The Elbow, Forearm, Wrist The Elbow, Forearm, Wrist and handand hand

Main AnatomyMain Anatomy• PhalangesPhalanges• MetacarpalsMetacarpals• CarpalCarpal• RadiusRadius• UlnaUlna• HumerusHumerus

CarpalsCarpals• How many bones make How many bones make

up the wrist?up the wrist?• 88• The wrist is formed The wrist is formed

where the distal aspect where the distal aspect of the radius and the of the radius and the ulna joins.  There are ulna joins.  There are eight carpal bones in eight carpal bones in all.  The carpal bones all.  The carpal bones are gliding joints and are gliding joints and are stabilized by are stabilized by anterior, posterior, and anterior, posterior, and connecting ligaments. connecting ligaments.

Muscles of the armMuscles of the arm

Forearm main Forearm main muscles:muscles:

carpi ulnaris carpi ulnaris

brachioradialis brachioradialis

muscles of forearm

Elbow DislocationElbow Dislocation

• Occurs when athlete falls on an outstretched Occurs when athlete falls on an outstretched hand, or a direct blowhand, or a direct blow

• Radius and Ulna are forced away from humerusRadius and Ulna are forced away from humerus• Take immediately to hospitalTake immediately to hospital

– Why?Why?– Danger of damage to blood vessels and nerves that Danger of damage to blood vessels and nerves that

can lead to paralysis of fingerscan lead to paralysis of fingers– Splint as is, and apply coldSplint as is, and apply cold

• To help with prevention of injury, teach To help with prevention of injury, teach athletes correct way to fall/tumble athletes correct way to fall/tumble (gymnastics)(gymnastics)

Elbow DislocationElbow Dislocation

http://www.gwc.maricopa.edu/class/bio201/muscle/arm/frmp.htm

Elbow HyperextensionElbow Hyperextension• When the elbow is extended past normal When the elbow is extended past normal

rangerange

• Falling onto an outstretched handFalling onto an outstretched hand– Athlete is normally apprehensive of straightening Athlete is normally apprehensive of straightening

the armthe arm

• S/S: S/S: – Swollen areaSwollen area

• 11stst Aid Aid– Cold and Compression and elevation (if possible)Cold and Compression and elevation (if possible)

• Start mild ROM exercises asapStart mild ROM exercises asap

Elbow HyperextensionElbow Hyperextension

Little League ElbowLittle League Elbow

• Cause:Cause:– Too much stress on the elbowToo much stress on the elbow– When muscle is stronger than the boneWhen muscle is stronger than the bone

• Muscle pulls away a chip of boneMuscle pulls away a chip of bone• Occurs in children who have not gone Occurs in children who have not gone

through puberty yetthrough puberty yet• Repetitive throwing motionsRepetitive throwing motions• PreventionPrevention

– Try to reduce the amount of throwing motionsTry to reduce the amount of throwing motions– Stop at the first sign of painStop at the first sign of pain

Little League ElbowLittle League Elbow

Tennis ElbowTennis Elbow

•Tennis Elbow - Sports Injury ClinicTennis Elbow - Sports Injury Clinic

•Causes:Causes:– Poor techniquePoor technique– Inadequate warm-upInadequate warm-up– overuseoveruse

Wrist SprainsWrist Sprains

• One of the most common injuriesOne of the most common injuries

• Landing on wrist, collision with another Landing on wrist, collision with another athletesathletes

• Ask is athlete heard a “pop”, look for Ask is athlete heard a “pop”, look for deformity and swellingdeformity and swelling

• 11stst aid aid– ICEICE

• Taping can help prevent further injuryTaping can help prevent further injury

Wrist Sprain TXWrist Sprain TX

• Wrist Sprain - Sports Injury ClinicWrist Sprain - Sports Injury Clinic

• Wrist Taping Wrist Taping

Wrist Fracture Wrist Fracture

• Happen to the radius, ulna and one Happen to the radius, ulna and one bone from the carpalbone from the carpal– The navicularThe navicular

• Same mechanisms as sprainSame mechanisms as sprain• Make sure it is not a sprain, or it can Make sure it is not a sprain, or it can

lead to necrosis, death of the bonelead to necrosis, death of the bone• Look for swelling and point tenderness Look for swelling and point tenderness

at the navicularat the navicular• Splint and apply iceSplint and apply ice

Sprained ThumbSprained Thumb• Most common in basketball and football Most common in basketball and football

• Ball hits the end of the thumb when trying Ball hits the end of the thumb when trying to catch itto catch it

• The joint that is injured:The joint that is injured:– MCP joint (metacarpophalangeal joint) MCP joint (metacarpophalangeal joint) – MCP jointMCP joint

• Swelling and pain at base of thumbSwelling and pain at base of thumb

• Try to pinch thumb and first finger togetherTry to pinch thumb and first finger together

• 1” elastic tape is best material to use to 1” elastic tape is best material to use to tapetape

Thumb sprainThumb sprain

Taping for sprained ThumbTaping for sprained Thumb

• Thumb Sprain Taping - Sports Injury Thumb Sprain Taping - Sports Injury ClinicClinic

Jammed FingerJammed Finger• Ball striking end of finger is most common MOIBall striking end of finger is most common MOI• What joint is most commonly sprained?What joint is most commonly sprained?

– PIP joint (proximal interphalangeal joint)PIP joint (proximal interphalangeal joint)

• S/S:S/S:– Swelling and soreness localized to that jointSwelling and soreness localized to that joint

• TXTX– Compression and IceCompression and Ice– Elastic tape is best way to maintain compressionElastic tape is best way to maintain compression– Use wood or metal splint to immobilize jointUse wood or metal splint to immobilize joint– Protect by “buddy” taping. Taping it to the Protect by “buddy” taping. Taping it to the

stronger adjacent finger. Try to put foam between stronger adjacent finger. Try to put foam between fingers if availablefingers if available

Jammed fingersJammed fingers

Dislocated FingersDislocated Fingers

• Volleyball and FootballVolleyball and Football

• Direct blow to tip of fingerDirect blow to tip of finger

• Usually which joint?Usually which joint?– Middle phalangeal jointMiddle phalangeal joint

• Splint as isSplint as is

• Apply coldApply cold

• PhysicianPhysician