Elbow pain and injuries
Specialized care for epicondylitis, bursitis, and elbow injuries
Lateral epicondylitis
What is lateral epicondylitis?
Lateral epicondylitis, also known as tennis elbow, is a condition that affects the tendons on the outer side of the elbow. These tendons, which connect muscles to bones, play a key role in the extension of the wrist and fingers. Excessive strain or repetitive movements can lead to progressive wear of the tendons, causing pain and inflammation.
What are the symptoms?
People with this condition typically experience sharp pain on the outer part of the elbow, specifically at the lateral epicondyle. This area may be sensitive to touch and cause discomfort during movements involving the wrist or forearm. A loss of muscle strength is also common, making simple tasks like holding an object, shaking hands, or lifting a cup of coffee difficult.
What are the causes of lateral epicondylitis?
Although often associated with tennis, this condition can affect anyone who performs repetitive movements that heavily strain the forearm and wrist. Manual workers, athletes, and regular users of tools or computer equipment are particularly at risk. This condition most commonly occurs in adults aged 30 to 60, but it can affect other age groups as well.
How is lateral epicondylitis treated?
The treatment for lateral epicondylitis primarily involves non-surgical methods. This includes rest, anti-inflammatory medications, and physical or occupational therapy. If conservative treatments fail or if the pain becomes too disabling, surgical intervention may be considered.
Comprehensive approach for elbow rehabilitation
The importance of physical therapy and occupational therapy
A physical therapist or occupational therapist with expertise in hand therapy will offer treatments tailored to your condition, such as the use of a custom-made splint to limit strain on the affected tendon, kinesiology taping, stretching and strengthening exercises, heat or cold application, massages, and ergonomic adjustments to your daily activities.
Post-surgical rehabilitation and recovery
If surgery is required, a rehabilitation program is essential to regain full mobility and adequate strength. Recovery time typically ranges from three to six months, depending on the severity of the condition and the patient’s commitment to their rehabilitation program.
Medial epicondylitis
What is medial epicondylitis?
Medial epicondylitis, also known as “golfer’s elbow,” is a painful condition located on the inner side of the elbow. It involves damage to the tendons that allow the wrist and fingers to flex, as well as rotate the palm downward. This condition is caused by repetitive movements that can weaken and inflame these tendons.
What are the symptoms?
- Pain and a burning sensation on the inner side of the elbow
- Weakness in the forearm, wrist, and hand
- Tenderness to the touch just above or below the medial epicondyle (the bony bump on the inner side of the elbow)
- Stiffness in the forearm
- Difficulty performing daily activities involving wrist flexion or gripping objects
What are the causes and risk factors?
Contrary to what its name suggests, this condition does not only affect golfers. Any activity involving repetitive wrist movements with the palm facing downward can lead to this condition. Activities and professions at risk include:
- Sports: golf, baseball (pitching), tennis, weightlifting
- Manual professions: painting, carpentry, gardening
- Daily activities: carrying a suitcase, playing the violin
Medial epicondylitis typically affects people aged 20 to 50, but it can occur at any age.
What are the treatments?
Treatment varies depending on the severity of the symptoms:
- Rest and activity modification: avoid movements that exacerbate the condition.
- Anti-inflammatory medications: to relieve pain.
- Wrist splint: to reduce strain on the tendons.
- Manual therapy and specific exercises: stretching, muscle strengthening.
- Corticosteroid injections: in certain cases of persistent pain.
- Surgery: as a last resort, if the pain persists after six months of conservative treatment.
What is the role of the hand therapist in recovery?
A physiotherapist or occupational therapist with expertise in hand therapy can help to:
- Identify and modify movements that cause pain
- Design a custom orthosis to reduce stress on the tendons
- Teach exercises to improve flexibility and strength
- Propose treatment modalities to reduce pain and promote recovery
If surgery is necessary, post-operative rehabilitation with a therapist is essential to regain strength and mobility. Early and appropriate care ensures optimal recovery and a return to activities without pain.
Fracture of the humerus
What is a humerus fracture?
