The whole truth about: muscles of the elbow joint and other interesting information about treatment.
Elbow joint(Latin name - articulatio cubiti, articulatio cubiti) formed by three bones - the distal epiphysis (end) of the humerus, the proximal epiphysis of the ulna and radius. Its anatomy is designed in such a way that the elbow joint is complex, as it is formed from three simple joints at once: the humeroulnar, brachioradial, proximal radioulnar, thanks to which a person can move his arms. We will consider them, as well as the structure of the elbow joint, in more detail below.
The elbow joint can move in two planes:
- Flexion and extension (frontal plane);
- Rotation (vertical plane). This movement is provided only by the humeroradial joint.
As can be seen in the anatomical atlas with photos, the articular capsule surrounds all three joints. It originates in front above the edge of the radial and coronoid fossae, on the sides almost at the edge of the trochlear and condyle of the humerus, behind just below the upper edge of the olecranon process and is attached to the edge of the radial and trochlear notches on the ulna and to the neck of the radius.
Elbow ligaments
The elbow joint is surrounded by four ligaments (a diagram is provided for visualization):- Ulnar collateral ligament. It originates on the medial epicondyle of the humerus and ends at the edge of the trochlear notch of the ulna. The ligament descends fan-shaped.
- Radial collateral ligament. It originates on the lateral epicondyle of the humerus, descends downwards, dividing into two bundles, where they bend around the radius in front and behind, attaching to the notch of the ulna.
- Annular ligament of the radius. It covers the articular circumference of the radius in front, behind and on the lateral side and is directed to the anterior and posterior edges of the radial notch of the ulna. The ligament maintains the position of the radius relative to the ulna.
- Square ligament. Connects the lower edge of the radial notch with the neck of the radius.
In addition to the annular ligament, there is also an interosseous membrane of the forearm, which also fixes the position of the ulna and radius bones relative to each other. The membrane has small holes through which blood vessels and nerves pass.
Muscles of the elbow joint
The muscles of the elbow joint that carry out movement in the elbow joint include a group of flexors, extensors, pronators and supinators, due to which the structure of the elbow joint ensures the movement of the human arms.
Biceps brachii
The biceps brachii muscle, thanks to which the arm can bend, has two heads - long and short. The long head originates from the supraglenoid tubercle of the scapula and ends in the muscle belly formed by both heads, as can be seen by looking at the figure. The abdomen passes into a tendon, which is attached to the tuberosity of the radius. Short head originates at the apex of the coracoid process of the scapula.- Bends the arm at the elbow joint;
- The long head is involved in abduction of the arm;
- The short head is involved in adducting the arm.
Brachialis muscle
A broad, fleshy muscle located under the biceps brachii. It originates on the anterior and lateral side of the distal end of the humerus, passes through the elbow joint, where the tendon fuses with the joint capsule, and attaches to the tuberosity of the ulna.
- Tenses the joint capsule.
Triceps brachii
This is a big one longus muscle, the structure of which has three heads: lateral, long and medial. The long head of the muscle originates from the subarticular tubercle of the scapula. Lateral head muscles originate from back surface humerus above the groove of the radial nerve from the medial and lateral intermuscular septa of the humerus. The medial head originates in the same way as the lateral one, but only below the groove of the radial nerve. All these three heads are directed downwards and connect to form a muscle belly, which turns into a strong tendon, which is attached to the olecranon process.
- Extension of the forearm at the elbow joint;
- Abduction and adduction of the shoulder to the body.
Elbow muscle
The anconeus muscle is a kind of continuation of the medial head of the triceps brachii muscle. It originates from the lateral epicondyle of the humerus and the collateral ligament and is attached to the posterior surface of the olecranon, woven into the articular capsule.Function - extends the elbow at the expense of the forearm.
Pronator teres
It is a thick and short muscle that has two heads: the brachialis and the ulna. The humeral head is attached to the medial epicondyle of the humerus, the ulna is attached to the medial edge of the tuberosity of the ulna. Both heads form a muscle belly, which passes into a thin tendon and attaches to the lateral surface of the radius.
- Pronation of the forearm;
- Flexion of the forearm at the elbow joint.
Brachioradialis muscle
The muscle is located laterally. It originates just below the lateral epicondyle of the humerus, goes down and attaches to the lateral surface of the radius.
- Flexes the forearm at the elbow joint;
- Fixes the position of the radius in a relaxed state.
