Research Articles

Best Treatment for Tennis Elbow

The best, most effective treatment for lateral epicondylitis, otherwise known as “tennis elbow” remains unknown. Many things have been tried including antiinflammatory drugs, exercise, bracing or splinting, injection therapy, and surgery. Short-term pain relief may be obtained but no long-term benefit has been reported.In this study, the results of three different types of treatment were compared on 60 patients who had lateral epicondylitis. Painful symptoms along the outside of the elbow (and d…Read more

The Optimal Program for Rehab of Elbow Tendon Injury

Overhead athletes (e.g., tennis players, javelin throwers, baseball pitchers, volleyball players) can lose significant function of the arm after an elbow tendon injury. Physical Therapists are often in charge of getting these players back to full force in hitting, pitching, serving, and spiking.But what is the optimal rehabilitation program for athletes who injure their elbows? In this article, an expert in sport rehabilitation and research addresses the current recommendations for treatment of …Read more

Update on the Evaluation and Treatment of Radial Head Fractures

The elbow is a complex joint with two bones in the forearm (the radius and the ulna) that work together and the upper arm (humerus) meeting those two bones to form the joint. So long as everything lines up properly, the elbow bends and straightens and the forearm rotates (palm up and palm down). But a fracture of the radial head can alter the entire biomechanics of the elbow.In this article, hand surgeons from the Hand and Upper Limb Centre in Ontario, Canada bring us up to date on the evaluatio…Read more

Total Elbow Replacement: Not for the Young and Active

Joint replacements are available now for the elbow. But it’s a tricky joint made up of three separate bones and two distinct joints. And it is responsible for repetitive motion of the hand and arm as well as rotation of the forearm, and weight-bearing activities through the hand and wrist.Because of the high activity demand on a replacement implant and its limited lifespan, total elbow replacement (TEA) isn’t usually recommended for young patients. In fact, it is considered a salvage procedure -…Read more

Modern Surgical Concepts for Ligamentous Reconstruction of the Elbow

Ligaments of the elbow are tough and are built to last. But repetitive overuse as in the case of the overhead throwing athlete can result in ligament damage and elbow instability. Chronic load and stress create wear and tear on the ulnar collateral ligament (UCL) in particular.In this article, surgeons at the Hospital for Special Surgery in New York City provide us with a complete review of ligament reconstruction of the UCL in throwing athletes. They begin with a brief history of this type of i…Read more

Electrodiagnostic Tests Predict Results of Surgery for Cubital Tunnel Syndrome

Using Electrodiagnostic Tests to Predict Results of Surgery for Cubital Tunnel Syndrome Carpal tunnel syndrome (CTS) gets a lot of attention because it affects so many people. But there’s a second type of nerve compression problem that deserves some attention too. And that’s ulnar nerve compression, also known as cubital tunnel syndrome or CuTS.Just like carpal tunnel syndrome, cubital tunnel syndrome causes pain, sensations of numbness and tingling, and weakness of the hand. But the areas of t…Read more

Step-By-Step Approach to Elbow Problems in Athletes

Any time an athlete injures his or her elbow, an accurate diagnosis is absolutely essential to providing the best treatment. Whether the examiner is an orthopedic surgeon, physician’s assistant, or Physical Therapist, there is a recommended order to the patient history and physical examination.In this article, surgeons from the Center for Shoulder, Elbow, and Sports Medicine at Columbia University in New York City provide a step-by-step approach to the evaluation of elbow injuries in throwing at…Read more

The Truth About Simple Elbow Dislocations

In this report, the incidence of simple elbow dislocations each year in the United States is reported. The authors also provide some demographics (details about age, race, sex, cause of injury) for the patients studied. The goal in understanding more about elbow dislocations is to prevent these injuries from ever happening.The term simple elbow dislocation may be a bit of an oxymoron (contradicting terms). There’s nothing simple about the elbow or dislocations. What the expression “simple” elbow…Read more

