubing exercises
 Wrist Flexors
 Increase flexibility by stretching
 Wrist Extensors
Tennis Elbow
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Strain of the Extensor-Supinator muscle group
Overuse injury
Pain on lateral epicondyle
Tx:
▫ Increase strength by tubing exercises
 Wrist Extensors
 Elbow Flexion (3way)
▫ Increase flexibility by stretching
 Wrist Flexors
Olecranon Bursitis
• Causes
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Trauma
Infection
Prolonged Pressure
Medical Conditions
 Rheumatoid Arthritis
 Gout
• Sx
▫ Redness / swelling and pain
▫ Decreased ROM
• Tx
▫ R.I.C.E.
▫ Anti-Inflammatory Drugs
▫ Padding of the elbow
Injuries Continued
• FX
▫ Olecranon Process
▫ Humerus
▫ Ulna/Radius
• Radial Collateral Ligament
▫ Varus Stress Test
▫ Pain in Lateral joint line
• Ulnar Collateral Ligament
▫ Valgus Stress Test
▫ Pain in Medial joint line