Javelin Thrower’s Elbow

Javelins Thrower’s Elbow is mostly caused by overuse. Javelin throwers elbow is a sprain or injury to the medial ulnar collateral ligament of the elbow, which is easily susceptible to injury. As the injury is commonly seen in javelin throwers, it is named javelin throwers elbow.

Javelin Thrower’s Elbow happens when a player is subjected to a valgus force (which is many times bigger than the tensile properties of the ulnar collateral ligament) because of improper throwing.

It is also seen in the athletes who play overhead sports. Initially, the subject complained of sharp pain while throwing and aching pain at the medial elbow after a heavy workload which eventually interferes with the performance of the athlete.

SIGNS AND SYMPTOMS

• Swelling around the elbow much to the medial aspect
• Decreased range of motion at the elbow due to pain
• Tenderness at the medial aspect of the elbow

PHYSIOTHERAPY MANAGEMENT

Acute phase

• Application of elbow sleeve
• Depending upon the extent of injury PRICE or POLICE protocol has to be administered
• Cessation of throwing or valgus force to be done for at least 4 to 6 weeks

REHABILITATION PHASE

• Strengthening exercises for elbow flexors, extensors, pronators, supinators, wrist flexors, and extensors have to be done.
• Stretching exercises
• Initially strengthening is done by performing isometrics, later on after stability is achieved throwing technique has to be incorporated I.e.by abducting the shoulder (120-130deg) so internal rotation of the arm brings the elbow forward without putting extra strain on UCL.

Physiotherapy rehabilitation has to be continued until the client complaints of zero pain or discomfort 

DIFFERENTIAL DIAGNOSIS

• Medial epicondylitis
• Medial epicondylitis with an avulsion fracture
• Ulnar nerve entrapment
• Ulno humeral arthritis.

If Three months of conservative management does not yield the desired results, the client is suggested for a surgical opinion.

Check out these links for relevant information: Pain management, Sports physiotherapy