Healthy ArmsHello and thank you for taking time out of your day to read my blog – Healthy Arms: Your Elbow and Wrist.

I am writing an overview of your wrist and elbow anatomy as well as some of the common conditions that can occur in them.

Find out what to do if you have any discomfort in your arms, as well as understand why it might have occurred and how to go about avoiding it happening again.

Elbow and Wrist Anatomy

Your upper arm is made up of one bone, the Humerus, and is home to four muscles, which aid movement at the elbow; the Biceps Brachii, Brachialis and Coracobrachialis in the anterior compartment of the arm (the front) and the Triceps Brachii in the posterior compartment (the back).

Your Lower arm has two bones, the Radius and the Ulna.  The joint these bones make with the Humerus, is your elbow. It is a hinge-type synovial joint. The forearm is home to many more muscles than the upper arm. The Pronator Teres, Flexor Carpi Radialis, Palmaris Longus, Flexor Carpi Ulnaris, Flexor Pollicis Longus, Pronator Quadratus, Flexor Digitorum Profundus… to name some of them.

Because the wrist and hand rely on muscles to operate them, many of those originate in the forearm.  Look at that list again and see if you can identify which muscles might directly move the bones of the hand, the carpals.

Muscle names often come from the bones they attach to or move, the shape of them, or the size of them, which is helpful when learning anatomy.

Your wrist is made up of both the Ulna and Radius of your forearm, as well as eight more bones. They are the Trapezoid, Trapezium, Scaphoid, Capitate, Hamate, Pisiform, Triquestrum and Lunate. The most injured of these is the scaphoid, which is located near to the base of your thumb.

There is a lot more going on in the forearm and wrist, including nerves and ligaments, so if any of the conditions I talk about next ring a bell, looking into it in more detail could help you.

Conditions at the Elbow and Wrist

Lateral Epicondylitis – Known as Tennis Elbow, is a type of tendinitis on the outside of the elbow. When you have overused your elbow in tennis like movements and it becomes irritated. This can happen in any repetitive movement, but as it is extremely common in tennis and other racquet sports, so it has become known as Tennis Elbow.

Medial Epicondylitis – Known as Golfers Elbow, is also a type of tendinitis on the inside of the elbow.

Carpal Tunnel Syndrome – when the median nerve that travels through the carpal tunnel becomes irritated. Can cause tingling, numbness, and other sensations in the wrist and hand.  Often the nerve has been squeezed from further up the arm, maybe even at the neck.

Cubital Tunnel Syndrome – When the ulnar nerve gets squeezed as it runs along the inside of your elbow and passes through tissue called the cubital tunnel. Characterised by numbness in your arm, hand, and fingers.

Radial Tunnel Syndrome – this is when the radial nerve is squeezed near the outside of your elbow.

Olecranon Bursitis – the bursa covering the olecranon (elbow point of ulna) becomes irritated and swollen. The bursa covers the joint to allow comfort of movement, and ease of sliding of muscles and tendons over bones.

Dislocation – when a bone gets knocked out of place by a force. Could also result in ligament damage, as it is ligaments that hold bones in place.

Fracture – when a break to the bone occurs near the elbow, it is a broken elbow. This happened to me in September 2019, when I tripped out of the rabbit run in my garden. I put out my arm and the force of landing on it broke the head of my radius bone.

Strains and Sprains – a strain is when a muscle gets stretched or torn. A sprain it is the ligaments. These are common in racquet sports.

Arthritis – a disease effecting any of the bones of the body, causing stiffness in the joints due to a breakdown of healthy tissues.

Lupus – an autoimmune illness that effects the whole body, however it can attack the hands and feet, and sometimes the elbow.

Osteochronditis Dissecans – found mostly in children and teenagers, where a piece of bone near the elbow dies. It can then break off which causes discomfort during movement. It can also occur in the knees.

Ganglion Cysts – these are non-cancerous fluid filled lumps and can cause compression of the soft tissues near them, but usually are harmless and can disappear on their own.

Healthy Arms: Helping Your Elbow and Wrist

As with several conditions, most of these can be solved with rest, and massage to relieve the tense muscles. Massage also allows greater blood flow to an area, and this can speed up recovery because blood carries oxygen and nutrients with it.

The next step, once a reduction in discomfort has happened, is stretching the muscles back to their pre-injury length. To avoid future reoccurrences, strengthening the muscles involved is vital so that they can cope with the load you are expecting of them.

Because of the close relationship the elbow and wrist have with the shoulder, do not think that it is just a problem in those two joints.  Taking the shoulder, and the neck too if it is a nerve issue, into consideration is vital if a problem is to be solved. Carpal Tunnel Syndrome is quickly diagnosed (and self-diagnosed) because of the location of the discomfort, but as I mentioned above, can be the result of something else going on.  It is disappointing that around half of all carpal tunnel surgeries are ineffective for this very reason.

I have spoken to many people in discomfort with one thing and another, and the commonality between them is that surgery would not be effective, or it has not been effective. Seek alternative treatments first, and often it is a combination of treatments that achieve results.

If you’re not sure where to start with keeping your elbows and wrists healthy, look at Pilates, yoga, swimming and dancing as great forms of exercise for your whole body as well as your arms overall. If you have a problem with your elbow or wrist, but do not know what it is and where to start with helping it, then book an appointment with a professional who can point you in the right direction.

As a Sports Massage Therapist, I am not a diagnostician, but I have seen many conditions in clinic so I can give you an educated guess so that you can investigate further. Plus, massage has many other benefits and you might find that you do not need any further treatment after all. Sometimes just knowing that something is not seriously wrong can go a long way to relieving your discomfort to a liveable level.

Thank you for reading this week’s blog, and I hope that it will be very soon that my doors will be open to appointments. Check out future blogs to learn what I have been up to during lockdown and what I have changed about the way I operate my clinic under new guidelines.

See you on the other side,

Chloe

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