- Cubital Tunnel/Ulnar Nerve Entrapment
- Tennis Elbow
- UCL Injuries & Tommy John Surgery
- Elbow Arthroscopy
- Golfer’s Elbow
- Bicep Tendon Rupture
- Biceps Tendon Surgery
- Patient Education – Animated Procedures & Conditions
Cubital Tunnel/Ulnar Nerve Entrapment
Similar to carpal tunnel syndrome, cubital tunnel syndrome causes pain and numbness as a result of long-term nerve inflammation. In cubital tunnel syndrome, the ulnar nerve is affected at the site of the cubital tunnel, located in the elbow. Inflammation may occur as a result of frequent bending of the elbow or simply from the natural anatomy of the elbow joint.
Patients with this condition often experience pain and numbness on the outside of the hand and wrist, especially after the elbow has been bent for a long period of time. Your doctor can diagnose this condition through a physical exam and nerve conduction velocity test.
Treatment for cubital tunnel syndrome may involve anti-inflammatory medication, splints, braces or life changes to relieve symptoms or prevent them from recurring. For symptoms that do not respond to conservative methods, surgery may be needed to relieve pressure on the ulnar nerve, which can be done through ulnar nerve transposition or medial epicondylectomy. Most patients are able to receive successful relief from cubital tunnel syndrome.
Tennis elbow, also known as lateral epicondylitis, is an elbow injury that occurs as a result of overuse, most commonly from playing tennis. The pain associated with this condition affects the lateral epicondyle, the area where the forearm’s tendons connect with the bony outer portion of the elbow. While tennis elbow typically affects adults aged 30 to 50, anyone who continually stresses their wrists is at a higher risk of developing this condition.
In many cases, tennis elbow heals on its own within two years. Initial pain can often be managed with rest, ice and over-the-counter painkillers. Cases that don’t respond to the aforementioned measures may require additional treatment, in the form of exercises, orthotics, or corticosteroids. Severe, persistent cases of tennis elbow may require surgery; however, surgery is only necessary for about ten percent of those suffering from tennis elbow.
The ulnar collateral ligament (UCL) is vital to maintaining elbow stability and function. However, this ligament is a common injury associated with several different sports, especially throwing sports such as baseball, javelin, and football. Although this is usually a chronic injury, the UCL can also be ruptured by a fall on an outstretched hand or similar trauma.
Surgery is not normally indicated for most patients, but may be necessary for athletes in order to help them fully recover. The ligament is reconstructed using another ligament from the patient’s own body (autograft), most likely from the forearm, hamstring, or knee. The palmaris longus tendon is a commonly used replacement, and it is threaded through holes drilled by the surgeon in a figure-8, thus ensuring adequate tension.
The elbow is then immobilized for one to two weeks, after which shoulder range of motion exercises can be performed. Most athletes do not return to play for a year or more. However, most patients eventually regain full strength and function after a lengthy recovery, with some athletes playing more successfully than they did before surgery.
Tommy John Procedure
Tommy John surgery is a surgical procedure performed to repair torn ligaments in the elbow after a damaging injury to the area. This procedure, named for Los Angeles Dodgers pitcher Tommy John, can effectively relieve pain and instability in patients with a torn or damaged ulnar collateral ligament (UCL). A torn UCL commonly affects pitchers, and could even end a baseball player’s career if severe enough.
During Tommy John surgery, the tendon in the forearm is used to recreate the damaged ligament and restore stability to the joint. Most patients achieve successful results from this procedure, although it often requires a lengthy recovery period of 12 to 18 months before athletes can return to activity. Your surgeon will provide specific instructions regarding postoperative care and instructions for patients who have undergone Tommy John surgery.
Arthroscopy is a type of surgery that uses anarthroscope (thin fiber optic camera) to visualize the area to be operated on, as well as multiple small portals through which the surgeon’s tools are manipulated. This procedure offers patients a relatively shorter recovery time as opposed to conventional “open” surgery. Much less soft tissue is injured during the operation, leaving less room for post-surgery complications.
Elbow arthroscopy is generally used for simple manipulations of the joint. It is also very useful for arthritis as tools capable of debriding can be inserted and used to smooth out the problematic bone surfaces in a minimally invasive manner.
The arthroscopic procedures are commonly used to confirm and examine abnormalities occurring in patients. This diagnostic use is helpful in ensuring that the patient will be recovering in the shortest amount of time possible. However, arthroscopy is not nearly as prevalent in elbow surgery as it is in other joint specialties such as the knee. This is because the small structure of the joint requires very specialized training.
