From the Guidelines
Lateral elbow sprain is a type of injury that affects the lateral collateral ligament of the elbow, causing pain, decreased range of motion, and instability.
Definition and Causes
- Lateral elbow sprain is a soft tissue injury that occurs when the lateral collateral ligament is stretched or torn, often due to a fall or direct blow to the elbow 1.
- This type of injury is commonly seen in athletes who participate in overhead throwing activities, as well as in individuals who experience traumatic injuries to the elbow.
Diagnosis and Imaging
- Diagnostic imaging, such as ultrasound (US) and magnetic resonance imaging (MRI), plays a crucial role in assessing acute elbow pain and identifying the damaged structures 1.
- US can be used to evaluate the lateral compartment of the elbow and detect changes related to tendon tears or muscular avulsions, but its accuracy in identifying injuries to the lateral collateral ligament is limited 1.
- MRI is a more accurate imaging modality for identifying the type of distal biceps tendon tear and enabling precise treatment planning 1.
Treatment and Management
- Treatment for lateral elbow sprain typically involves conservative measures, such as physical therapy and bracing, although surgical fixation may be necessary in cases of gross instability 1.
- The goal of treatment is to restore joint stability, reduce pain and inflammation, and improve range of motion and function.
- In some cases, US can be used to guide injections or other interventions to help manage pain and promote healing 1.
From the Research
Definition and Causes of Lateral Elbow Sprain
- Lateral elbow sprain is typically related to instability of the elbow, which can be posttraumatic in nature 2.
- The lateral elbow is supported by a combination of bony anatomy and the ligaments and tendons that originate at the lateral epicondyle 2.
- Injury to the medial or lateral ulnar collateral ligaments may result in instability, with repetitive trauma from overuse being a common etiologic factor in athletes 3.
Symptoms and Diagnosis
- Chronic posterolateral rotatory instability (PLRI) is the most common form of chronic elbow instability, usually occurring from a fall on the outstretched hand 4.
- PLRI is mainly a clinical diagnosis with a history of instability, clicking, and lateral-sided pain, with a positive clinical examination including the pivot-shift test, push-up, chair, and tabletop test 4.
- MRI can often help guide diagnosis but more commonly assists in surgical planning 4.
Treatment and Rehabilitation
- Surgery is indicated in patients with persistent, symptomatic instability of the elbow causing pain or functional deficit 4.
- Rehabilitation with the arm overhead improves elbow stability after lateral collateral ligament (LCL) injury, and initiating earlier range of motion in this "safe position" might decrease elbow stiffness and allow optimal ligament healing 5.
- Active motion with forearm pronation should be encouraged in the dependent position, and varus arm positioning should be avoided 5.