Flexor carpi radialis
It is a flat, long muscle that originates from the medial epicondyle of the humerus and passes down to the base of the palmar surface.
- Wrist flexion;
- Participates in flexion of the forearm at the elbow joint.
Palmaris longus muscle
Just like the flexor radialis, it originates from the medial epicondyle of the humerus, goes down and passes into the palmar aponeurosis.
- Participates in flexion of the forearm at the elbow joint;
- Flexes the hand;
- Stretches the palmar aponeurosis.
In addition, it is worth noting such muscles as the acting superficial flexor digitorum, flexor ulnaris carpi, extensor digitorum, and extensor carpi ulnaris, which also indirectly contribute to movements of the elbow joint.
The structure and functions of various parts of the body, including bone joints, are studied by anatomy. The elbow joint refers to the bony joints of the free upper limb and is formed as a result of articulation individual parts 3 bones: humerus, ulna and radius.
Components of a joint
The elbow joint is an unusual bony joint that connects the shoulder and forearm.
The special structure allows the joint to be classified as a complex and combined articulation.A complex joint is one in which more than two articular surfaces take part in its formation. There are three of them in the elbow:
- articular surface of the distal epiphysis of the humerus (trochlear and head of the condyle);
- articular surface of the ulna (trochlear and radial notch);
- head and articular circumference of the radius.
A combined joint refers to those joints in which several independent joints are united by a single joint capsule. In the elbow, three independent ones are combined into one capsule.
The anatomy of the human elbow joint is very unusual; it combines 3 different types of joints in one joint:
- humeroulnar – uniaxial, trochlear;
- brachioradial – spherical, but movement is carried out around two axes (frontal and vertical);
- radioulnar – cylindrical (rotation around a vertical axis).
Possible movements in the elbow
The structure of the joint allows you to perform a certain set of movements. These are flexion, extension, rotation (pronation and supination).
Joint capsule
The joint capsule surrounds 3 joints. It is fixed at the front and sides.
The front and back are quite thin, weakly stretched, but on the sides it is protected by ligaments of the elbow joint. The anatomy of the synovial membrane includes bones that are not covered by cartilage, but are still located in the joint.Elbow ligaments
Each bone connection is a complex and thoughtful anatomy. The elbow joint is strengthened by ligaments that provide its protection and movement in different planes.
The ulnar collateral ligament begins at the base of the humerus (medial condyle) and ends at the ulna (trochlear notch).
The radial collateral ligament starts from the humerus (lateral epicondyle), is divided into 2 bundles, which diverge and go around the head of the radius, and are attached to the ulna (radial notch).The annular and quadrate ligaments secure the radius and ulna.
The tendons of the elbow joint are attached by tuberous projections. The anatomy of this joint is called the "ulnar head". She is the one who most often suffers from injuries and damage.
In addition to the main ligaments of the joint, the interosseous membrane of the forearm also participates in the function of fixing the bones. It is formed by strong bundles that connect the radius and ulna bones. One of these bundles goes in the opposite direction from the others, called an oblique chord. It has openings through which blood vessels and nerves pass. The oblique chord is the origin for a number of muscles of the forearm.
Muscles of the elbow joint, anatomy and their functions
There are several unusual bone joints in the human body. They are all studied by anatomy. The elbow joint is unusual in its own way. It is protected by a good muscular frame. The coordinated work of all muscles ensures the smooth functioning of this bone connection.
All muscles affecting the elbow joint can be divided into 3 groups: extensors, flexors, rotators (carry out pronation and supination).
The extensors of the joint are the triceps brachii muscle (triceps), the tensor fascia of the forearm and the elbow muscle.
The joint flexors are the biceps brachii (biceps), brachioradialis and brachialis.Pronators - brachioradialis muscle, pronator teres, pronator quadratus perform rotational movements in and out.
Supinators - the biceps brachii muscle, the supinator, and the brachioradialis muscle rotate the forearm from the inside.
Carrying out physical exercise, which strengthen the listed muscles, it is important to remember safety precautions. The elbow joint is very often injured in athletes.
Blood supply to the elbow joint, anatomy
It is very important for the joint to receive the nutrients that come to it along with the blood in a timely manner. It reaches all joints and muscles from a group of arteries. They consist of 8 branches that are located on top of the joint capsule.
The network of arteries supplying blood to the joint consists of vessels called anastomosis.
