What is Golfers Elbow?

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Article featured on Montana Bones

Medial epicondylitis, also known as golfer’s elbow, is a painful condition in which the tendons connecting the forearm to the elbow have become damaged due to injury or overuse. Previously thought to be a form of tendonitis, or inflammation of the tendon, medial epicondylitis is now considered to be a form of tendonosis in which the collagen fibers making up the tendon have deteriorated. Patients with this condition experience pain on the inside of the elbow that may radiate into the forearm. This pain results when the epicondyle puts pressure on the ulnar nerve, a nerve in the forearm. Most often, medial epicondylitis can be treated successfully by simple measures like resting the arm and applying ice. In some cases, however, it requires surgical correction.

While it may be caused by a single injury, medial epicondylitis is usually caused by repetitive gripping, flexing and swinging of the arm. These actions, common in golfers, cause the targeted tendons to stretch and tear. Medial epicondylitis is also frequently diagnosed in baseball pitchers, bowlers, tennis players, swimmers and individuals who do painting, raking or hammering since all of these activities involve similar arm motions. This condition is much more common in men than in women, but much less common in either than tennis elbow.The difference between the two conditions is that tennis elbow occurs on the outside of the elbow while golfer’s elbow occurs on the inside.

SYMPTOMS AND DIAGNOSIS OF MEDIAL EPICONDYLITIS

Symptoms of medial epicondylitis may appear suddenly or gradually. These symptoms may include:

  • Pain on the inside of the elbow or forearm
  • Weakness or stiffness in the wrists and hands
  • Tingling or numbness in the hand or fingers, particularly the ring finger or pinkie

The pain of medial epicondylitis may worsen with certain actions, such as swinging the arm, squeezing the hand, turning a doorknob or lifting something heavy, especially when the palm is facing downward.

DIAGNOSIS OF MEDIAL EPICONDYLITIS

Medial Epicondylitis is diagnosed through physical examination, the use of X-rays and, on occasion, other diagnostic tests such as MRIs or ultrasound.

TREATMENT OF MEDIAL EPICONDYLITIS

There are several simple treatment options for medial epicondylitis. The treatments for medial epicondylitis may include:

  • Resting the arm
  • Wearing a bandage or splint on the wrist or elbow
  • Icing the affected region
  • Taking over-the-counter pain relievers
  • Doing therapeutic exercises
  • Receiving electrical stimulation treatments
  • Taking prescribed corticosteroids orally or by injection
  • Receiving shock wave treatments of the area

The symptoms of medial epicondylitis may resolve in weeks or may persist for months. As the pain subsides, a physical or occupational therapist may suggest different ways of moving the arm to avoid a recurrence of symptoms. If the condition lasts more than 3 to 6 months, becoming chronic, surgery may be considered.

SURGICAL REPAIR OF MEDIAL EPICONDYLITIS

There are several types of surgery performed to repair medial epicondylitis. Such surgeries may be performed arthroscopically or as open surgery and are normally done outpatient with a local anesthetic. They usually take between 3 and 4 hours to complete. Most patients may return to a relatively normal routine in about 4 weeks, but may have residual discomfort, weakness or numbness for several months following surgery. Post-surgical physical therapy is usually required. Types of procedures used for surgical repair of medial epicondylitis may include:

Tendon Debridement – in which only the affected tissues within the tendon are removed, or debrided

Medial Epicondyle Release or Epicondylectomy and Ulnar Nerve Release – in which the medial epicondyle is removed, allowing the ulnar nerve to glide freely, releasing it from what is known as ulnar nerve entrapment

Ulnar Nerve Transposition – in which the forearm muscles are cut and temporarily disconnected from the epicondyle so that the ulnar nerve can be moved from behind the elbow to in front of it

RISKS OF SURGICAL REPAIR OF MEDIAL EPICONDYLITIS

While the surgical procedures discussed are considered safe, there are potential risks with any surgery which may include:

  • Excessive bleeding
  • Blood clots
  • Adverse reactions to anesthesia or medications
  • Post-surgical infection
  • Breathing problems