The humerus is the long bone of the arm that connects the shoulder to the elbow. A humerus fracture occurs when excessive force causes the bone to break. It can affect different parts of the bone: the proximal region (near the shoulder), the diaphysis (central part), or the distal region (near the elbow).
What are the symptoms of a humerus fracture ?
Common symptoms include intense pain, swelling, bruising, and sometimes a visible deformity of the arm. Inability to move the joint normally, as well as a feeling of weakness or numbness, may also be present if nerves are affected.
What are the causes of humerus fractures?
Humerus fractures often occur following trauma, such as a fall on an outstretched arm, a car accident, or a direct impact. In older adults, osteoporosis increases the risk of fracture, even after minor trauma.
What are the treatments for humerus fractures?
Treatment depends on the type and severity of the fracture. In cases where the bone remains well-aligned, immobilization with a splint or cast may be sufficient. In the case of significant displacement or complex fractures, surgery may be required, involving the placement of plates, screws, or an intramedullary rod to stabilize the bone.
What is the role of the therapist in recovery?
A physiotherapist or occupational therapist plays a crucial role in rehabilitation after a humerus fracture. The treatment includes exercises aimed at restoring the mobility of the shoulder and elbow, strengthening muscles, and improving arm function. Proper rehabilitation helps reduce stiffness and accelerates recovery, making it easier to return to daily activities.
Fracture of the olecranon
What is an olecranon fracture?
The elbow joint is made up of three bones: the humerus (upper arm), the radius (thumb side), and the ulna (little finger side). The olecranon is part of the ulna and refers to the bony tip visible at the back of the elbow when it is bent. Since it is located directly under the skin, without significant muscular protection, it is particularly vulnerable to fractures.
What are the causes and risk factors?
- Fall directly onto the back of the elbow
- Direct impact against a hard object (e.g., car accident, violent blow)
- Fall with impact on the hand, transmitting a shock to the olecranon
What are the symptoms?
- Intense pain, worsened by elbow movements
- Swelling and bruising around the elbow
- A feeling of instability or the impression that the elbow could dislocate
- Possible numbness in the fingers (ring and little fingers)
What are the treatments?
Initial diagnosis and assessment
- An X-ray is performed to assess the extent of the fracture and the position of the bone fragments.
- The treatment depends on the degree of displacement of the fractured bone.
Possible treatments
- Immobilization: if the fracture is not displaced, a cast or splint is used to stabilize the elbow.
- Surgery: if the bone fragments are displaced, surgery is necessary to realign and fix the bone.
What is the role of the hand therapist in recovery?
The physiotherapist or hand occupational therapist intervenes based on the type of fracture and whether or not surgery is required. They collaborate with the doctor to ensure appropriate rehabilitation. They may design a specific orthosis to support and protect the elbow. A home exercise program is suggested to reduce pain and swelling while gradually working on the range of motion and strength of the injured joint.
Fracture of the radial head
What is a radial head fracture?
The forearm is made up of two bones, the radius and the ulna, which connect the elbow to the wrist and allow for the rotation of the forearm as well as flexion and extension of the elbow. A radial head fracture occurs when the proximal end of the radius, located near the elbow, is broken. It is one of the most common elbow fractures in adults.
What are the causes and risk factors?
- Fall on the hand with the arm extended
- Direct impact on the elbow
- High-impact sports or a fall from a significant height
- Osteoporosis increasing the risk of fracture
What are the symptoms?
- Pain and swelling in the elbow or forearm area
- Reduced mobility of the elbow and forearm
- Abnormal appearance of the elbow in some cases
- Sensation of numbness on the back of the hand and thumb
What are the treatments?
Diagnosis and immobilization
- An X-ray of the elbow is performed to confirm the fracture
- Depending on the severity, the treatment can range from simple immobilization to surgery
Possible treatments
- Immobilization: wearing a sling, brace, or cast to stabilize the joint and promote healing.
- Surgical treatment: necessary in cases of displaced fractures, sometimes involving fixation or partial replacement of the fractured bone.
What is the role of the hand therapist in recovery?
