eMedicine Specialties > Sports Medicine > Upper Limb

Elbow and Forearm Overuse Injuries: Follow-up

Author: Vincent N Disabella, DO, FAOASM, Team Physician, Student Health Service, University of Delaware
Contributor Information and Disclosures

Updated: Feb 12, 2008

Follow-up

Return to Play

Return to play is usually appropriate when (1) the patient's symptoms are tolerable, (2) anatomic and biomechanic corrections are made, and (3) 90% of the strength of the affected side as compared with the unaffected side has returned. If the dominant side is affected, athlete's elbow and forearm should return to 100% of the strength of the nondominant side.

Complications

The major complication of overuse syndromes is the individual returning to the same poor habits that caused the original insult. Care must be taken when correcting the biomechanics of an injury, in order not to cause overuse injuries at another point in the kinetic chain. Very rarely, permanent nerve damage can result from nerve entrapment syndromes.

Prevention

The best way to prevent overuse injury is to stress to athletes and coaches the proper biomechanics with any physical activity. A frequent mistake that athletes make is increasing the intensity or duration of an activity too rapidly for the body to adapt. Runners use a 10% rule that is usually fitting: only increase the weight, distance, or duration of an exercise 10% every 10 workouts.

Related Medscape topic:
Resource Center Exercise and Sports Medicine

Prognosis

The prognosis of most overuse injuries is very good, as long as the athlete completes a thorough rehabilitation program. The correction of any training or biomechanical errors that caused the original overload is also very important.

Education

Educate athletes and coaches concerning preventive measures to help eliminate overuse injuries in their respective sports. Many times, it is important to have the athletes participate in a sound strength and conditioning program to ensure that these individuals are physically prepared for the stresses of their sport.

Related Medscape topics:
Resource Center Exercise and Sports Medicine
Resource Center Trauma
CME/CE Guidelines Issued for Overuse Injuries in Child and Adolescent Athletes
CME/CE Medical Interventions Effectively Treat Overuse Injuries in Adult Endurance Athletes
CME Tendinopathy -- From Basic Science to Treatment

Miscellaneous

Medicolegal Pitfalls

  • The only potential medicolegal issue in elbow and forearm overuse injuries is the misdiagnosis of a nerve entrapment syndrome, which allows the injury to progress to permanent nerve damage. This condition very rarely occurs if the physician initially performs a thorough history and physical examination and follows the patient closely throughout the treatment of the injury.

Related Medscape topics:
Resource Center Medical Malpractice and Legal Issues
Resource Center Trauma

Special Concerns

  • Overuse injuries of the elbow are often seen in pediatric athletes. This is especially true in the throwing athletes, which is covered in a special article in this journal entitled Little League Elbow Syndrome. Take caution with these athletes to prevent permanent damage to the physis.
 


More on Elbow and Forearm Overuse Injuries

Overview: Elbow and Forearm Overuse Injuries
Differential Diagnoses & Workup: Elbow and Forearm Overuse Injuries
Treatment & Medication: Elbow and Forearm Overuse Injuries
Follow-up: Elbow and Forearm Overuse Injuries
References
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References

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Further Reading

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Keywords

biceps tendinosis, biceps tendinopathy, biceps tendonitis, anterior capsule strain, pronator syndrome, median nerve compression syndrome, median nerve entrapment, radial tunnel syndrome, posterior interosseous nerve compression syndrome, triceps tendinosis, triceps tendinopathy, triceps tendinitis, olecranon impingement syndrome, posterior impingement syndrome, hyperextension valgus overload syndrome, boxer's elbow, tennis elbow, olecranon stress fractures, radiocapitellar chondromalacia, posterolateral rotatory instability, ulnar neuropathy

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Contributor Information and Disclosures

Author

Vincent N Disabella, DO, FAOASM, Team Physician, Student Health Service, University of Delaware
Vincent N Disabella, DO, FAOASM is a member of the following medical societies: American College of Sports Medicine, American Medical Society for Sports Medicine, and American Osteopathic Association
Disclosure: Nothing to disclose.

Medical Editor

Joseph P Garry, MD, Director of Sports Medicine and Sports Medicine Fellowship, Associate Professor of Family Medicine and Exercise & Sport Science, Department of Family Medicine, East Carolina University Brody School of Medicine
Joseph P Garry, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Heart Association, American Medical Society for Sports Medicine, North American Primary Care Research Group, and North Carolina Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

CME Editor

Jon B Whitehurst, MD, Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner and Executive Board Member, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital
Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

Chief Editor

Sherwin SW Ho, MD, Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago
Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

 
 
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