Rehabilitation of the Elbow Following Sports Injury (original) (raw)

2010, Clinics in Sports Medicine

Injuries to the elbow occur frequently in the overhead athlete due to the repetitive loads and forceful muscular activations inherent in throwing, hitting, serving, and spiking. 1,2 The most common injuries in the athlete include humeral epicondylitis, valgus extension overload, and ulnar collateral ligament injury. 3,4 The initial upper extremity evaluation including radiographs is the critical first step in early recognition and diagnosis of elbow injury, and allows for the referral to physical therapy whereby a comprehensive rehabilitation program can be initiated. The purpose of this article is to review the common elbow injuries in the overhead athlete and clinical tests used to confirm them, in addition to providing key concepts in the rehabilitation programs used to treat individuals with elbow injury and return them to high-level overhead activity. COMMON INJURIES IN THE ATHLETE'S ELBOW One of the most common overuse injuries of the elbow is humeral epicondylitis. 5,6 The repetitive overuse reported as one of the primary causative factors is particularly evident in the history of many athletic patients with elbow dysfunction. Epidemiologic research on adult tennis players reports incidences of humeral epicondylitis ranging from 35% to 50%. 7-11 This incidence is actually far greater than that reported in elite junior players (11%-12%) (United States Tennis Association, unpublished data, 1992). 12 Reported in the literature as early as 1873 by Runge, 13 humeral epicondylitis or ''tennis elbow'' as it is more popularly known, has been extensively studied by many investigators. Cyriax, 14 in 1936, listed 26 causes of tennis elbow, and an extensive study of this overuse disorder by Goldie 15 in 1964 reported hypervascularization