The elbow is a hinge joint made up of 3 bones – humerus, radius and ulna. The bones are held together by ligaments to provide stability to the joint. Muscles and tendons move the bones around each other and help in performing various activities. Elbow dislocation occurs when the bones that make up the joint are forced out of alignment.
Elbow dislocations usually occur when a person falls onto an outstretched hand. Elbow dislocations can also occur from any traumatic injury such as motor vehicle accidents. When the elbow is dislocated you may have severe pain, swelling, and lack of ability to bend your arm. Sometimes you cannot feel your hand, or may have no pulse in your wrist because arteries and nerves run along your elbow may be injured.
To diagnose elbow dislocation your doctor will examine your arm. Your doctor will check the pulses at the wrist and will evaluate the circulation to the arm. An X-ray is necessary to determine if there is a break in the bone. An arteriogram, an x-ray of your artery can be helpful to know if the artery is injured.
An elbow dislocation is a serious injury and therefore requires immediate medical attention. At home, you may apply an ice pack to the elbow to ease pain and swelling. However it is important to see your doctor for help. You can also check if the arteries and nerves are injured or remain intact. You can feel your pulse by pressing tips of your fingers at the base of your wrist. They should turn white or blanch and a pink color should come back in 3 seconds. To check for nerves, first bend your wrist up and move your fingers apart and then touch your thumb to your little finger. You can also check for numbness all over your hand and arm. If you have problem with any of these tests you need to see your doctor right away.
You doctor will put your dislocated elbow back in place by pulling down your wrist and levering your elbow. This procedure is known as reduction. As it is a painful procedure you may be given medications to relieve your pain before the procedure. After the reduction you may have to wear a splint to immobilize your arm at the elbow. After few days you may also need to do gentle motion exercises to improve the range of motion and strength.
Elbow dislocations may be prevented if you avoid falling on outstretched arm or avoid situations that may cause falls such as walking at night or walking on slippery floors.
Golfer’s elbow, also called Medial Epicondylitis, is a painful condition occurring from repeated muscle contractions in the forearm that leads to inflammation and micro tears in the tendons that attach to the medial epicondyle. The medial epicondyle is the bony prominence that is felt on the inside of the elbow.
Golfer’s elbow and Tennis Elbow are similar except that Golfer’s elbow occurs on the inside of the elbow and Tennis Elbow occurs on the outside of the elbow. Both conditions are a type of Tendonitis which literally means “inflammation of the tendons”.
Signs and symptoms
Signs and symptoms of Golfer’s Elbow can include the following:
- Elbow pain that appears suddenly or gradually
- Achy pain to the inner side of the elbow during activity
- Elbow stiffness with decreased range of motion
- Pain may radiate to the inner forearm, hand or wrist
- Weakened grip
- Pain worsens with gripping objects
- Pain is exacerbated in the elbow when the wrist is flexed or bent forward toward the forearm
Golfer’s Elbow is usually caused by overuse of the forearm muscles and tendons that control wrist and finger movement but may also be caused by direct trauma such as with a fall, car accident, or work injury.
Golfer’s elbow is commonly seen in golfer’s, hence the name, especially when poor technique or unsuitable equipment is used when hitting the ball. Other common causes include any activity that requires repetitive motion of the forearm such as: painting, hammering, typing, raking, pitching sports, gardening, shoveling, fencing, and playing golf.
Golfer’s Elbow should be evaluated by an Orthopaedic specialist for proper diagnosis and treatment.
- Medical History
- Physical Examination
- Your physician may order an x-ray to rule out a fracture or arthritis as the cause of your pain.
- Occasionally, if the diagnosis is unclear, your physician may order further tests to confirm golfer’s elbow such as MRI, ultrasonography, and injection test
Conservative Treatment Options
Your physician will recommend conservative treatment options to treat the symptoms associated with Golfer’s Elbow. These may include the following:
- Activity Restrictions: Limit use and rest the arm from activities that worsen symptoms
- Orthotics: Splints or braces may be ordered to decrease stress on the injured tissues
- Ice: Ice packs applied to the injury will help diminish swelling and pain. Ice should be applied over a towel to the affected area for 20 minutes four times a day for a couple days. Never place ice directly over the skin
- Medications: Anti-inflammatory medications and/or steroid injections may be ordered to treat the pain and swelling
- Occupational Therapy: OT may be ordered for strengthening and stretching exercises to the forearm once your symptoms have decreased
- Pulsed Ultrasound: A non-invasive treatment used by therapists to break up scar tissue and increase blood flow to the injured tendons to promote healing
- Professional instruction: Consulting with a sports professional to assess and instruct in proper swing technique and appropriate equipment may be recommended to prevent recurrence
If conservative treatment options fail to resolve the condition and symptoms persist for 6 -12 months, your surgeon may recommend surgery to treat Golfers Elbow. The goal of surgery to treat Golfers Elbow is to remove the diseased tissue around the inner elbow, improve blood supply to the area to promote healing, and alleviate the patient’s symptoms.