Elbow joint is a very important joint in the upper extremity in that it provides a great deal of motion within the arm. This is very important in many activities of daily living, like eating, drinking, hygiene, dressing, grooming, hugging, sporting and many more.
In order to understand elbow joint and treat elbow pain successful we need to know its anatomy. Elbow joint comprises of three bones namely; humerus the arm bone, the ulna and radial, the two forearm bones.
The ulna is situated on the inside of the joint and forms a cup shape which allows articulation with the Humerus. The radius is the smaller of the two forearm bones and sits on the outside of the joint. The radial head is round and again cup-shaped to allow it to move around the wide base known as the capitulum of the humerus. This can be seen in the below picture.
There are three joints in elbow namely: first Humeroulna joint is the joint between humeral and ulnar bone. It allows bending and straightens of the elbow. The second joint is Humeroradial; this is the joint between humeral and radial bones. It also allows bending and straightens of the elbow joint and allows turn up and down of the palm. The third joint is the Radioulnar is the joint between the Radial and Ulna bone it allows turn up and turns down of the palm.
The elbow joint is hold together by ligaments and muscles.
Ligaments of elbow are: Lateral Collateral ligament, Medial Collateral ligament and Annular ligament.
Muscles of the elbow are: Biceps muscle, this muscle crosses both the shoulder joint and elbow joint. It bends elbow and shoulder joint and turn up the palm. Triceps muscle, this muscle straighten the elbow joint. Brachialis muscle bends the elbow joint when palm is turn down. Brachioradialis muscle bends elbow and also assist in turning up and down the palm. Pronator Teres muscle bends elbow and assist in turning down the palm. Extensor carpi radialis brevis muscle; this is the last elbow muscle its help in straightening the elbow and bends the wrist up.
CAUSES OF ELBOW PAIN
Causes of the elbow pain includes the following; Inflammation of elbow muscles, inflammation of elbow ligaments, irritation of the elbow bones, over use of the elbow joint, repetitive movement of elbow joint, dislocation of elbow joint, subluxation of the elbow joint, trauma to the elbow joint, shoulder pain, neck pain and nerve entrapment.
These are common diagnosis of the elbow joint pain: Tennis elbow, golf elbow, tendinitis, bursitis, strain/sprain, dislocation, and subluxation.
Treatment of the elbow pain can be medication, physical and surgery, if the medication and physical treatment fail or has no role to play. In this writing, I am going to only discuss the physical treatment.
The successful Physical treatments of the elbow pain depend on the cause of the pain and understanding of the treating provider/Therapist based on the result of the examinations. The following are some treatment suggestions:
- Therapeutic exercise (strengthening technique if the cause of the pain is the muscle imbalance and stretching if the cause is fascia restriction, range of motion limitation, or abnormal elbow angle.) in order to promote healing.
- Ultrasound with continuous mode can be used if the pain area is localized or pulse mode of ultrasound to promote healing.
- Soft tissue mobilization can be utilized on the muscle to release fascia restriction, increase neurovascular bundle motility, increase circulation and improve normal muscle fiber length and promote healing.
- Myofascial release also can be used to increase arthrokinematic of the joint, increase neurovascular bundle motility, increase circulation, release fascia restriction, reduce pain and promote healing.
- Application of ice or contrast bath, if the condition is acute or inflammatory stage to reduce inflammation and heat if condition is not at acute stage. These treatment procedures promote healing.