COMMON PAIN SYNDROMES AND INJURIES RELATED TO THE SHOULDER INCLUDE, BUT ARE NOT LIMITED TO:
- Elbow and Wrist Pain
- Carpal Tunnel Syndrome
- Cubital Tunnel Syndrome
- "Golfer’s Elbow" [Medial Epicondylitis]
- Hand Injury
- "Tennis Elbow" [Lateral Epicondylitis]
- Wrist Fractures
The bones of the elbow are the humerus (the upper arm bone), the ulna (the larger bone of the forearm on the opposite side of the thumb), and the radius (the smaller bone of the forearm on the same side as the thumb). The elbow itself is essentially a hinge joint, meaning it bends and straightens like a hinge. There is a second joint where the end of the radius (the radial head) meets the humerus. This joint is complicated because the radius has to rotate so that you can turn your hand palm up and palm down. At the same time, it has to slide against the end of the humerus as the elbow bends and straightens. The joint is even more complex because the radius has to slide against the ulna as it rotates the wrist as well. The end of the radius at the elbow is shaped like a smooth knob with a cup at the end to fit on the end of the humerus. The edges are smooth where it glides against the ulna.
The muscles of the forearm cross the elbow and attach to the humerus. The outside, or lateral, bump just above the elbow is called the lateral epicondyle. Most of the muscles that straighten the fingers and wrist all come together in one tendon to attach in this area. The inside, or medial, bump just above the elbow is called the medial epicondyle. Most of the muscles that bend the fingers and wrist all come together in one tendon to attach in this area. These two tendons are important to understand because they are a common location of tendonitis. The main muscles that are important at the elbow are the biceps, the triceps, the wrist extensors (attaching to the lateral epicondyle) and the wrist flexors (attaching to the medial epicondyle).
The wrist joint is a very complex joint formed between the ends of the radius and ulna and the carpal bones. It is a joint that connects the arm to the hand. There are 8 carpal bones: Lunate, Triquetrum, Pisiform, Capitate, Trapezium, Trapezoid, Hamate, Scaphoid. Two bones, the scaphoid and the lunate, articulate with the radius and ulna to form the wrist joint. Most of the forearm muscles have a tendon that crosses the wrist joint and attaches in the hand. There are many muscles on the front and back of the forearm that are responsible for flexing and extending our hand. Three nerves pass from the forearm, across the wrist and into the hand. These are the radial nerve, the median nerve and the ulnar nerve. The radial nerve it towards the thumb side and provides sensation to the back of the hand from the thumb to middle finger. The median nerve is involved in carpal tunnel syndrome and supplies sensation to the thumb and next two fingers with sensation on just half of the ring finger. The ulnar nerve in on the pinky side and reaches the other half of the ring finger and the pinky.