Common elbow injuries in sport

• Published in: Sports medicine (Auckland) Vol. 26; no. 3; pp. 193 - 205
• Main Authors: FIELD, L. D, SAVOIE, F. H
• Format: Journal Article
• Language: English
• Published: Chester Adis International 01-09-1998; Hong Kong; Auckland
• Subjects: Athletic Injuries - diagnosis; Athletic Injuries - therapy; Biological and medical sciences; Collateral Ligaments - injuries; Cumulative Trauma Disorders - etiology; Diagnosis, Differential; Elbow Joint - injuries; Glucocorticoids - therapeutic use; Humans; Injuries of the limb. Injuries of the spine; Medical sciences; Osteochondritis Dissecans - diagnosis; Tennis Elbow - diagnosis; Tennis Elbow - therapy; Traumas. Diseases due to physical agents; Juxtaarticular disease; Human; Treatment; Lateral; Diseases of the osteoarticular system; Diagnosis; Athlete; Elbow; Trauma; Sports medicine; Epicondylitis
• ISSN: 0112-1642; 1179-2035
• DOI: 10.2165/00007256-199826030-00005

Athletes of all ages and skill levels are increasingly participating in sports involving overhead arm motions, making elbow injuries more common. Among these injuries is lateral epicondylitis, which occurs in over 50% of athletes using overhead arm motions. Lateral epicondylitis is characterised by pain in the area where the common extensor muscles meet the lateral humeral epicondyle. The onset of this pathological condition begins with the excessive use of the wrist extensor musculature. Repetitive microtraumatic injury can lead to mucinoid degeneration of the extensor origin and subsequent failure of the tendon. Lateral epicondylitis can almost always be treated nonoperatively with activity modification and specific exercises. If the athlete fails to respond to nonoperative treatment after 6 months to 1 year, they are candidates for surgical intervention. Medial epicondylitis is characterised by pain and tenderness at the flexor-pronator tendinous origin with pathology commonly being located at the interface between the pronator teres and flexor carpi radialis origin. Golfers and tennis players often develop this condition because of the repetitive valgus stress placed on the medial elbow soft tissues. Careful evaluation is important to differentiate medial epicondylitis from other causes of medial elbow pain. As with lateral epicondylitis, patients with medial epicondylitis not responding to an extensive nonoperative programme are candidates for surgical intervention. A less common cause of medial elbow pain is medial ulnar collateral ligament injury. Repetitive valgus stress placed on the joint can lead to microtraumatic injury and valgus instability. When the medial ulnar collateral ligament is disrupted, abnormal stress is placed on the articular surfaces that can lead to degenerative changes with osteophyte formation. As with other elbow injuries, a strict rehabilitation regimen is first employed; ligament reconstruction is only recommended if the injury fails to improve and only in athletes requiring a high level of performance. Excessive valgus stress can also lead to posteromedial olecranon impingement on the olecranon fossa producing pain, osteophyte and loose body formation. Arthroscopic elbow debridement can often be helpful in improving motion and in reducing pain in such patients.