Options for the Middle-Aged with Elbow Arthritis

Middle-aged adults with elbow pain, loss of motion, and stiffness from osteoarthritis are too young for a joint replacement. Where does that leave them? In this article, hand surgeons from the Hospital for Special Surgery in New York City review the evidence for various surgical procedures to address this problem.They use the case of a 46-year-old man with osteoarthritis of the elbow to discuss surgical treatment options for the middle-aged adult. This particular patient had obvious arthritic ch…Read more

Biceps Tendon Ruptures in Both Arms

Biceps tendon ruptures in both arms may not be as uncommon as was once thought. According to this study, up to eight per cent of adults may experience bilateral (both sides) distal biceps tendon ruptures. The damage doesn’t occur in both arms at the same time. Usually the biceps tendon in one arm ruptures and then some years later the patient has the same thing happen in the other arm.The biceps muscle is located on the upper arm. It mainly flexes or bends the elbow but also supinates the forear…Read more

New Treatment for Tennis Elbow

Steroid injections are no longer routinely recommended for lateral epicondylitis (tennis elbow). Instead, Physical Therapists offer an alternative treatment in the form of something called iontophoresis.In this article, the use of steroid injection is compared with iontophoresis delivered in two different ways. Iontophoresis uses a small electric current to drive steroid medication through the skin. It is a noninvasive method of reducing the pain of tennis elbow.Iontophoresis has traditionally b…Read more

Conflicting Evidence to Predict Surgical Outcome for Cubital Tunnel Syndrome

Reviewing 26 studies involving a total of 1500 patients still doesn’t answer the question: What factors predict the outcome of surgery for cubital tunnel syndrome? Six of the most commonly used prognostic factors were evaluated. These included age, duration of symptoms, severity of preoperative status, results of preoperative electrodiagnostic testing, type of surgery, and Workers’ Compensation status.Cubital tunnel syndrome is a condition that affects the ulnar nerve where it crosses the inside…Read more

First Study to Report Long-Term Results of OAT Treatment for the Elbow

Athletes involved in lifting heavy weights, repetitive elbow motions, or overhead activities are at risk for a condition called osteochondral lesions. Osteochondral lesions refer to damage or defects to the joint cartilage (chondral) that go all the way down to the first layers of bone (osteo). Holes in the osteochondral layer and/or loose fragments of bone and cartilage in the joint can cause pain, locking of the joint, and eventually osteoarthritis.There are many ways to treat this problem sta…Read more

Comparing Two New Blood Treatments for Tennis Elbow

Blood as a healing agent was first used in the 1990s for facial and plastic surgery and has since expanded in its application. Now it is used with a variety of orthopedic treatments as well. One of those procedures is as an injection into the elbow to help heal chronic tennis elbow.Tennis elbow (also known as lateral epicondylitis) doesn’t always occur in tennis players. Anyone can develop tennis elbow. It is usually the result of overuse of the elbow. Not everyone who plays tennis or who engage…Read more

Results of Surgery for Bone Fractures Around Elbow Joint Replacements

What do all these activities have in common? Feed yourself. Comb your hair. Button your shirt. Open a door. Tie your shoes. Rise up from a chair using your arms. You need pain free elbow motion to accomplish any one of these tasks. And that’s what an elbow joint replacement is supposed to provide. But complications can arise following elbow arthroplasty (another word for joint replacement).In this study, surgeons from the Mayo Clinic report on the results of surgical treatment for 30 patients wh…Read more

Long Term Effects of Elbow Dislocation

A simple elbow dislocation isn’t always so simple. By simple, we mean a dislocated joint that can be set back into its proper place. There’s no fracture and surgery isn’t needed to relocate the joint. The joint is stable. That’s all good. But how’s that elbow looking and working years later?To answer this question, orthopedic surgeons from a trauma unit take a look back at their records and find 110 adults with a simple elbow dislocation. Patients included ranged in age from 15 to 88 years old. …Read more

Tennis Elbow Responds to New Injections

Elbow pain from using a strong grip or repeated wrist movements is called lateral epicondylitis or tennis elbow. This type of pain responds well to a new injection treatment that may replace steroid injections.Plasma taken from the patient’s own blood with high concentrations of platelets is used. The platelet-rich plasma (PRP) releases growth factors into the soft tissues. The result is a faster, more effective healing response.In this study from the Netherlands, researchers report on the two-y…Read more

