I think I tore my biceps tendon, what can I do?
Your biceps muscle has tendons at the shoulder and the elbow that attach it to bone to give the muscle points to pull from to allow motion about your elbow. The attachment site at the elbow is an area that can be vulnerable to injury in certain patients. Some patients can have degeneration within this tendon as they get older which puts the tendon at risk of rupture. This can occur with a traumatic event or something as simple as picking up a piece of furniture. Most of these injuries occur in men in their 40s – 60s. While some cases can be treated without surgery, many patients elect to have their tendon repaired so they can get back to their occupations or hobbies without strength limitations. The surgery is done via one or two incisions and the tendon is repaired back to its normal insertion site to allow it help flex the elbow and supinate (turn the palm up) the forearm.
I fractured my elbow, what can be done to fix it?
Fractures of the elbow constitute a spectrum of injuries with regard to severity and location. In general, these fractures can involve your distal humerus (arm side of elbow) or your proximal radius and ulna (forearm side of elbow). Some fractures can be treated non-operatively with a short course of immobilization in a splint followed by early range of motion to help prevent stiffness. Meanwhile, other fractures may require surgery that consists of open reduction of the fracture through an incision(s) and internal fixation with plates and screws. Occasionally there are some fractures in elderly patients that are severe enough that an elbow replacement will provide the patient with a better long-term outcome than attempting to repair the fracture. In the vast majority of cases, early range of motion is key to try to help prevent stiffness which can be a problem with these fractures.
What is lateral epicondylitis? How do I treat it?
Lateral epicondylitis is better known as tennis elbow. It is a condition that can affect up to 1-3% of adults every year and is most common in patients in their 30s – 50s. While it was thought by some to be an inflammatory condition, it is really the result of microtears and subsequent degeneration in the tendons of the muscles that extend the wrist. In the vast majority of patients, this condition can be successfully treated non-operatively with a combination of rest, physical therapy, bracing and activity modification. Occasionally some patients may require a steroid shot to help in the process. Occasionally ultrasound treatments may be used as well to try to help the recovery process. A small minority of patients will not improve with these treatment modalities and will end up requiring surgery, which can be done arthroscopically or open.
What is medial epicondylitis? How do I treat it?
Medial epicondylitis is better known as golfer’s elbow. It is a condition that affects the tendons of the muscles that help to flex the wrist and pronate the forearm. It much less common than tennis elbow and tends to affect patients in their 30s – 60s. Like tennis elbow it is the result of microtears and subsequent degeneration within the tendons of the muscles on the medial (inside) aspect of the elbow. Occasionally, the ulnar nerve may be irritated as well and cause numbness and tingling to radiate down to the small and ring fingers. If the nerve is also affected, patients may report weakness with grip and placing a key in a lock. Many patients will see relief with rest, activity modification, bracing and physical therapy. Again, a small subset of patients may require an ultrasound procedure to help the healing process. While this works for most patients, there is a group of patients in whom these conservative treatments are unsuccessful. In these patients, surgery may be performed with a small incision to address the diseased tendon.
My elbow is stiff and I think I have arthritis, what can I do?
Elbow arthritis is much less common than arthritis in the shoulder. Some causes of elbow arthritis are: a prior injury (post-traumatic), an underlying condition (i.e. rheumatoid arthritis), or primary osteoarthritis to name a few. Depending on the underlying cause, patients can present over a wide age spectrum. For patients who have an underlying condition, such as rheumatoid arthritis, that is contributing to the disease spectrum, utilizing medications targeted to treat the underlying condition should be one of the first lines of treatment. In the vast majority of patients, the treatment approach starts with conservative measures. These include physical therapy, activity modification, splinting, anti-inflammatory medications, and occasional steroid injections. For patients in whom these conservative treatments fail, surgical options include both arthroscopic and open procedures, with the final treatment option being total elbow replacement.