Many of us, especially athletes, will have elbow pain at some point in our lives. Even though it is a stable joint, we use it constantly throughout the day for tasks as simple as typing at a desktop. Sports injuries are also common when it comes to our elbows, especially for tennis players, pitchers, weightlifters, and other athletes who overuse their arm while training. Union County Orthopaedic Group helps people get back to the activities they love, whether it be lifting their children or serving a tennis ball, without elbow pain.
Richard P. Mackessy, MD, Christopher Ropiak, MD, and Mina Abdelshahed, MD all specialize in surgical and non-surgical treatment of the elbow. Each have years of experience helping patients in the Union County and Northern New Jersey area manage painful elbow symptoms as well as overcome major sports injuries with surgery.
Conditions and Injuries of the Elbow:
- Ulnar Nerve Entrapment
- Cubital Tunnel Syndrome
- Ulnar Collateral Ligament Tear
- Biceps Tendon Tear
- Elbow Instability
- Elbow Fracture/Sprain
- Golfer’s Elbow (Medial Epicondylitis)
- Olecranon Bursitis
- Osteochondritis Dissecans
- Tennis Elbow (Lateral Epicondylitis)
Treatments for the Elbow:
- Elbow Arthroscopy
- Tendon Repair
- Ligament Reconstruction
Anatomy of the Elbow:
Our elbow joint is actually made up of three different joints formed by the two bones in our forearm, the radius and ulna, and our upper arm bone, the humerus. The main joint is a simple hinge structure that allows us to bend and flex our arms at the elbow. The end of the ulna, the larger of our two forearm bones, forms a shallow cups that the rounded head of the humerus sits on to form the hinge. The humerus also has two bony protrusions known as the medial and lateral epicondyles. These epicondyles are the bumps you feel at the side and at the point of your elbow.
The radius sits outside the main joint, forming a small cup under the capitulum, or the bony portion of the humerus that makes the point of our elbow. This second joint is responsible for turning our forearm so that our palm faces up or down, movements called supination and pronation.
The third joint exists between the radius and ulna. It is a pivot joint that also allows us to rotate our arm. All of these joints are enclosed in a joint capsule, formed by ligaments. The capsule is filled with synovial fluid to help lubricate the joint as it moves. The head of the radius, ulna, and humerus is lined with a rubbery, smooth tissue called articular cartilage. This helps the joint glide smoothly while in motion, protecting the bones from damage as they rub against each other. The whole elbow structure is stabilized and made functional with the help of ligaments, tendons, and muscles.
Three main ligaments hold the elbow joint together and keep it stable as we move our arms. These are also the ligaments most often injured due to overuse.
The medial or ulnar collateral ligament begins at the medial epicondyle, passes over the inside of the elbow joint, and splits into two triangular bands. The anterior band attaches to the top of the ulna, known as the Coranoid process, while the posterior band attaches to the posterior end of the ulna, or Olecranon process. This ligament is often injured from overhead actions like pitching.
The lateral or radial collateral ligament attaches the lateral epicondyle to the annular ligament. This annular ligament encompasses the head of the radius and ulnar bones, holding them tightly together. These ligaments can tear during elbow dislocations.
Tendons and Muscles
Tendons attach muscle to bone, allowing us to move our arm at the elbow joint. The main tendons that cross the elbow are the culprit of some of the most common elbow injuries, such as tennis elbow, golfer’s elbow, and other cases of tendonitis.
Tendonitis most frequently affects the tendons that attach our forearm muscles to the medial and lateral epicondyles, those bony protrusions on the humerus. The extensor tendons, especially the Extensor Carpi Radialis Brevis, are short but tough fibrous bands of tissue that hold the ECRB muscle and other extensor muscles of the forearm to the epicondyles. These muscles bend our wrists and move our fingers, which is why simple tasks like gripping, typing, or writing can often lead to inflammation, or tendonitis, in the extensor tendons.
Different tendons and muscles help us bend, flex, and rotate our arms at the elbow. The biceps muscle allows us to bend our elbow, while the triceps muscle straightens the arm forcefully, such as when you perform a push up. The biceps tendon connects the bicep to the front of the radius bone while the triceps tendon attaches the tricep to the back of the ulna.
The main nerves in our arm originate from the shoulder and run through tunnels across our elbow and down to our wrist and hands. Since we bend our elbow constantly, the radial, medial, and ulnar nerves can easily become irritated as they are compressed against the walls of their tunnels, causing pain and other neuromuscular issues. Since these nerves are mainly responsible for providing sensation to the hand and fingers, nerve issues occurring at the elbow may be felt as numbness, tingling, or pain in your hands or wrists.