Risks of the specific surgeries discussed may include a condition known as chronic regional pain syndrome, or CRPS. This complication, which is rare, may cause ongoing swelling, pain, skin discoloration and stiffness.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Give Praise to the Elbow: A Bending & Twisting Marvel

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Article featured on Harvard Health

I recently saw a car vanity plate that read “LBODOC” (as in elbow doc). The driver — probably an orthopedic doctor or arthritis specialist — was clearly a fan of the elbow, an unassuming joint and a surprisingly central player in many daily tasks. I could relate: throughout my medical career, the elbow has been my favorite joint.

Here’s why we should give praise to elbows and do all we can to protect them.

What if we didn’t have elbows?

Let’s face it: the human experience would be quite different without elbows.

Imagine your arm without a joint that bends at the elbow. You’d be unable to easily feed yourself, put on makeup, shave your face, or brush your teeth. It’d be tough to get dressed or throw a ball without elbows. And, importantly, wiping yourself after using the bathroom would be nearly impossible.

Yet, when it comes to joints and joint disease, we hear little about elbows; hips and knees get most of the attention. So, let’s consider for a moment what the lowly elbow does and why it deserves more credit.

How do your elbows work?

Three bones come together at the elbow joint: the humerus, which is in the upper arm, and two long bones called the ulna and radius in the lower arm.

Your elbow has two main motions:

  • Flexing and straightening. Flexing your arm allows you to bring your hand toward your body (flexion), which you do when bringing food to your mouth or putting your hands on your hips. Straightening your arm (extension) allows such motions as putting your arm in a shirt sleeve or reaching your toes.
  • Turning up and down. You can also flip your palms from facing the ceiling (supination) to facing the floor (pronation). These motions are important for many common movements, such as turning a key or a doorknob.

Bumping your elbow: Why is it called the funny bone?

Probably for two reasons:

  • The humerus in the upper arm sounds just like the word humorous, meaning funny.
  • Bumping your elbow often puts pressure on the ulnar nerve, since it’s located between the bones of the joint. Pressure on this nerve can cause a funny tingling sensation that runs down your arm.

Elbow trouble: Four well-known problems — and a surprising fifth

Like so many overlooked and underappreciated things, most people think little about their elbows until something goes wrong. Here are some of the most common elbow problems:

  • Arthritis. Several types of arthritis can affect the elbow, including rheumatoid arthritis, psoriatic arthritis, and gout. Interestingly, the most common type of arthritis, osteoarthritis, doesn’t usually affect the elbow unless there’s been prior damage to the joint.
  • Bursitis. The bursa is a saclike structure that surrounds the tip of the elbow. Bursitis develops when it becomes swollen or inflamed, due to infection, gout, or bleeding.
  • Tendonitis. Tendon inflammation (tendonitis) may develop on the inside part of the elbow (called “golfer’s elbow”) or the outside (called “tennis elbow”). Despite these names, you don’t have to play any particular sport to develop elbow tendonitis.
  • Trauma. Everyday activities and athletic pursuits put the elbow at risk. A bike accident, falling off a skateboard, or just tripping on a curb and falling onto your arm can cause significant elbow injuries. These include ligament damage, broken bones, or bursitis.

And the surprising fifth problem? Cell phone-induced nerve irritation: holding your elbow bent for a long time can lead to “cell phone elbow” due to pressure on the ulnar nerve. This can cause numbness and pain down the arm. The solution? Put the phone down — or at least go hands-free.

How can you protect your elbows?

Considering all our elbows do for us, we need to do our best to protect them. That means:

  • Wear elbow protectors when engaging in activities likely to injure the elbows (like skateboarding or roller blading).
  • Learn proper technique for activities that can stress the elbow like racquet sports, baseball, weight training, or repetitive motions in carpentry and other types of work. For example, a trainer or coach can help you improve your tennis stroke to avoid overstressing the elbow joint and its tendons or ligaments.
  • Use appropriate equipment. For example, avoid using a tennis racquet that’s too heavy for you.
  • Train well. Strengthening forearm muscles and stretching can help avoid golfer’s elbow.