The topographic anatomy of the elbow joint is a very complex diagram of the connections of blood vessels. Thanks to this scheme, there is an uninterrupted flow of blood to the joint. The outflow is carried out through the veins.
Innervation of muscles
What makes the process of movement in a joint possible? There are special nerve formations that innervate muscles. This is radial and average nerves. They run along the front of the elbow.
Features of the elbow joint, research methods
The elbow joint is very vulnerable as it is constantly exposed to physical stress.
Very often, in order to understand the cause of the pain, the doctor prescribes additional tests. This can be radiography, MRI, ultrasound, tomography, arthroscopy, elbow puncture.
These examinations will reflect the current condition of the bones and ligaments, and the joint space. The image of a particular study will reflect its entire anatomy. The elbow joint is a complex joint that requires caution and detailed study using additional equipment.The main method for diagnosing elbow diseases is radiography. Pictures are taken in two projections. They allow you to see all the changes in the bones.
To determine diseases of the soft components of the elbow, doctors use other research methods.
Injuries and illnesses
Regular pain in the elbow area may indicate that there are some problems. After examination, the most common diagnosis is arthrosis. There is arthritis and much more.
Arthrosis
Occurs much less frequently than in knee or hip joints. The risk group includes people whose work is associated with increased loads on the elbow joint, who have had an injury or surgery on the elbow, with endocrine or metabolic disorders, or with arthritis.
Main symptoms: constant aching pain that occurs after physical activity. Goes away after rest. Clicking or crunching in the elbow. Limitation of range of motion.
Arthritis
Inflammatory joint damage. Possible reasons multitude. They can be infections, allergic reactions, high loads on the joint, and nutritional disorders.
The form of arthritis can be acute or chronic.
Main symptoms: constant pain, skin hyperemia, swelling, limited joint mobility.
Rheumatoid arthritis
The elbow joint is most often affected by rheumatoid arthritis. Its symptoms: stiffness of movement in the morning, symmetrical arthritis (both joints are inflamed), chronic pain, involvement of smaller joints (hands, ankles, wrists, knees) in the painful process.
Epicondylitis
A common disease in people whose activities involve high loads on the elbow joint (tennis, golf, wrestling).
There are 2 types: lateral, medial.
Main symptoms: pain in the area of the damaged epicondyle, which spreads to the muscles of the forearm (anterior or posterior). At the beginning of the disease, pain occurs after exercise. In the future, pain is felt even from minimal movements.
Bursitis
Inflammation of the joint capsule. Most often it occurs in people whose activities are associated with constant injuries to the back of the elbow.
Main symptoms: swelling, throbbing pain, swelling in the back of the elbow, limited range of motion. Often, with the main symptoms, the temperature rises, a state of general weakness, malaise occurs, and headaches begin.Injuries
Unwanted physical impact on the elbow can lead to injury. These are dislocations, bone fractures, sprains, hemorrhage into the joint (hemarthrosis), muscle damage, rupture of the joint capsule.
The listed injuries and illnesses most often occur in everyday life. In order to protect yourself from them, you should take preventive measures: avoid excessive stress, give yourself timely rest, it is important to prevent traumatic situations at work, adherence to a diet, moderate physical training and joint gymnastics.
How to cure epicondylitis of the elbow joint (“tennis elbow”)
Lateral epicondylitis of the elbow, or tennis elbow, is an inflammation of the muscles and tendons where they attach to the bones in the elbow joint.
The causes of the disease can be: excessively hard work, microtraumas, and sometimes it develops against the background of cervical osteochondrosis.
Most often this disease affects people over 40 years of age, as well as those engaged in heavy physical labor, for example:
- athletes (tennis players, throwers, weightlifters, boxers);
- agricultural workers (tractor drivers, laborers, milkmaids);
- construction workers (painters, plasterers, masons), etc.
Epicondylitis comes in two forms: lateral and medial. In the case of lateral epicondylitis, the pain is expressed along the outer surface of the elbow, with medial epicondylitis - along the inner surface. Symptoms of the disease are pain in the affected area, radiating to the forearm and intensifying when moving the affected arm.
Treatment for tennis elbow
The biggest mistake of a person suffering from epicondylitis of the elbow joint is not starting treatment in a timely manner or stopping treatment at the first signs of improvement.