The hand physiotherapist or occupational therapist works in collaboration with the physician to assist in the treatment of radial head fractures. They may design a custom orthosis to support and protect the elbow. They also teach strategies to reduce swelling, relieve pain, and gradually improve mobility and strength in the elbow, wrist, and hand. Appropriate care is essential to restore upper limb function and support the return to daily activities.
Radial nerve paralysis
What is radial nerve palsy?
The radial nerve is one of the main nerves of the arm. It originates in the neck and runs the entire length of the arm. This nerve is responsible for extending the elbow, wrist, and fingers, while also providing sensation to the back of the hand. Compression or injury to this nerve can lead to muscle weakness and impaired sensation.
What are the symptoms of radial nerve palsy?
Symptoms include weakness or inability to extend the wrist and/or fingers. Numbness or tingling on the back of the hand may also occur. Patients may have difficulty releasing objects after grasping them.
What are the causes of radial nerve palsy?
This paralysis can result from a fracture of the humerus or prolonged pressure on the arm, such as after sleeping in a restrictive position for an extended period.
What are the treatments for radial nerve palsy?
A thorough medical examination may include diagnostic tests to assess nerve damage. Depending on the severity and underlying cause, either surgical or conservative treatment may be recommended.
What is the role of the hand therapist in recovery?
A hand therapist can design a custom orthosis to keep the fingers in extension and support the wrist, thus facilitating daily tasks while waiting for nerve recovery. In the case of surgery, manual therapy helps restore mobility and functionality of the hand, with a tailored rehabilitation program.
The therapist can also teach specific exercises to maintain joint flexibility, prevent deformities, and engage the affected muscles. Specific recommendations to compensate for the loss of mobility are provided in order to facilitate the functional use of the affected hand.
Distal biceps rupture
What is a distal biceps rupture?
The biceps is a muscle located at the front of the arm, consisting of two parts: a proximal portion (near the shoulder) and a distal portion (near the elbow). It is essential for bending the elbow and turning the palm upward. A distal biceps rupture occurs when the muscle’s attachment to the forearm detaches from the bone, leading to a loss of strength and mobility.
What are the symptoms of a distal biceps rupture?
Characteristic signs include pain at the front of the arm, visible bruising, and in some cases, a “pop” sensation followed by muscle retraction, forming a lump on the arm. Weakness may be observed, especially during movements requiring forearm rotation, such as using a screwdriver.
What are the causes of a distal biceps rupture?
This type of injury typically occurs during a sudden and excessive strain on a flexed arm, such as lifting a heavier load than expected. A direct trauma or a fall can also be the cause of this rupture.
What are the treatments for a distal biceps rupture?
There are two types of ruptures: partial and complete. A partial rupture means that some muscle fibers remain attached and can be treated without surgery through rest, immobilization, and physical therapy. A complete rupture often requires surgical intervention to reattach the tendon to the bone and restore arm strength.
What is the role of the physiotherapist in recovery?
A physiotherapist helps relieve pain, reduce swelling, and preserve elbow mobility after an injury or surgery. They may recommend a protective splint and guide the patient through a progressive exercise program aimed at strengthening the arm while minimizing the risk of complications. Rehabilitation allows for the optimal use of the limb for daily and professional activities.
Lacertus syndrome
What is the lacertus syndrome?
Lacertus syndrome is a compression of the median nerve at the elbow, specifically beneath the bicipital aponeurosis (lacertus fibrosus). This condition can cause symptoms similar to carpal tunnel syndrome, but the origin of the compression is higher up in the arm.
What are the symptoms of lacertus syndrome?
Symptoms include:
- Pain and numbness in the forearm, hand, and fingers, especially the thumb, index, and middle fingers
- Muscle weakness affecting grip and hand dexterity
- A feeling of quick fatigue during repetitive arm movements
- Decreased pinching strength and difficulty bending the fingers
What are the causes of lacertus syndrome?
This condition can result from:
- Hypertrophy or thickening of the lacertus fibrosus.
- Excessive strain on the forearm (e.g., repetitive activities, weightlifting, sports such as tennis or climbing).
