Elbow, Wrist,

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Elbow, Wrist, Hand Injuries
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Elbow Anatomy

• Hinge Joint- Moves in flexion and extension
• 3 Bones Humerus, radius and ulna
• Radius allows the forearm to pronate and supinate

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Ligaments of the Elbow

• Radial Collateral Ligament

• Ulnar Collateral Ligament

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Anatomy Cont.

• Muscles
• Triceps perform elbow extension
• Biceps perform elbow flexion
• Wrist flexors attach to the medial epicondyle of
  the humerus and run toward the hand and perform
  flexion of the wrist
• Wrist extensors attach the lateral epicondyle of
  the humerus and run toward the hand and perform
  extension of the wrist.

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Muscles of the Elbow
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Treating Elbow Injuries

• Ulnar Collateral Lig. Sprain
• More prone to sprains than other ligaments of the
  elbow
• Caused by repetitive movements
• Caused by a direct blow
• Signs Symptoms
• Medial elbow pain
• Swelling
• Treatment
• RICE
• Moderate or Severe may need to be splinted
• Strengthen wrist flexors

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Treating Elbow Injuries

• Radial Collateral Lig. Sprains
• Signs Symptoms
• Same as ulnar except for pain is on the lateral
  side
• Treatment
• Same as UCL
• Strengthen wrist extensors

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Muscle and Tendon Injuries Most often caused by
either excessive resistive forces or overuse
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Common Injuries
Lateral epicondylitis Tennis Elbow
Mechanism of Injury Signs and Symptoms Treatment Prevention Strategies
Repetitive extension of the wrist. Aching pain in lateral elbow during and after activity. RICE, anti-inflammatory medications, strengthening exercises. Proper technique, progressive increase in frequency/intensity of training.
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Common Injuries
Medial epicondylitis Little Leaguers or
Golfers Elbow
Mechanism of Injury Signs and Symptoms Treatment Prevention Strategies
Repetitive flexion of the wrist. Pain in medial elbow, could radiate down arm point tenderness, mild swelling. RICE, anti-inflammatory medications, strengthening exercises Proper technique, progressive increase in frequency/intensity of training.
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Review!
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Wrist and Hand Anatomy

• Radius
• Ulna
• 8 Carpal bones
• 5 Metacarpal bones
• 14 Phalanges

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Wrist and Hand Joints

• Metacarpal Phalengeal
• MCP
• Thumb
• Interphalengeal
• PIP
• DIP

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Common Injuries
Interphalengeal Dislocation
Mechanism of Injury Signs and Symptoms Treatment
Blow to the tip of the finger. Pain, deformity, no ROM. Splint in position found, immediate referral to a physician.
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Taping Injuries of Wrist Hand
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Prophylactic Wrist Taping (Circular)

• First apply pre-wrap below the wrist joint,
  around the wrist, and the heel of the hand.
• Make sure that you keep the fingers spread and
  hand flat while applying the tape.
• Place the first strip of tape just below the
  wrist joint, pulling the tape in a circle around
  the wrist, from the outside toward the inside of
  the arm. 
• Apply 3 4 additional strips moving up the wrist
  toward the hand.  Each strip should overlap about
  half of the strip before it.
• For additional support, continue back down the
  wrist in the same pattern.

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Prophylactic Wrist Taping (Figure 8 Through
the hand)
This tape job can provide slightly more support
than the basic circular, and also provides more
of a limit on the wrists range of motion.  It
works well for mild sprains and provides extra
support.

• Complete steps 1-4 of Prophylactic Wrist taping
  (Circular).
• The next strip should start on the first strip,
  and cross over the back of the hand, then
  continue through the space between the thumb and
  finger, the across the palm.  It may help to fold
  the tape when it crosses the thumb web to make it
  more comfortable. 
• Continue pulling the same strip of tape back
  across the back of the hand and back to the point
  of the wrist where the strip started. 
• Repeat this pattern 3 or 4 times, making the next
  strip of tape overlaps half of the previous strip.

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Prophylactic Wrist Taping (Figure 8 Through
the hand)

1. Apply 3 4 additional strips moving up and down
   the wrist toward the hand.  Each strip should
   overlap about half of the strip before it.
2. The addition of a fan or checkrein may provide
   additional support and limitation of movement.
3. The tape should allow the thumb and fingers to
   move freely, and only restrict movement of the
   wrist. 

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Prophylactic Thumb Taping

1. The athlete should fully extend and adduct the
   fingers while keeping the thumb in a relaxed,
   neutral position (as if holding a can). The
   taper should stand in front of the athletes
   thumb
2. Apply pre-wrap to the hand and wrist.
3. Place an anchor strip around the base of the
   wrist. Add another 2/3 strip anchor attaching
   from the wrist anchor to the back of the hand
   between the thumb and pointer finger to the palm
   side attaching to the wrist anchor.

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Prophylactic Thumb Taping

• Add a series of three spica strips. The first
  spica is started on the radial side at the base
  of the thumb and carried under the thumb,
  completely encircling it, and then crossing to
  the starting point. The strip should continue
  around the wrist and finish at the starting
  point. Each of the following spica strips should
  overlap the preceding strip by at least 2/3 inch
  and move downward on the thumb.

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Prophylactic Thumb Taping

1. Apply C-strips starting at base of thumb, apply
   tape from dorsal side of hand around the base of
   thumb to the palmer side to the hand. Each of the
   following strips should overlap the preceding
   strip by at least 2/3 and move upward on the
   thumb.
2. Secure the open ends of the C strips by the
   single strip of tape through the hand. Apply
   anchor strip around the wrist.

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Questions?

• Everyone Practice
• Remember to have partners sign-off your lab
  skill sheets