To get rid of the disease epicondylitis forever, it is necessary to provide complete rest to the hand for the entire period of treatment. If you damage a tendon that has not had time to heal, your arm will begin to hurt again, and epicondylitis will develop into a chronic form, which takes much longer and is more difficult to treat.
Drug treatment
Since pain with epicondylitis of the elbow joint is caused by an inflammatory reaction, anti-inflammatory therapy is used. Experts recommend using locally non-steroidal anti-inflammatory drugs in the form of gels or ointments.
Yes, one of effective means is Nurofen Gel (active ingredient - ibuprofen). It is applied 3-4 times a day with a thin strip 3-5 cm long and rubbed until completely absorbed. The pain goes away within 2-3 weeks.
In more serious cases, when gels and ointments do not help, local injections of glucocorticosteroids mixed with an anesthetic (betamethasone dipropionate) are used. After injections, the pain disappears after 2-3 days. To prevent relapses, an optimal motor regimen without overloading the diseased joint is recommended.
Physiotherapy
IN acute period For diseases of lateral epicondylitis, the following are used for anti-inflammatory and analgesic effects:
- high-intensity pulsed magnetic therapy;
- diadynamic therapy;
- percutaneous electroanalgesia (Eliman-401 device);
- infrared laser radiation.
In the subacute period of the disease "tennis elbow" the following are used:
- ultraphonophoresis of hydrocortisone and anesthetic mixture on the damaged area;
- paraffin-ozokerite applications at a temperature of 45 degrees C;
- naphthalon applications;
- extracorporeal shock wave therapy (Medolit device); applies in the absence positive dynamics from other methods of physiotherapy;
- local cryotherapy on the painful area with dry cold air (temperature -30 C).
All these procedures are aimed at relieving pain and inflammation in the elbow joint and muscle tension.
Non-drug treatment
It is widely used in the treatment of tennis elbow (epicondylitis of the elbow joint). manual therapy. As a rule, 12-15 sessions are enough to relieve pain in 90% of patients. Manual therapy is especially effective in addition to other treatment methods.
Also helps a lot special gymnastics, aimed at relaxing muscles and reducing their pain spasm. It is very important to choose and perform the exercises correctly, so it is better to do this with a doctor. Exercises are performed for several weeks 1-2 times a day every day.
Many patients have noticed significant improvement when treated with medicinal leeches (hirudotherapy). Over 5-6 sessions, the pain noticeably decreases. Leeches are placed on certain points of the body, and the sensitive nerve is irritated, which helps to increase blood circulation. The saliva of a medicinal leech relieves swelling, reduces pain and has an anti-inflammatory effect.
Surgical methods of treatment
They are used in rare cases when other types of treatment do not bring positive results. Surgical methods include:
- tunneling;
- excision of the hypertrophied joint ligament.
Traditional medicine recipes
Tincture of horse sorrel roots
Take half a liter jar of roots + half a liter of vodka, leave for 10 days and apply as compresses at night for 10 days.
Bay oil
4 tbsp. crushed bay leaf is poured into 200g of vegetable oil, mixed, poured into an airtight container and left for a week in a warm place.
Then filter and use as compresses or rub into a sore spot.
These recipes can be used to relieve pain, but they should not replace competent treatment of epicondylitis (tennis elbow) by a specialist!
Watch a useful and interesting video about epicondylitis with Elena Malysheva:
Prevention
It is easier to prevent any disease than to treat it. This is completely true for a disease such as tennis elbow. To prevent the development of epicondylitis it is necessary:
- Before physical activity, do a warm-up to warm up the muscles and tendons;
- fix the elbow joints with elastic bandages during heavy physical activity;
- take breaks during long monotonous workouts or when performing monotonous work.
Important fact:
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A famous doctor tells
Inflammation of the elbow joint leads to a sharp decrease in a person’s performance. Mostly young and middle-aged people face this problem. In most cases, inflammation develops in the right elbow, since the working arm of right-handed people is injured.
To understand what can become inflamed in a joint, you need to know its structure.
How is the elbow joint structured?
Compared to other joints, the elbow is more complex, because it connects the 3 bone ends of the ulna, radius and humerus. It can only perform flexion-extension because it is limited by trochlear contact surfaces.
From above, the joint is protected by a thin capsule, which is supported by ligaments and tendons. A special fluid is always produced inside the joint capsule to lubricate the moving parts (bone heads). In addition, it delivers nutrients.
