The Physical Medicine and Rehabilitation Center, P.A.

A comprehensive Spine, Sports and Occupational Rehabilitation Facility


Lateral Epicondylitis (Tennis Elbow)

The symptoms of tennis elbow include pain and tenderness in the bony knob on the outside of your elbow (lateral epicondyle). The condyle is where the injured tendons, primarily the extensor carpi radialis brevis, connect to the bone. The pain may also radiate into the upper or lower arm. Although the damage is in the elbow, you're likely to hurt when performing a repetitive gripping motion with your hands.

Tennis elbow may cause the most pain when you:

  • Lift something
  • Make a fist or grip an object, such as a tennis racket
  • Open a door or shake hands
  • Raise your hand or straighten your wrist

Tennis elbow (lateral epicondylitis) is a painful condition that occurs when tendons in your elbow are overloaded, usually by repetitive motions of the wrist and arm. Despite its name, athletes aren't the only people who develop tennis elbow. People whose jobs feature the types of motions that can lead to tennis elbow include plumbers, painters, carpenters and butchers.

The pain of tennis elbow occurs primarily where the tendons of your forearm muscles attach to a bony bump on the outside of your elbow. Pain can also spread into your forearm and wrist.

Rest and over-the-counter pain relievers often help relieve tennis elbow. If conservative treatment with an occupational therapist don't help or if symptoms are disabling, your doctor might suggest surgery to stabilize and correct tendon damage.

Medial Epicondylitis (Golfer's Elbow)

Medial Epicondylitis is a condition that causes pain where the tendons of your forearm muscles attach to the bony bump (medial epicondyle) on the inside of your elbow. The pain might spread into your forearm and wrist. Golfer's elbow is similar to tennis elbow, which occurs on the outside of the elbow. It's not limited to golfers. Tennis players and others who repeatedly use their wrists or clench their fingers also can develop golfer's elbow. The pain of golfer's elbow doesn't have to keep you off the course or away from your favorite activities. Rest and appropriate treatment can get you back into the swing of things.

Terrible Triad

A terrible triad injury refers to a posterior dislocation of the elbow associated with radial head and coronoid process fractures. The treatment of terrible triad injuries of the elbow continues to evolve. Radial head fixation and arthroplasty, coronoid process fixation, and repair of the lateral collateral ligament continue to be the mainstays of treatment. In the elbow with persistent instability after repair of these elements, application of a static external fixation, hinged external fixation, Ulnohumeral joint pinning, or an internal hinge may be needed. In patients who undergo treatment after the acute injury period, the coronoid may require reconstruction using radial head autograft, iliac crest autograft, olecranon autograft, or allograft. As debilitating as it is to be diagnosed with elbow Terrible Triad, occupational therapy and a diligent patient can lead to a full, functional recovery.

Ulnar Collateral Ligament Reconstruction (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 tendon from donated tissue of a cadaver. The procedure is common among collegiate and professional athletes in several sports, most notably baseball.

The procedure was first performed in 1974 by orthopedic surgeon Frank Jobe, a Los Angeles Dodgers team physician. It is named after the first baseball player to undergo the surgery, major league pitcher Tommy John.

Distal Humerus Fractures of the Elbow

A distal humerus fracture is a break in the lower end of the upper arm bone (humerus), one of the three bones that come together to form the elbow joint. A fracture in this area can be very painful and make elbow motion difficult or impossible.

Most distal humerus fractures are caused by some type of high-energy event—such as receiving a direct blow to the elbow during a car collision. In an older person who has weaker bones, however, even a minor fall may be enough to cause a fracture.

Treatment for a distal humerus fracture usually involves surgery to restore the normal anatomy and motion of the elbow.

Distal humerus fractures are also sometimes caused by weak or insufficient bone. This is most common in older patients whose bones have become weakened by osteoporosis. In these patients, a fracture may

Elbow Bursitis

What is Elbow Bursitis (Olecranon Bursitis)?

Olecranon bursitis is the proper name for the inflammatory condition ‘elbow bursitis’. Elbow pain due to olecranon bursitis occurs when a small bursa within the elbow (which normally acts as a small cushion between bones and tendons) becomes inflamed and swollen. This can occur for several reasons which will be discussed below.

What are the causes of Elbow Bursitis?

The elbow is very susceptible to injury. Below are some of the common causes for elbow bursitis:

  • Repetitive strain and stress to the elbow such as from playing sports, lifting weights or resting elbows on hard surfaces for long periods of time.
  • Sudden impact such as from a fall, sports injury or an accident.
  • Natural wear and tear of the elbow joint.
  • Pre-existing inflammatory conditions such as osteoarthritis.

What are the signs & symptoms of bursitis in the elbow?

  • A small to large visible lump on the elbow.
  • Discomfort and elbow pain at rest.
  • Pain in the elbow when bending the arm.
  • Pain when placing weights on the elbows.

Elbow Joint Pain Causes

Elbow pain is often caused by overuse. Many sports, hobbies and jobs require repetitive hand, wrist or arm movements. Elbow pain may occasionally be due to arthritis, but in general, your elbow joint is much less prone to wear-and-tear damage than are many other joints.

Olecranon Bursitis

Usually, no surgical intervention is required in cases of olecranon bursitis. If the patient's condition becomes severe and does not respond to conservative treatment, however, bursectomy may be indicated.

In cases of septic olecranon bursitis, the evidence supports the initial use of conservative treatment with a hand therapist rather than immediate bursectomy. Only patients with severe, refractory, chronic/recurrent olecranon bursitis should be treated via incision, drainage, or bursectomy.

If surgery is required in olecranon bursitis, endoscopic olecranon bursal excision is an effective alternative to open incision in either aseptic or septic cases.


Come and see one of our hand therapists to get fitted for a compressive elbow sleeve that may help to prevent the bursal fluid from reaccumulating after aspiration occur even after a minor fall.

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