Review Sport injuries of the elbow

Athletic injuries of the elbow are common especially in throwing sports such as baseball and tennis. An early diagnosis, early initiation of treatment, and appropriate referrals for surgical management enable athletes to return safely to competition as quickly as possible. Elbow injuries may involve any of the anatomical structures in the region. The normal range of motion at the elbow joint is 140° of flexion from full extension and from 75° of pronation to 85° of supination. The functional range of motion for activities of daily living is from 30° to 130° of flexion and 50° of supination and pronation. This arc of motion allows independent function but would be very limiting for many athletic pursuits. The most appropriate range of motion varies with the type of sport. For example, a gymnast performing handstands requires at least full extension (if not hyperextension) to lock the elbows, whereas baseball pitchers may have a flexion contracture of their dominant elbow of up to 20° that does not limit their eVectiveness. Elbow injuries in athletes can be classified into acute or chronic. Most injuries in the athlete are chronic overuse injuries. Overuse injuries are the result of repetitive overload resulting in microtears of the soft tissues. They are often myotendinous to the flexor-pronator muscle group and can lead to tendonitis or muscular injury and eventually elbow flexion contracture. Repetitive microrupture of the flexor-pronator muscle group compromises the healing process leading to muscle contracture and fatigue. More repetitive stresses to the ulnar side of the elbow aVect the ulnar collateral ligament. Imperfect healing of the medial collateral ligament (MCL) results in its attenuation and elbow instability. Any further valgus stresses induce compression of the radiocapitellar joint.