An injury that everyone has probably heard of is the so-called “tennis elbow“. Although it bears that name, it does not happen only in tennis; it is a common occurrence in people who work a lot with their hands or use their forearms (fitters when using screwdrivers or even waiters when opening bottles of wine). In fact, it is not an injury in the full sense of the word but rather an overload syndrome.
The pain is most common on the outside of the elbow in the area of the protuberance called the epicondyle (hence the Latin name lateral epicondylitis), from which the group of muscles that raise the hand and fingers (extensors) originate. Excessive use of the mentioned muscle group leads to inflammation of the “grip” thereof, which is manifested by characteristic pain, and later by a decrease in muscle strength.
Analogous to epicondylitis, on the inside of the elbow there is also a bony protrusion (medial epicondyle or epitrochlea) on which another group of forearm musculature attaches, namely the one that bends the hand towards the forearm – the flexor group. The grip of this group is susceptible to inflammation, but it manifests less often.
In most cases, the treatment is relatively simple – you can massage the painful part with ice and anti-inflammatory cream several times a day; it is mandatory to use a brace in the form of an elbow strap, which is used to rest the inflamed grip. Physical therapy is also indispensable, which significantly speeds up healing. In case of stubborn changes, the inflamed area can be infiltrated with a stronger anti-inflammatory drug up to a maximum of 3 infiltrations. In the event that the above does not help, surgical treatment is required.
The next frequent question is: “Doctor, a ‘bump’ has popped out on my elbow.” In the back of the elbow, following its prolonged pressure on a surface (e.g. by ceramicists) or after a fall, a swelling appears that can be the size of a plum and filled with liquid content. It is an inflammation of the mucous sac located above the olecranon (bony protrusion on the back of the ulna), which fills with inflammatory exudate. However, there is no reason to worry because the treatment is simple – puncture and removal of fluid followed by the use of an elastic bandage and cold compresses for several days.
In sports such as handball, water polo, tennis or volleyball, elbow ligaments are often injured, i.e. stretched, when trying to shoot or when cushioning strong serves. The condition is extremely painful and disabling and prevents the continuation of sports activities. It is necessary to apply ice and functional immobilization with braces, which prevent harmful movements and thus prevent pain. Physical therapy is also a must, as well as rest from specific hand activities for a certain period of time, depending on how the condition develops.
Elbow trauma. The elbow often pops out (luxations), which requires the help of a physician. After returning the elbow joint to its original position, immobilization is necessary, the aim of which is to ensure tissue healing. After removing it, a good physical therapy treatment is mandatory, the goal of which is to restore the appropriate range of motion to the elbow as well as the strength of the adjacent musculature.
Elbow fractures are extremely serious injuries. Quite often after these, elbow contracture of a weaker or stronger degree occurs, which brings a significant degree of work or sports incapacity. Fractures must therefore be treated immediately and in appropriate institutions with experience. Long-term physical therapy is mandatory after surgery.
Finally, it is necessary to mention degenerative processes – such as elbow arthrosis. It’s usually caused by excessive use in the aforementioned sports and martial arts. Due to long-term microtraumas, the process of cartilage damage and the appearance of protracted inflammatory processes occur. The aforementioned causes result in contractures due to the thickening and shortening of the spherical capsule, but also due to the appearance of bony outgrowths (osteophytes), each of which reduces movement in its own way. There is also a frequent occurrence of free articular bodies that travel through the joint and in some movements get caught between the articular bodies, causing pain and the “locking” of the elbow.
It is best to prevent degenerative changes before they occur, preferably by preventing excessive injuries. If they do develop, the first possible surgery is elbow arthroscopy – with which we are able to “clean” the joint from broken pieces of cartilage or loose bodies, remove osteophytes and calcifications in and around the joint, and restore mobility to the said joint. At the end of the treatment spectrum for degenerative changes comes the replacement of the elbow joint with an endoprosthesis – in case of considerable pain and advanced degenerative processes.