Sports injuries: overhead elbow

Overhead elbow sports injuries are a group of pathologies seen in sports activities with overhead throwing or strokes, e.g. tennis, volleyball, baseball, javelin throwing. There has been a tremendous increase in the number of participants in these sports activities worldwide.

Pathology

During the mid-to-late arm swing, tremendous forces are generated over the elbow as the elbow shifts into hyperextension and valgus positioning. Excessive forces tend to affect specific components of the joint:

• medial elbow: tensile forces can damage the ulnar collateral ligament, flexor-pronator muscle mass, or ulnar nerve
• posterior compartment: shear forces can damage the articular cartilage and cause an olecranon fracture
• lateral elbow: compressive forces can cause radiocapitellar contusion, fracture, or osteochondritis dissecans (in skeletally immature patients)

Elbow injuries commonly associated with overhead sports are as follows:

• flexor-pronator muscle mass injuries
• little leaguer's elbow
• medial epicondyle apophysitis
• olecranon stress fractures
• osteochondritis dissecans of the capitellum
• posterior olecranon impingement
• ulnar collateral ligament injuries
• ulnar neuritis
• valgus extension overload syndrome