The bones end in the periosteum. It protects and periodically renews tissues; useful components from the synovial fluid pass through it. The photo of the structure of the elbow joint can be seen below.
What can become inflamed inside the elbow?
Depending on which part of the elbow joint is involved in the inflammatory process, the following diseases are distinguished:
- Bursitis - the tissues inside the joint become inflamed, and the process involves the joint capsule, which produces synovial fluid into the cavity of the diseased joint. This causes the patient to feel severe pain.
- Epicondylitis is an external inflammation of the periosteum of the humerus and muscle tendons.
Elbow arthritis has 3 different forms:
- Acute purulent arthritis. It is characterized by severe pain in the joint area and increased body temperature. In this case, treatment will be aimed at removing the pus that has accumulated in the joint cavity. In exceptional situations, surgical intervention is resorted to.
- Psoriatic arthritis.
- Gouty arthritis.
Typically, the last 2 forms are asymptomatic for a long time, so the disease goes undetected for a long time. Gradually, patients begin to feel mild nagging pain and stiffness after being at rest for a long time.
Psoriatic arthritis is characterized by the following signs: plaque formation and peeling of the skin around the elbow.
Why does inflammation begin?
In each individual case, the inflammatory process can begin various reasons, and they can be purely individual.
Although there are common factors that provoke the development of inflammation:
- Consequences of the patient's professional activity. The elbow can become inflamed after prolonged monotonous activities that lead to serious stress on the joints.
- Injuries can also trigger inflammation. Elbows often suffer from bruises, sprains, blows or dislocations.
- Too much high load on the joint in athletes, especially weightlifters.
- Infectious factor. An infectious focus may arise in the body and spread to the elbow area.
A separate group consists of the causes of the disease. Tuberculosis, measles, gonorrhea, and trauma can all contribute to the development of elbow arthritis.
What are the symptoms of the disease?
Symptoms of arthritis depend on the affected area. Signs of bursitis:
- severe acute pain suddenly appears in the elbow;
- the skin around the elbow turns red and becomes hot;
- swelling and swelling appear;
- normal functioning of the tendons becomes difficult;
- a seal forms on the elbow, which remains movable when pressed;
- the patient seems to be carrying his arm in a bent position at an angle of 90 degrees.
With bursitis, fluid is released and penetrates the joint capsule, and this makes any movement of the arm difficult. Symptoms also include muscle resistance during movement and tendons that work poorly.
The following symptoms are typical for epicondylitis:
- pain occurs only during physical activity;
- mild swelling of the joint;
- crunching or crackling noise when performing movements.
Treatment is carried out after diagnosis. A surgeon or traumatologist makes a diagnosis based on the data obtained during the examination. The doctor may order additional tests: x-rays, analysis of intra-articular fluid, blood and biochemical tests for protein.
Treatment methods
Treatment is always carried out comprehensively. To begin with, the elbow is fixed with a bandage made from a headscarf, bandages, and an elbow pad. This ensures maximum rest for the diseased areas.
If, after studying the joint fluid, pathogenic microflora is detected, then antibiotics are used for oral administration or as intramuscular injections.
Non-steroidal anti-inflammatory drugs are effective for relieving attacks of pain and for relieving inflammation and swelling. Such substances are included in ointments for external use, tablets for oral administration and injections for intramuscular administration.
Applications with bischofite help relieve inflammation, and at night you can apply a compress with Vishnevsky ointment to the joint area.
Injections with hormones can also be used; they are injected directly into the joint. They will dull pain well when other drugs and methods no longer work.
Treatment of inflammation is also carried out using physiotherapeutic methods and massage. The exception is acute purulent processes.
The following methods are used:
- electrophoresis with the addition of anti-inflammatory substances;
- magnetic therapy;
- shock wave therapy;
- applications with paraffin and ozokerite;
- laser irradiation.
Operations are indicated exclusively for purulent nature of the disease.
Traditional methods of treatment
Treatment at home traditional methods before visiting a doctor, it will help to dull the pain and reduce the size of the lump on the elbow. You can treat a sore elbow in different ways:
- The most commonly used is propolis tincture. It is used for compresses.
- For the next method you need to take old agave (at least 3 years old), honey and 96% alcohol. Grind the aloe leaves in a meat grinder or blender, and then squeeze the juice out of the pulp. Add honey in proportions 1:2, then 3 parts alcohol. Pour everything into a bottle and shake well. Let it brew for a day and also use it as compresses. Store the tincture in the refrigerator. Warm to room temperature before use.