The bottom line

As the junction between hand and shoulder, our elbows play a pivotal role in everyday function. It’s high time we recognized them for what they do for us. Even if the elbow isn’t your favorite joint — as it is for me — perhaps it should be in your top five. After all, think of all the things you couldn’t do without them.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Baseball Season is Here: Watch out for UCL Tears

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The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What is Little League Elbow?

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Article featured on Nationwide Children’s

Little league elbow is a painful inflammation of the bony bump on the inside of the elbow.

This spot is the attachment site where the tendons of the muscles that bend your wrist and fingers are located.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Why Does My Elbow Hurt?

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Article featured on WebMD

Your elbow lets you throw, lift, swing, and hug, for starters. You can do all this because it’s not a simple joint. And that means there are a lot of ways things can go wrong. Your elbow’s a joint formed where three bones come together — your upper arm bone, called the humerus, and the ulna and the radius, the two bones that make up your forearm.Each bone has cartilage on the end, which helps them slide against each other and absorb shocks. They’re lashed into place with tough tissues called ligaments. And your tendons connect your bones to muscles to allow you to move your arm in different ways.If anything happens to any of these parts, not to mention the nerves and blood vessels around them, it can cause you pain.Here are some of the different ways your elbow can hurt:

One-time Injuries

Some injuries, hopefully, are one-off events, like when you fall or get hit hard while playing a sport.

  • Dislocated elbow. When one of the bones that forms the elbow gets knocked out of place, you have a dislocated elbow. One of the more common causes is when you put your hand out to catch yourself during a fall. It can also happen to toddlers when you swing them by their forearms — that’s called nursemaid’s elbow. If you think you or your child has a dislocated elbow, call your doctor right away.
  • Fractured elbow: If one of your arm bones breaks at the elbow, you have a fracture. Usually, this happens with a sudden blow, as you might get in a contact sport or a car accident. And don’t be fooled if you can still move your elbow afterward. If you’re in pain and it doesn’t look right, it could be broken. You’ll need medical attention.
  • Strains and sprains: File these under, “Oof, I think I pushed it a little too far.” When muscles get stretched or torn, it’s called a strain. When it’s ligaments, it’s a sprain.
You can get a strain when you put too much pressure on your elbow muscles, like when you lift heavy objects or overdo it with sports.Elbow sprains are common in athletes who throw, use racquets, or play contact sports.Both are treated with rest, ice and — once the pain is gone — stretching and strength exercises.

Wear-and-Tear Injuries

Other injuries occur over time, as you repeat certain actions and put wear and tear on your elbow. You can injure yourself playing sports or in any number of work settings, from a factory to an office.

  • Bursitis: Often caused by repeating the same motion over and over, you can also get bursitis from an accident or infection. Bursa are small sacs with fluid in them. You have them in your joints to help cushion your bones, tendons, and muscles. They also help skin slide over bone. But they can get swollen and cause you pain. Often, bursitis is simply treated with pain medicine and starts to get better within a few weeks.
  • Tennis elbow and golfer’s elbow: These are both types of tendinopathy or tendinosis, which means you have damage in the tendons around your elbow from overuse. Despite the names, the injuries aren’t limited to golfers or tennis players. You’re just more likely to get them based on the arm motions used in those sports. The main difference between the two is that tennis elbow affects the outside of your elbow, while golfer’s elbow affects the inside.
  • Trapped nerves: You might be familiar with carpal tunnel syndrome, where a nerve that passes through your wrist gets squeezed and causes some wrist and arm issues. You can have similar problems in your elbow.
  • If you have radial tunnel syndrome, you have a similar issue with the radial nerve as it passes through the radial tunnel near the outside of your elbow. You may have burning or numbness on your outside forearm and elbow.
  • Stress fractures: With a stress fracture, you have a small crack in one of your arm bones, usually from overuse. They’re more common in the lower legs and feet, but athletes who throw a lot, such as baseball pitchers, can get them in the elbow, too. The pain is usually worse when throwing.

