All About the Elbow

What is the elbow joint and how does it work?

The elbow is a hinge joint that bends and straightens the arm. Your forearm also rotates around the elbow joint. The elbow joint is composed of bone, cartilage, ligaments and fluid.

What kinds of injuries and conditions can affect the elbow?

Common elbow injuries and conditions include:

• Tennis elbow or golfer's elbow—overuse injuries that are a form of tendinitis affecting the muscles that attach around the elbow joint
• Dislocation
• Fractures
• Torn tendons
• Arthritis
• Sprains-injuries to a ligament
• Strains-injuries to a tendon
• Bursitis

Who is most prone to elbow overuse injuries?

Baseball pitchers especially can develop overuse injuries of the elbow. Problems develop when the tendon on the inside of the elbow becomes overstretched when pitching too many innings, throwing too hard or throwing too many breaking balls. That can also cause trouble with the ligament on the inside of the elbow.

How is this baseball player's condition treated?

An operation called the Tommy John procedure is pretty common among high-performance baseball players. It's a ligament reconstruction on the inside of the elbow. Sports medicine specialists Robert and Daniel Zanotti, MD, at the Center for Orthopedics perform this procedure.

What is the treatment for a torn elbow tendon?

When tendon tears occur in the elbow, they often need surgical repair. Sometimes this surgery can be done arthroscopically, but when there is a tear in a major tendon like the biceps tendon in the elbow, minimally invasive surgery is performed through a very small incision.

What kind of nerve conditions can affect the elbow?

The elbow can develop nerve entrapment conditions involving ulnar nerve—the “funnybone” on the inside of the elbow that curves tightly around a bony prominence in that area.

The ulnar nerve can be injured in a single incident where you bruise the nerve. Or with overuse, you can develop an entrapment neuropathy where the nerve is being pinched by the tissues around the elbow, similar to a carpal tunnel condition.

How is ulnar nerve entrapment treated?

In its early stages, ulnar nerve entrapment can be treated conservatively with bracing and physical therapy. In the late stages, surgery is usually necessary to transpose or re-route the nerve around the ulna bone in the forearm so it's not being pinched anymore.

How can arthritis affect the elbow?

Arthritis in the elbow is marked by pain and reduced range of motion.

• Osteoarthritis, also known as wear-and-tear arthritis or degenerative joint disease, occurs less often in the elbow than in weight-bearing joints such as the knee or hip. This type of arthritis occurs when the protective cartilage wears off the joint, eventually resulting in painful bone-on-bone arthritis.
• Rheumatoid arthritis or RA is a systemic disease that may attack many parts of the body. This most-disabling form of arthritis is believed to be an auto-immune disease caused by a virus or genetic component.

Who is most likely to develop elbow arthritis?

Arthritis of the elbow is most common among patients with:

• A history of elbow injury, such as a fracture or dislocation
• Work or sports that place increased demands on the elbow joint
• Ligament injury leading to an unable elbow
• Previous elbow surgery
• Loss of joint cartilage

How is elbow arthritis treated?

The first line of treatment for elbow arthritis consists of conservative, non-surgical methods such as:

• NSAIDs—either prescription or over-the-counter
• Physical therapy
• Cortisone injections to treat inflammation
• Synvisc injections to lubricate the knee joint

Can the elbow joint be replaced?

Yes. When conservative treatment methods fail to relieve the pain and stiffness of elbow arthritis, the elbow joint can be surgically replaced.

The Center for Orthopedics is one of the few orthopedic practices in northeast Ohio to offer elbow replacement surgery.