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Contusions

Common injuries among athletes, contusions often involve the muscles of the forearm and portion of the bony prominence of the elbow. In athletes, the forearm often absorbs the greatest portion of the impact - particularly in contact sports. This repeated force to the muscles can result in bruising and possibly bleeding, which produces stiffness during active range of motion activities. Occasionally a contusion is accompanied by a fracture, depending on the severity of the force.

Depending on the area impacted by the force, a contusion can also produce an actute hemorrhagic bursitis or a common chronic olecranon bursitis. A contusion to the ulnar nerve (an area often referred to as the "funny bone") can be very painful and send burning sensations down the ulnar side of the forearm to the ring and little fingers.

Those at Risk
Athletes involved in high impact contact sports such as football, baseball and basketball are most likely to be affected by this condition, though contusions can also result from an accident or fall.

Diagnosis
Patient history, combined with a thorough physical examination that includes range of motion tests, are used in diagnosing elbow trauma. An X-ray may be taken to identify a possible fracture, which sometimes accompanies a trauma resulting in a contusion.

Treatment
Once any accompanying fracture is addressed, a period of rest followed by a series of range of motion exercises may be all that is necessary in the treatment of contusions to the elbow or forearm.

Elbow Instability
Elbow instability is the detachment or thinning of an elbow ligament often caused by throwing activities or sports, or a trauma that resulted in a dislocation. Instability can affect either the outer (lateral) or inner (medial) portion of the elbow.

Elbow instability is classified according to five criteria, which help in identifying the severity of the condition - acute, chronic, or recurrent, as well as the area of irritation, the direction of displacement, the degree of displacement, and any associated fractures.

This condition is symptomatically similar and sometimes confused with arthritis and tendonitis.

Those at Risk
Athletes involved in throwing sports generally develop medial elbow instability. And those experiencing trauma or earlier surgery to repair a dislocated elbow most often develop lateral elbow instability.

Diagnosis
In order to accurately diagnose elbow instability, a physical examination with patient history is obtained - along with X-rays and magnetic resonance imaging (MRI) enhanced with an arthrogram. An arthrogram is the process of injecting the elbow with a small amount of dye in order to enhance the clarity of the MRI, which aids in the capturing of ligament disruption.

Treatment
The conservative treatment plan indicated for elbow instability includes anti-inflammatory medication - possibly combined with a period of immobilization.

In cases nonresponsive to conservative treatment, surgery is performed to reconstruct the biomechanics of the joint and repair the ligaments. Surgery is indicated only when the risk of long-term arthritis from prolonged friction is present.