Diseases

Several diseases can also cause elbow pain, though it’s usually not the main symptom.

  • Arthritis: Many types of arthritis can affect your elbow, but the main ones are rheumatoid arthritis and osteoarthritis.
    • Rheumatoid arthritis is the most common type of arthritis in the elbow. When you have it, your immune system attacks your body’s healthy tissue and causes swelling in your joints. You get osteoarthritis when your elbow cartilage breaks down over time, which means the bones rub together and cause pain and stiffness.
  • Osteochondritis dissecans: Children and teenagers mostly get this condition, where a piece of bone near the elbow dies. The bone piece and some cartilage then break off, which causes pain during physical activity. It’s more common in the knees, but can happen in the elbow, as well.
  • Gout: This is actually a type of arthritis. Uric acid, normally a waste product to be sent out of your body, builds up as crystals in your tissues. If the buildup happens in your elbow, it can be very painful.
  • Lupus: This is another illness where your immune system attacks healthy parts of your body, including your joints and organs. It more commonly affects your hands and feet, but it can cause problems in your elbow.
  • Lyme disease: Carried by ticks, Lyme disease can cause serious problems if not treated early. You may have issues with your nervous system and pain in your joints, like your elbow.

When to Call Your Doctor

If you think you’ve fractured or dislocated your elbow — it hurts and doesn’t look right — go to the emergency room.

Call your doctor if you have:

  • Elbow pain that doesn’t go away with rest and ice, or pain that doesn’t go away even when you’re not using your arm
  • Intense pain, swelling, and bruising around your elbow
  • Pain, swelling, or redness that gets worse, especially if you have a fever, too
  • Problems using your elbow, such as difficulty bending your arm

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday

What a Dislocated Elbow Means

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Article featured on the Cleveland Clinic.

The elbow is composed of three bones. A dislocation happens when any of these bones become separated or knocked out of place. If you think you have dislocated your elbow, you should get immediate medical help.

What is a dislocated elbow?

A dislocated elbow occurs when any of the three bones in the elbow joint become separated or knocked out of their normal positions.

Dislocation can be very painful, causing the elbow to become unstable and sometimes unable to move. Dislocation damages the ligaments of the elbow and can also damage the surrounding muscles, nerves and tendons (tissues that connect the bones at a joint).

You should seek immediate medical treatment if you think you have an elbow dislocation. Treatment reduces the risk of irreversible damage.

How common is a dislocated elbow?

The incidence of the injury has been estimated at 2.9 events per 100,000 people over the age of 16. In children, dislocations can happen when someone yanks on the child’s arm.

SYMPTOMS AND CAUSES

What causes a dislocated elbow?

There can be various causes of a dislocated elbow.

  • Most elbow dislocations occur when people try to stop a fall with their outstretched hand.
  • Car accidents can cause dislocated elbows when people reach out to brace themselves against impact.
  • Sports injuries can cause dislocations.
  • Overuse can also be a cause.
  • In some cases, a joint disorder such as Ehlers-Danlos syndrome causes dislocations. Ehlers-Danlos makes joints unusually loose and flexible.

What are the signs and symptoms of a dislocated elbow?

A dislocated elbow can be partial or complete. A complete elbow dislocation involves a total separation and is called a luxation. When the elbow joint is partially dislocated, it is called a subluxation.

Doctors also classify elbow dislocations according to the extent of the damage and where it occurs. The 3 types include:

  • Simple: No major injury to the bone
  • Complex: Severe injuries to the bone and ligament
  • Severe: Damage to the nerves and blood vessels around the elbow

The signs and symptoms of a dislocated elbow vary depending on the severity of the injury and the bones involved. They include:

  • Bruising
  • Deformed-looking arm (bone looks out of place)
  • Weakness in the joint
  • Loss of ability to move the elbow
  • Pain
  • Swelling

DIAGNOSIS AND TESTS

How is dislocated elbow diagnosed?

