The humerus is a long bone in the arm that runs from the shoulder to the elbow. It connects the scapula and the two bones of the lower arm, the radius and ulna, and consists of three sections. The humeral upper extremity consists of a rounded head, a narrow neck, and two short processes. The body is cylindrical in its upper portion, and more prismatic below. The lower extremity consists of 2 epicondyles, 2 processes, and 3 fossae. As well as its true anatomical neck, the constriction below the greater and lesser tubercles of the humerus is referred to as its surgical neck due to its tendency to fracture, thus often becoming the focus of surgeons.
Ulnar collateral ligament reconstruction, colloquially known as Tommy John surgery (TJS), is a surgical graft procedure where the ulnar collateral ligament in the medial elbow is replaced with either a tendon from elsewhere in the patient's body, or with one from a deceased donor. The procedure is common among collegiate and professional athletes in several sports, particularly in baseball. The surgery is performed to restore optimal function for repetitive elbow movements or specifically throwing ability, often extending the careers of professional athletes. In many athletes, the surgery is done more than once during their careers.
In baseball, the pitcher is the player who throws ("pitches") the baseball from the pitcher's mound toward the catcher to begin each play, with the goal of retiring a batter, who attempts to either make contact with the pitched ball or draw a walk. In the numbering system used to record defensive plays, the pitcher is assigned the number 1. The pitcher is often considered the most important player on the defensive side of the game, and as such is situated at the right end of the defensive spectrum. There are many different types of pitchers, such as the starting pitcher, relief pitcher, middle reliever, lefty specialist, setup man, and the closer.
In baseball and softball, the curveball is a type of pitch thrown with a characteristic grip and hand movement that imparts forward spin to the ball, causing it to dive as it approaches the plate. Varieties of curveball include the 12–6 curveball, power curveball, and the knuckle curve. Its close relatives are the slider and the slurve. The "curve" of the ball varies from pitcher to pitcher.
The ulnar collateral ligament (UCL) or internal lateral ligament is a thick triangular ligament at the medial aspect of the elbow uniting the distal aspect of the humerus to the proximal aspect of the ulna.
Epicondylitis is the inflammation of an epicondyle or of adjacent tissues. Epicondyles are on the medial and lateral aspects of the elbow, consisting of the two bony prominences at the distal end of the humerus. These bony projections serve as the attachment point for the forearm musculature. Inflammation to the tendons and muscles at these attachment points can lead to medial and/or lateral epicondylitis. This can occur through a range of factors that overuse the muscles that attach to the epicondyles, such as sports or job-related duties that increase the workload of the forearm musculature and place stress on the elbow. Lateral epicondylitis is also known as “Tennis Elbow” due to its sports related association to tennis athletes, while medial epicondylitis is often referred to as “golfer's elbow.”
The cubital tunnel is a space of the dorsal medial elbow which allows passage of the ulnar nerve around the elbow. It is bordered medially by the medial epicondyle of the humerus, laterally by the olecranon process of the ulna and the tendinous arch joining the humeral and ulnar heads of the flexor carpi ulnaris. The roof of the cubital tunnel is elastic and formed by a myofascial trilaminar retinaculum. In 14% of individuals, the roof of this tunnel is covered by epitrochleoanconeus muscle, a variant muscle.
The lateral epicondyle of the humerus is a large, tuberculated eminence, curved a little forward, and giving attachment to the radial collateral ligament of the elbow joint, and to a tendon common to the origin of the supinator and some of the extensor muscles. Specifically, these extensor muscles include the anconeus muscle, the supinator, extensor carpi radialis brevis, extensor digitorum, extensor digiti minimi, and extensor carpi ulnaris. In birds, where the arm is somewhat rotated compared to other tetrapods, it is termed dorsal epicondyle of the humerus. In comparative anatomy, the term ectepicondyle is sometimes used.