- A previous trauma to the front of the elbow
- Anatomical abnormalities that promote compression of the median nerve
What are the treatments for lacertus syndrome?
The treatment depends on the severity of the symptoms. A conservative approach may include:
- Rest and modification of activities that strain the arm
- Manual therapy and stretching to reduce muscle tension
- Wearing a splint to limit aggravating movements
- Anti-inflammatory medications or cortisone injections if necessary
If conservative treatment fails, surgery may be considered to release the median nerve from compression.
What is the role of the hand therapist in recovery?
A hand therapist helps restore mobility and strength in the arm by offering:
- Specific exercises to improve flexibility and reduce nerve compression
- Mobilization techniques to reduce pain
- Ergonomic adjustments to limit strain on the median nerve
- A rehabilitation program after possible surgery to restore optimal function of the hand and arm
Syndrome of the cubital tunnel
What is cubital tunnel syndrome?
Cubital tunnel syndrome is a condition caused by the compression or irritation of the ulnar nerve at the elbow. This nerve, which runs from the neck to the fingers, plays a crucial role in the motor function and sensation of the hand. When the nerve is compressed in the cubital tunnel, it leads to various symptoms affecting the hand and arm.
What are the symptoms of cubital tunnel syndrome?
Symptoms include pain, numbness, and tingling, primarily in the little finger and ring finger. Muscle weakness may also occur, making certain daily tasks, such as holding an object or typing, more difficult. In advanced cases, a “claw” hand position may develop.
What are the causes of cubital tunnel syndrome?
The syndrome can result from prolonged elbow flexion, such as during sleep or while holding a phone, repeated pressure on the inner elbow, or trauma. Certain frequent movements or intense activities that strain the elbow can also contribute to the development of this condition.
What are the treatments for cubital tunnel syndrome?
A conservative treatment is generally preferred, including adjusting daily habits and wearing a splint to limit elbow flexion during the night. If these measures do not alleviate symptoms, surgical intervention to relieve pressure on the nerve may be considered.
What is the role of the hand therapist in recovery?
A hand therapist supports the patient by identifying and modifying movements that aggravate the symptoms. They may suggest specific exercises to improve neural mobility, use a custom-made splint, and provide targeted rehabilitation techniques to help prevent the progression of the syndrome and restore hand function.
Radial tunnel syndrome
What is radial tunnel syndrome?
Radial tunnel syndrome is a condition caused by the compression of the radial nerve as it passes through the radial tunnel in the forearm. This nerve plays a crucial role in extending the wrist, fingers, and elbow, as well as providing sensation to the back of the hand. When the radial nerve is compressed, it leads to pain and muscle weakness, which can affect the use of the hand and arm.
What are the symptoms of radial tunnel syndrome?
Symptoms include diffuse pain in the forearm, particularly on the outer side, often aggravated by repetitive wrist and forearm movements. Muscle weakness may occur, making it difficult to extend the wrist and fingers. Unlike other neuropathies, numbness is typically absent, as the radial nerve is primarily motor in this area.
What are the causes of radial tunnel syndrome?
The syndrome can be caused by repetitive movements involving the wrist and forearm, such as using manual tools, intense sports practice, or direct trauma to the forearm. Prolonged compression of the nerve due to swelling of surrounding tissues can also be a cause.
What are the treatments for radial tunnel syndrome?
The treatment is based on a conservative approach, including adjusting daily activities, reducing aggravating movements, and wearing a splint to limit excessive wrist motions. Anti-inflammatory medications or injections may be prescribed for severe pain. If compression persists and leads to significant weakness, surgery may be considered to release the nerve.
What is the role of the hand therapist in recovery?
A hand therapist helps the patient adapt their movements to reduce compression of the radial nerve. They may suggest specific exercises to improve mobility and muscle strength, as well as targeted rehabilitation techniques to restore the function of the arm and wrist. A custom-made splint may also be recommended to relieve pain and facilitate recovery.
Take back control of your movements
Elbow pain holding you back? A targeted evaluation and a customized treatment plan can make all the difference.