A doctor diagnoses a dislocated elbow by looking at the arm and moving the joint.

In many cases, doctors use an imaging test called an X-ray to see if the bone is injured. Occasionally, doctors use tests called MRI or CT scans to look for damage to the surrounding muscles and tendons.

MANAGEMENT AND TREATMENT

How is a dislocated elbow condition managed or treated?

Some dislocated elbows return to their usual position on their own. More severe cases need a doctor to return the bones to their proper position.

Treatment for a dislocated elbow varies according to the severity of the injury. Steps you can take to reduce pain while you wait to see a doctor include:

  • Rest
  • Apply ice
  • Keep the elbow elevated

Treatments for an elbow dislocation include:

  • Manipulation: A doctor returns the bones to their normal positions, called a joint reduction.
  • Medication: Your doctor may recommend over-the-counter medicine to reduce pain.
  • Rest: Once the joint is back in place, you may need to keep it immobile and protect it. Using a sling can help the elbow joint heal.
  • Physical therapy: You may need to do exercises to strengthen the muscles and tendons in the elbow to help support it after it heals.
  • Surgery: You may need surgery if:
    • Your doctor is unable to return the bones to their proper positions through manipulation.
    • Dislocation damaged nerves or blood vessels in the elbow.
    • Torn tendons or muscles need repair.

PREVENTION

Can dislocated elbow be prevented?

Caution can help reduce your risk of a dislocated elbow. Be careful on slippery surfaces and stairs to avoid falls. Avoid overtraining in sports to avoid overuse injuries.

What are the risk factors for dislocated elbow?

People at higher risk for a dislocated elbow include those who:

  • Are over age 65 (because they are more prone to falls)
  • Overtrain in sports, especially activities involving throwing
  • Have inherited joint disorders such as Ehlers-Danlos syndrome

OUTLOOK/PROGNOSIS

What is the prognosis (outlook) for people with dislocated elbow?

Recovery times vary according to the severity of the elbow dislocation. Many dislocated elbows do not cause any further problems once they heal. They usually feel better as soon as a doctor puts the joint back in place.

LIVING WITH

When should I call the doctor?

Contact your doctor if you have the symptoms of a dislocated elbow. Do not try to push a dislocated elbow back into place yourself. This effort could damage the surrounding tissue and tendons and lead to complications. If you have a dislocated elbow, let your doctor know if you think you are not healing correctly or continue to have problems.

What questions should I ask my doctor?

If you have a dislocated elbow, you may want to ask your doctor:

  • How serious is the dislocation?
  • Will I need surgery or other treatment?
  • What signs of complications should I look out for?
  • Do I need a follow-up visit, and if so, when?

When can I go back to my regular activities?

Healing time for a dislocated elbow varies depending on the severity of the injury. Most people with a dislocated elbow can return to their usual activities once a doctor has returned the joint to its normal position.

A sling can help protect the elbow joint so you can return to your usual activities while the joint heals. Your doctor will let you know when you can resume more physical activities such as sports or lifting heavy objects.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Elbow Fractures in Children

Elbow Fractures in Children

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Article Featured on AAOS

Elbow fractures are common childhood injuries, accounting for about 10% of all childhood fractures. In many cases, a simple fracture will heal well with conservative cast treatment. Some types of elbow fractures, however, including those in which the pieces of bone are significantly out of place, may require surgery. Other structures in the elbow—such as nerves, blood vessels, and ligaments—may also be injured when a fracture occurs and may require treatment, as well.

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Olecranon Bursitis

What Is Olecranon Bursitis

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Description

The olecranon (oh-LEH-cruh-nahn) is the pointy bone at the tip of the elbow.  The bursa is the thin sac of fluid that lies between this boney tip and the skin.  It helps the skin slide over the bone smoothly.  Normally, this sac has only a tiny bit of fluid inside of it and lays flat.  However, the bursa can become irritated or inflamed and fill with extra fluid (see Figure 1).  When this happens, a painful swelling develops at the back of the elbow.  This swelling is olecranon bursitis.

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