When dealing with an elbow injury it’s important to consider the mechanism of the injury.
This can be in the form of trauma, an injury caused by overuse, a fall onto an outstretched arm, or symptoms that occur gradually over time.
The location of pain with elbow injuries is key as the site of the pain often indicates the site of the injury.
Sounds such as a popping or snapping can indicate a rupture. An osteopath will also look for any sensations experienced by the patient such as pins and needles and numbness to discover any indication of nerve involvement or colour or pulse changes to indicate vascular involvement.
The osteopath will conduct a full examination of the affected elbow. This will include an observation to look for any obvious deformities, swelling or signs of trauma and/or injury. Your osteopath will also take the joint through full range of movement as well as applying some stress to the joint to test for the integrity of the supporting ligaments. Muscle specific tests can also be used to identify individual muscle and tendon involvement.
Your osteopath may provide a referral for imaging. X-rays are the most common imaging tool with elbow pain, especially if it’s been traumatic in onset. MRI scans are also used if there are signs of ligament or tendon injuries, loose bodies or osteochondral injuries.
Treatment depends on the type of injury that has occurred. In an acute setting for injuries such as soft tissue injuries, early mobilisation can be beneficial and should be encouraged as soon as possible. In the case of an injury such as a fracture or where surgery may be indicated, the injury should be fixed in an internal fixation position.
Rehab focusses on a few concepts:
Types of injuries include:
Elbow dislocations
This joint is the second most dislocated joint in the upper body with the type of dislocation being determined by which direction the trauma occurred. A dislocation will often occur when the person has fallen onto their outstretched arm. Pain, a popping sensation and visual deformity are common findings. Once the dislocation has been addressed it’s important to assess for any secondary injury to structures like nerves and ligaments etc. Additionally, x-rays are required in all cases of dislocation. Treatment involves an early reduction of the dislocation and a short period of immobilisation. Depending on the severity, a return to activity will generally be from one to six weeks.
Tendinopathy (Tennis elbow)
Common extensor origin tendinopathy and common flexor tendon origin tendinopathy (tennis elbow), are a common injury to the elbow joint. A tendinopathy is often related to overload from an increase in activity. It is described as activity related pain that has often developed over time. When advanced, the patient can feel pain at rest. There will often be tenderness at the site of the injury with muscle testing also provoking pain. Osteopaths will often make this diagnosis in the clinic but they can be aided by the use of MRI’s and ultrasounds. Your osteopath will approach your tennis elbow treatment as follows: education, load management and strengthening.
Tendon ruptures
A rupture of the various tendons at the elbow is another common injury. These often follow a trauma and the patient will notice a popping noise followed by significant bruising. With a rupture the tendon may not always be palpable. Muscle weakness will be apparent though. In the event of a rupture, surgery is often indicated followed by a period of immobilisation before rehabilitation begins.
Fractures
Like ruptures, a fracture will often occur from a traumatic event, such as a fall. The presentation will likely include local tenderness and significant swelling. A period of immobilisation is needed to facilitate treatment.
Osteolink will be able to assess and develop their clinical diagnosis and help you decide on the appropriate course of action. Rehabilitation is essential in the injuries mentioned and your osteopath will be able to devise a plan that will to decrease your pain and improve your movement.
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