Six Disabling Complications of Elbow Replacement

Elbow joint replacement isn’t nearly as common as a hip or knee replacement. But when there’s a severe fracture or painful arthritis limiting function, it can be a life-saver. As with any joint replacement procedure, there can be complications. In fact, the risk of problems following elbow replacement is far greater than with a hip or knee replacement.In this review article, surgeons from Harvard Medical School and Massachusetts General Hospital team up together to give us some details about thi…Read more

Pronator Syndrome: Illness or Disease?

If you have ever experienced the aching forearm pain caused by pronator syndrome, then it’s likely you believe this condition to be a real and true problem. But some experts in the orthopedic world aren’t convinced.Pronator syndrome is a nerve entrapment (pressure on the median nerve in the forearm). The median nerve traveling down the inside of the forearm can get pinched between two other soft tissue structures such as muscles, tendons, ligaments, or fascia (connective tissue).The syndrome pro…Read more

Update on the Surgical Treatment of a Stiff Elbow

Surgeon Alert: Update on the Surgical Treatment of a Stiff Elbow Surgeons will want to take a look at this article. Two surgeons from the Department of Orthopaedic Surgery at Washington University in St. Louis (WUSTL) provide an in-depth review of surgical treatment of the stiff elbow.The authors begin by discussing when to do arthroscopic surgery versus an open procedure. Then they move on to surgical technique including equipment, patient positioning, and a description of various techniques (…Read more

Treatment of Chronic Elbow Bursitis

Swelling or a boggy lump around the point of the elbow is often caused by a condition known as chronic olecranon bursitis. The swelling might increase and decrease but it never goes away fully. Some people have elbow pain or tenderness (especially if there is an infection) but many do not. Elbow range-of-motion may be limited but full motion is often present.How can this be treated when there is no infection? That’s the question answered in this review of chronic olecranon bursitis. A bursa is a…Read more

Surgeons Advice on Acute Compartmental Syndrome of the Arm

From the outside you wouldn’t know by looking at the forearm that there are three separate compartments. Each section is separated by connective tissue called fascia. The hand has 10 of these compartments. There are a total of 15 compartments in the entire upper extremity (arm) from shoulder to hand. Any condition that changes the pressure in a compartment can reduce blood flow (called ischemia) and cause death of the tissues (necrosis).Injuries that increase pressure in any one of these compart…Read more

Getting Athletes with Elbow Injuries Back on Track

When it comes to ulnar collateral ligament (UCL) injuries in overhead throwing athletes, the authors of this study bring a wealth of experience to the table. After performing surgery on 1,281 patients, their success rate is much higher than reported in other published studies.The ulnar collateral ligament is located at the elbow. It supports the humerus-to-radius connection and helps stabilize the elbow. The humerus is the upper arm bone. The radius is one of the bones in the forearm. Without th…Read more

Unusual Biceps Tendon Injury

Review and Update on Unusual Biceps Tendon Injury From anatomy to the post-operative rehab process, the authors of this article provide us with a complete review of injuries to the biceps tendon. The specific focus is on the distal insertion of the tendon. That’s where it attaches to the radius (bone in the forearm).Read more

Preferred Treatment for OCD of the Elbow

Orthopedic Surgeons Offer Their Preferred Treatment for OCD of the Elbow Overhead throwing athletes (especially pitchers) of all ages are at risk for elbow and shoulder problems. In this review, orthopedic surgeons from Harvard Medical School, Wellesley Hospital, and Tufts University walk us through all aspects of osteochondritis dissecans (OCD) of the elbow in pediatric patients.What is osteochondritis dissecans? OCD is a condition in which a piece of cartilage and the underlying bone have bee…Read more

Treating Unstable Elbow Injuries

The elbow is normally a very stable, solid joint. It doesn’t dislocate easily. But when a traumatic injury occurs and enough force is placed on it, fracture and dislocation can be the result. In this continuing medical education (CME) article, orthopedic surgeons from the Hand and Upper Extremity Service at Massachusetts General Hospital in Boston present an update on the surgical repair of traumatic elbow instability.The key anatomical feature of elbow dislocations is the lateral collateral lig…Read more

Can Ultrasound Findings Predict Tendon Healing in the Elbow?