- Heating with salt is very effective. You need to heat table salt (1/2 cup) in a frying pan. Then pour it into a canvas bag and tie it well. In the evening, apply to the sore joint, bandaging it with something warm. This method must be used very carefully, since with purulent arthritis the condition may worsen and the pain may intensify.
- Bursitis of the elbow joint is effectively treated with the golden mustache plant. You need to chop about 20 g of antennae, place in an enamel container and pour 300 ml of water. Place the dishes on the fire, boil the liquid for 7 minutes, then cool and strain. Soak a cotton napkin in the broth and apply to the affected area. Place a plastic bag on top or cling film and wrap everything well with a woolen scarf. Do this procedure at night. The duration of treatment with this method is 20 days.
- At home, burdock root can help relieve pain. To prepare the decoction, you need 1 tbsp. l. Boil the dried roots in 500 ml of water, let it brew and cool. Then strain the infusion. Soak a clean cloth in the broth and apply to the sore elbow. Be sure to wrap a warm scarf over it.
- An ancient and effective way to treat inflammation of the elbow joint is cabbage leaf. It is washed, dried well, and all veins are removed. Then beat with a heavy hammer until the juice appears. A wet cabbage leaf is applied to the inflamed elbow, secured with a bandage and insulated with a scarf.
Treatment methods for lateral and medial epicondylitis of the elbow joint
Epicondylitis of the elbow joint is considered an inflammatory pathology. It affects the elbow area, where the muscles attach to the forearm bone. Depending on the area of inflammation, the disease is divided into external and internal.
External epicondylitis of the elbow joint is characterized by inflammation in the tendons that are located with outside elbow joint.
Internal epicondylitis involves the development of inflammation in the muscles that promote flexion and extension of the hand.
Causes of the disease
The inflammation presented cannot occur suddenly, since epicondylitis is a secondary disease. It is not yet possible to determine the exact causes of the development of this pathology.
Experts have only been able to determine which groups of people are most susceptible to this disease. These include:
- people working in the construction industry (plasterers, painters, masons);
- people working in agriculture (tractor drivers, milkmaids, laborers);
- athletes (weight lifters, wrestlers, weightlifters, boxers).
The presented activities themselves do not contribute to the development of epicondylitis.
The dominant hand gets the most. Therefore, the main reason for the development of epicondylitis is overload of tendons, microtrauma of tissues that cause the development of inflammatory processes.
Symptoms of the disease
The main manifestations of the disease include pain and difficulty in active movements in the wrist and elbow joints. Passive movements with this pathology are not painful or difficult.
The pain is aching in nature and can radiate to the middle third of the forearm and outer part shoulder I am concerned about pain in the area of the lateral epicondyle. The epicondylus itself hurts when you feel it.
Painful sensations can become stronger with simple movements such as shaking hands or clenching the hand into a fist. Pain may increase with even slight resistance to supination and extension.
At first it disappears in a state of rest. But later it becomes constant and intense. Due to damage to the ligamentous apparatus, the range of movements is limited or pathological mobility of the joint may occur.
Types of epicondylitis
There are two types of epicondylitis.
Lateral epicondylitis (external)
A disease characterized by the development of inflammation at the site of muscle attachment to the lateral epicondyle of the bone.
As a rule, this pathology is called “tennis elbow,” because this problem occurs in people who play this sport. However, this type of epicondylitis can develop not only in athletes.
The main factor in the development of lateral epicondylitis of the elbow joint is overstrain of the muscles at the site of their attachment to the epicondyle of the shoulder bone.
This overexertion often occurs while playing tennis or when performing other monotonous work (sawing wood, painting walls, and so on). This pathology occurs in a person between the ages of 30 and 50 years.
Medial epicondylitis (internal)
The disease is also often called “golfer's elbow.” But this does not mean that only people who play golf can suffer from this disease. It’s just that golf is one of the common causes of medial epicondylitis.
Other frequently repetitive movements can also cause this disease.
Such movements include: playing sports, throwing, consequences of injuries, using different types hand tools.
Treatment of the disease
Treatment for lateral and medial epicondylitis of the elbow joint is largely similar.
Therapy for epicondylitis is carried out comprehensively, depending on the duration of the disease, changes in the tendons and muscles in the area of the hand and forearm, as well as the level of joint dysfunction.