The lateral collateral ligament is an extrinsic ligament of the knee located on the lateral side of the knee. Its superior attachment is at the lateral epicondyle of the femur ; its inferior attachment is at the lateral aspect of the head of fibula. The LCL is not fused with the joint capsule. Inferiorly, the LCL splits the tendon of insertion of the biceps femoris muscle.
In baseball, sidearm is a motion for throwing a ball along a low, approximately horizontal plane rather than a high, mostly vertical plane (overhand).
Golfer's elbow, or medial epicondylitis, is tendinosis of the medial common flexor tendon on the inside of the elbow. It is similar to tennis elbow, which affects the outside of the elbow at the lateral epicondyle. The tendinopathy results from overload or repetitive use of the arm, causing an injury similar to ulnar collateral ligament injury of the elbow in "pitcher's elbow".
Ulnar nerve entrapment is a condition where pressure on the ulnar nerve as it passes through the cubital tunnel causes nerve dysfunction (neuropathy). The symptoms of neuropathy are paresthesia (tingling) and numbness primarily affecting the little finger and ring finger of the hand. Ulnar neuropathy can progress to weakness and atrophy of the muscles in the hand. Symptoms can be alleviated by attempts to keep the elbow from flexing while sleeping, such as sticking one’s arm in the pillow case, so the pillow restricts flexion.
The elbow is the region between the upper arm and the forearm that surrounds the elbow joint. The elbow includes prominent landmarks such as the olecranon, the cubital fossa, and the lateral and the medial epicondyles of the humerus. The elbow joint is a hinge joint between the arm and the forearm; more specifically between the humerus in the upper arm and the radius and ulna in the forearm which allows the forearm and hand to be moved towards and away from the body. The term elbow is specifically used for humans and other primates, and in other vertebrates forelimb plus joint is used.
A supracondylar humerus fracture is a fracture of the distal humerus just above the elbow joint. The fracture is usually transverse or oblique and above the medial and lateral condyles and epicondyles. This fracture pattern is relatively rare in adults, but is the most common type of elbow fracture in children. In children, many of these fractures are non-displaced and can be treated with casting. Some are angulated or displaced and are best treated with surgery. In children, most of these fractures can be treated effectively with expectation for full recovery. Some of these injuries can be complicated by poor healing or by associated blood vessel or nerve injuries with serious complications.
The overhandthrow is a single-handed throw of a projectile where the object is thrown above the shoulder.
Ulnar collateral ligament injuries can occur during certain activities such as overhead baseball pitching. Acute or chronic disruption of the ulnar collateral ligament result in medial elbow pain, valgus instability, and impaired throwing performance. There are both non-surgical and surgical treatment options.
Medial knee injuries are the most common type of knee injury. The medial ligament complex of the knee consists of:
Dr. Jeremy Bruce is an Orthopaedic Surgeon at Erlanger Hospital in Chattanooga, Tennessee. He is also a Program Director and Director of Sports Medicine for the Orthopedic Residency program at The University of Tennessee College of Medicine in Chattanooga. He is a ringside physician that has covered UFC fights, Bellator fights, Ringside World Boxing championship, USA Boxing events and is a member of the USA Boxing Medical Commission. Dr. Bruce was a member of the USA Bobsled and Skeleton Team and competed alongside future Olympic gold medalist Jim Shea in the North American Skeleton Championship in Calgary, AL (1994).
A medial epicondyle fracture is an avulsion injury to the medial epicondyle of the humerus; the prominence of bone on the inside of the elbow. Medial epicondyle fractures account for 10% elbow fractures in children. 25% of injuries are associated with a dislocation of the elbow.
Early sports specialization is the phenomenon of a child or teenaged athlete intensively pursuing a single sport or athletic activity year-round, instead of participating in a wide variety of activities. Premature emphasis on a single sport is associated with physical injuries, mental health problems, and psychosocial harm to young athletes. Many young athletes who are pushed to excel in a single sport quit playing prematurely, or are forced to stop because of injuries.