Tennis elbow, also known as lateral elbow tendinopathy can be very hard to predict. Physical Therapy often helps reduce painful symptoms, improve motion, and restore function. But after months of therapy, some patients may still need surgery. On the other hand, some people heal up nicely on their own and don’t need rehab or surgery.Is there some way to predict in advance who needs what? In this study, orthopedic surgeons and radiologists team up to explore the usefulness of ultrasound studies in…Read more

Tennis Elbow Could Originate in the Neck

It might seem funny but tennis elbow (also known as lateral epicondylitis) could be caused by a problem in the neck. In other words, it may not be coming directly from the elbow. True lateral epicondylitis occurs as a result of local trauma and tissue inflammation. Overuse of the extensor carpi radialis brevis tendon causes microtrauma where the tendon attaches to the elbow.Read more

A Thorough Review of Cubital (Not Carpal!) Tunnel Syndrome Information

Have you been diagnosed with ulnar nerve entrapment syndrome? This article describes the mechanisms of entrapment, and conservative and surgical treatment options. Contact Synergy Therapeutic Group if you would like further information about Physical Therapy treatment options.Read more

A Rare But Important Tendon Injury

Have you fallen on your outstretched arm, and now have difficulty straightening your elbow? This article is concerned with triceps muscle rupture, and outlines the importance of early diagnosis, and treatment. Persons who have sustained an arm injury are advised to seek an assessment at Synergy Therapeutic Group to diagnose their specific injury.Read more

Review of Osteochondritis Dissecans of the Capitellum Management

Attention Synergy Therapeutic Group patients suffering with elbow pain! This is a mid term report of a study of young athletes who have undergone surgical treatment for osteochondritis dessicans at the elbow. Check with your Physical Therapist to find out if your chronic elbow pain could be from osteochondritis dessicans.Read more

Pinched Nerves Can Happen Anywhere

Radial nerve compression is described, presenting in three peripheral areas in the arm: posterior interosseus nerve syndrome, radial tunnel syndrome, and superficial radial nerve compression. Synergy Therapeutic Group patients who are presented with arm pain, or paralysis, may find this article of interest, but should take caution that there is the possibility of nerve pinching to be ocurring more proximally, like in the the neck area.Read more

Wanted: Instrument to Measure Results of Treatment for Cubital Tunnel Syndrome

You’ve heard it over and over from us: doctors, Physical Therapists, and other individuals dedicated to research are seeking evidence to show what treatment works best for each orthopedic condition or problem. Today, we report on the results of information gathered about cubital tunnel syndrome. Are patients happy with the results? Does their satisfaction match the surgeon’s view of the results?Cubital tunnel syndrome is a condition that affects the ulnar nerve where it crosses the inside edge o…Read more

Education a Good Option for Ulnar Neuropathy (Cubital Tunnel Syndrome)

Many people have heard of carpal tunnel syndrome, where a nerve going through the wrist to the hand is compressed, causing pain and numbness. But, although ulnar neuropathy, pressure on the nerve in the elbow, is the second most common nerve entrapment problems after carpal tunnel, not many people know about it.The most common cause of ulnar neuropathy in older people is degeneration in the elbow. In younger patients, it’s often caused by repetitive motions, much like carpal tunnel syndrome is. …Read more

Optimal Treatment for Cubital Tunnel Syndrome Still Not Defined

While most people have heard of carpal tunnel syndrome, a condition in which the nerves going through the carpal tunnel in the wrist are pinched, another condition called cubital tunnel syndrome also exists. With cubital tunnel syndrome, the pressure is on the back of the elbow onto the ulnar nerve – where your “funny bone” is. It can cause pain, weakness, or numbness of the hand. It can also cause numbness or a pins-and-needles sensation on the ring finger or small finger (pinky).