History And Physical Examination History

A detailed history and physical examination is essential in evaluating the elbow for UCL insufficiency. Most athletes who present for evaluation participate in activities involving repetitive overhead throwing motions. Knowledge of previous elbow injuries and treatments aids the examiner in the initial examination. The chronology of the development of elbow pain can give clues to the underlying problems and can indicate where the injury lies on the spectrum of UCL injury.

A history of mild pain following a return to activities involving overhead throwing motions or a significant increase in activity intensity or duration indicates an overuse syndrome. This syndrome generally responds to nonoperative treatment directed at inflammation after overuse. Athletes who have this problem often are able to continue throwing at 100% of their maximal effort, but develop pain with progression to heavy throwing or with alteration in throwing mechanics.21,22,28

Pain in the medial portion of the elbow with throwing beyond 60% to 75% of maximal effort can indicate ligament attenuation. Athletes who have ligament attenuation often have a history of recurrent medial elbow injury and might sense movement in the elbow when attempting to throw beyond 75% of maximal effort. In a chronic case of UCL insufficiency, the athlete might experience mechanical symptoms, such as locking and catching, or crepitation, that suggest the presence of loose bodies or early degenerative changes in the joint.

In contrast to this gradual development of UCL insufficiency, an acute rupture of the ligament can occur in athletes who might or might not have had previous symptoms. They often report developing a sudden, sharp pain over the medial portion of the elbow. They can identify the exact moment that symptoms developed and might feel or sense a pop at the moment of ligament rupture. Medial elbow opening with valgus stress can cause ulnar nerve stretching with paresthesia radiating into the medial forearm, hand, and fourth and fifth digits. A pitcher might not be able to continue throwing or to exceed 75% of maximal effort.

Cure Tennis Elbow Without Surgery

Cure Tennis Elbow Without Surgery

Everything you wanted to know about. How To Cure Tennis Elbow. Are you an athlete who suffers from tennis elbow? Contrary to popular opinion, most people who suffer from tennis elbow do not even play tennis. They get this condition, which is a torn tendon in the elbow, from the strain of using the same motions with the arm, repeatedly. If you have tennis elbow, you understand how the pain can disrupt your day.

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