Medial epicondylitis, more commonly known as Golfer’s Elbow, is a form of tendonitis that manifests on the inner side of the elbow. It is caused by the tendon in the forearm being stressed from constant use, but is not restricted to golfers; pitchers and even those not involved in sports can develop golfer’s elbow.
Golfer’s elbow is generally treated using analgesics and anti-inflammatory medication, as well as resting the elbow.
Bicep Tendon Rupture
Tendon rupture in the upper extremities commonly affects the biceps tendon, and may occur at either end. This tendon can easily be damaged as a result of injury, overuse or age, which may cause the tendon to become inflamed or to tear in more severe cases. Patients with tendon rupture often experience bruising, deformity, pain and weakness with movement. You may notice a popping sound if the tendon tears completely.
Treatment for a tendon rupture often includes a period of rest and immobilization, as well as applying ice and taking anti inflammatory medication. Complete tears, or those that do not heal with conservative treatment, may require surgery to fuse the tendon back down to the bone and relieve symptoms.
Bicep Tendon Surgery
The biceps tendon attaches muscles to the shoulder in two separate places and helps bend the elbow and rotate the forearm. Injury to the tendon can occur as a result of age, inactivity or over-activity, and can result in inflammation or a partial or complete tear. These injuries can cause severe pain, bruising and weakness.
Treatment for biceps tendon injuries may only require rest and anti-inflammatory medications, but more severe cases may require surgery. Surgical treatment depends on the type and severity of the condition. Most of these procedures can be performed through arthroscopy to reduce incision size and recovery time. Theses surgeries can include simply shaving away the torn fibers, removing the torn tendon stump and reattaching the remaining tendon (tenodesis), or completely reattaching torn tendons with screws and sutures.
Patient Education – Animated Procedures & Conditions
Click on a topic below to learn more and view an educational animation.
- Arthroscopic Debridement of the Elbow
- Cubital Tunnel Release at the Elbow
- Medial Ulnar Collateral Ligament Reconstruction (Tommy John Surgery)
- Ulnar Nerve Transposition at the Elbow
This outpatient procedure, performed under local anesthesia with sedation or general anesthesia, allows the physician to examine the cartilage, bones, ligaments and tendons of the elbow for damage or disorders. The physician uses a small camera, called an arthroscope, which is inserted into the elbow. » Watch the animation
This outpatient procedure, performed under general or regional anesthesia, alleviates compression of the ulnar nerve. This nerve travels along the inner side of the elbow and down to the hand. Cubital tunnel release is used to treat cubital tunnel syndrome. » Watch the animation
This procedure is designed to repair a torn elbow ligament – an injury typically caused by strong, repetitive overhead throwing motions of the arm or by dislocation of the elbow. It was first performed in 1974 on baseball pitcher Tommy John. » Watch the animation
This outpatient procedure, performed under general or regional anesthesia, repositions the ulnar nerve to prevent it from sliding against or becoming pinched by the medial epicondyle (the bony bump on the inner side of the elbow). Ulnar nerve transposition is used to treat cubital tunnel syndrome. » Watch the animation
- Lateral Epicondylitis (Tennis Elbow)
- Medial Epicondylitis (Golf Elbow)
- Medial Ulnar Collateral Ligament Injury
- Overuse Injuries of the Elbow
This condition, commonly called tennis elbow, is a degeneration of the tendons that attach to the lateral epicondyle, the bony bump on the outer side of the elbow. » Watch the animation
This condition is a degeneration of the tendons that bend the wrist toward the palm of the hand. These tendons are located above the medial epicondyle, the bony bump on the inner side of the elbow. Although this condition is often referred to as golfer’s elbow, medial epicondylitis can be caused by any repetitious use of these muscles. » Watch the animation
This condition is an injury to the medial ulnar collateral ligament, a ligament composed of three bands located on the inner side of the elbow. The MUCL connects the humerus to the ulna. Injury to the MUCL can cause pain, weakness and sometimes a feeling of instability in the arm. » Watch the animation
Overuse injures can cause pain and other problems in the elbow, forearm, wrist and hand. These injuries typically affect athletes and people who perform repetitive motions. Children and adolescents, whose bones have not yet matured, and factory workers are particularly susceptible to overuse injuries. » Watch the animation