The elbow joint is a synovial joint that has its articulation with three bones the ulna and radius distally and the humerus proximally. A synovial joint are free moveable joints that are lubricated by synovial fluid the elbow joint is a hinge joint and acts in only one plane. The joint articulations that form with the three bones include the Humeroulnar joint which is between the trochlea on the humerus and the trochlear notch on the proximal ulna. The other joint is the Humeroradial joint which is between capitulum on the lateral side of the humerus that connects with the head of the radius. The last joint articulation is the Proximal Radioulnar joint that is both proximal ends of radius and ulna connect with each other.
Movements of the Elbow
There are 2 main movements of the elbow joint that are assisted by the muscles surrounding the structure. There are also 2 other movements that contribute to elbow movements that occur at the Proximal Radioulnar Joint.
Flexion – This involves decreasing the angle between the forearm and arm. In flexion the muscles of the anterior compartment of the arm are being activated there are two muscles in particular that assist in elbow joint flexion. The Biceps Brachii has two heads the Longhead which originates from the supraglenoid tubercle of the scapula and passes through the bicipital groove on the anterior aspect of the humerus and the Shorthead originates from the coracoid process of the scapula they join together to form the biceps brachii. The insertion of the muscle is at the radial tuberosity. The other muscle that assists in flexion is the Brachialis which originates from the distal half of the anterior surface of the humerus and inserts into the tuberosity of the ulna. Other muscles that assist is the Brachioradialis which originates on the lateral aspect of the humerus just above the lateral epicondyle of the and inserts on the lateral aspect of the distal radius.
Extension – This is the increasing of the angle at the elbow to bring back the arm into anatomical position from its previously flexed position. There is only one muscle that is involved in extension and that is the Triceps Brachii. The Triceps Brachii has three heads The Longhead which originates at the infraglenoid tubercle of the scapula, The Lateral Head which originates at the lateral aspect of the humerus above the radial groove and The Medial Head which originates from the medial aspect of the humerus just below the radial groove. Each of these heads converge into one and insert at the olecranon process of the ulna posteriorly.
Pronation and Supination – These rotational movements occur at the distal end towards the wrist when the radius moves over the ulna. Supination is the palm of the hand is facing up and Pronation is the rotation of the forearm when the palm is facing down. Your forearm is always pronated.
Ligaments of the Elbow Joint
Ulnar Collateral Ligament – This ligament extends from the medial epicondyle of the humerus to the coronoid process of the ulna it has three parts; the anterior, posterior and inferior bands.
Radial Collateral Ligament – This ligament is attached at the lower part of the lateral epicondyle of the humerus. The distal fibers blend with a ligament called the annular ligament which basically covers the head of the humerus as well as most of the extensor muscles.
The Annular Ligament – This ligament reinforces the proximal radioulnar joint. There is one last ligament know as the quadrate ligament that maintains the joint during pronation and supination movements.
Injuries of the Elbow Joint
Signs and Symptoms – You will notice a large goose egg swelling on the olecranon with the following symptoms of Swelling, Heat, Altered Function, Redness and Pain or more commonly know as the SHARP symptom. You will notice a decrease in ROM and due to that is because there has been a calcification or blood that has occurred in the bursa in the elbow. Some treatments include Pressure, Ice, Elevate, Rest (PIER Principle), Aspiration or surgery.
Lateral Epicondylitis (Tennis Elbow)
This is the inflammation at the origin of the tendons of the forearm extensor muscles or supinator muscle. The most common affected muscle is the Extensor Carpi Radialis Brevis. Some signs and symptoms include decreased wrist flexibility, pain with gripping and calcium deposits. Treatment includes PIER, manual therapy Breakdown of scar tissue, increasing ROM and Muscle flexibility through manual therapy, and taping or bracing.
Medial Epicondylitis (Golfers Elbow)
This is a lesion of the common flexor tendon at the medial epicondyle of the humerus some signs and symptoms are similar to those of lateral epicondylitis but it occurs on the medial side the involved muscles are Pronator Teres and Flexor Carpi Radialis.
It is possible to damage the Ulnar Collateral Ligament and tear it, these types of tears are common in those who play sports where they are throwing objects constantly.
How does Physiotherapy Help in Elbow Injuries?
Treatment for Elbow Injuries at Curezone Physiotherapy
Your physiotherapist in Mississauga may apply ice and electrical stimulation to ease pain and improve healing of the muscle fibres. Our physiotherapy sessions may also include some techniques that can help in healing in a chronic tennis elbow are:
- Manual Therapy
Your Physiotherapist may use hands-on tissue manipulation techniques to create a small amount of micro-trauma to the area to re-start the inflammation process.
- Shock Wave Therapy and Laser Therapy
- Ultrasound treatment
- Electric therapy
- Specific exercises that have a goal of stressing the tissue to just beyond its current capability can be used as a pro-inflammatory technique.
Ways to strengthen the Elbow Joint
- Wall Bicep Stretch
- Wrist Flexion and Extension Stretch
- Grip Strengthening exercises
- Prayer Stretch/Reverse Prayer Stretch
- Any Elbow range of motion
Exercises (Can be done with any weight comfortable to the patient)
- Barbell Curl
- Goblet Curl
- Overhead Triceps Extension
- Wrist Curls or Supination exercises
Make sure you book your appointment today and get assessed by our physiotherapist now.