Conservative impact
Treatment of external and internal epicondylitis of the elbow joint is conservative. Only in the case of a long and persistent course of the disease, if recovery has not been achieved, is surgical intervention used.
Therapeutic measures help relieve muscle tension, relieve pain and suppress inflammation. Localization of the process in order to determine the choice of therapy method is not of fundamental importance.
To relieve muscles, you can use the following methods:
- Wearing orthoses, which are fixed in the upper part of the forearm. Such orthopedic clamps “switch off” the inflamed area of the muscle, preventing it from contracting. Such devices must be used while the patient is awake; orthoses must be removed at night.
- Gentle mode. If a person’s work activity is accompanied by constant movements in the wrist joint (painters, deboners, mechanics), then it is extremely important to stop working for the duration of treatment.
- Immobilization of the upper limbs using splints. The wrist joint is fixed to immobilize the hand. This is necessary for advanced processes that are accompanied by severe pain.
- Special gymnastics. For these purposes they use static exercises which promote tendon stretching. It must be performed with the maximum possible abduction and adduction of the hand so that an angle of 90 degrees is formed with the forearm. The brush should be held in this position for 10-15 seconds. The number of repetitions is 7-10, 2 times a day.
- Application wrist trainers to perform 3D exercises. Exercises begin with exercise equipment that has minimal rigidity. The duration of classes should increase gradually. The selection of exercises should be carried out in such a way that the muscles are not overstrained.
In order to eliminate pain and inflammation, it is necessary to use:
- Taking medications. In most cases, the doctor prescribes the patient to take anti-inflammatory drugs. When treating epicondylitis of the elbow joint with ointments, apply to the skin in the area pain an ointment is applied, which contains indomethacin, ibuprofen, diclofenac and other non-steroidal agents. It needs to be applied 3-4 times a day. In addition, dimexide can be used in the form of compresses or lotions. It is diluted in a ratio of 1:3 with the addition of a solution of hydrocortisone and anesthetic. Apply lotions once at night. To achieve a quick and long-lasting effect, the inflammation site is treated with diprospan.
- Physiotherapy, which includes medicinal electrophoresis using anti-inflammatory drugs, galvanization, phonophoresis, magnetotherapy, paraffin therapy, application of therapeutic mud.
- Cooling of the elbow joint using devices that accumulate cold or irrigation with chlorethyl. You can replace it with ice cubes wrapped in a towel. You need to do this manipulation 1-2 times a day.
- Massage must be performed directly on the area where there is pain. You should knead the points where you can feel the tightness of the muscles. The duration of the massage is 10-15 minutes. Massaging movements should not cause the patient discomfort. The massage is performed 1-2 times daily, duration is 10-12 days.
- Shock wave effects are based on the influence of infrasound directly on inflamed tissue. Submitted modern technique gives very good result, restoring microcirculation in the inflamed muscle tissue. You need to perform 5-7 sessions. Afterwards, pronounced positive dynamics are observed.
If you use the above recommendations, the disease will recede. If positive effect If it is not observed and it is not clear how to treat epicondylitis of the elbow joint using conservative methods, then doctors resort to surgical intervention.
Surgical exposure
Surgery is used if conservative therapy is ineffective. In most cases, this applies to those people whose work activities are accompanied by daily stress on the muscles of the forearm.
Surgical treatment includes the following techniques:
- dissection of the extensor carpi tendon;
- tendoperiostetomy;
- arthroscopic effect.
- lengthening of the extensor carpi brevis tendon
Its main advantage, compared to others, is its low invasiveness. After arthroscopic surgery, patients can perform light work after 2 weeks.
Disease prevention
It is always better to prevent any disorder than to treat it. This exactly applies to a disease such as epicondylitis of the elbow joint.
Basic prevention methods include:
- before implementation physical activity You should perform a warm-up, which is aimed at warming up the muscles and tendons;
- rationally distribute loads without overstraining muscles;
- fix the elbow joints with an elastic bandage during heavy physical activity;
- during long monotonous workouts or when performing monotonous work, take breaks.
Epicondylitis of the elbow joint is not a very dangerous disease. But this does not mean that it needs to be launched. Therefore, if the slightest symptoms occur, immediately contact a specialist for proper treatment.
Video: How to help yourself with elbow pain?
Anatomy of the elbow joint
Bones of the elbow joint’>
Bones of the elbow joint
Bone anatomy
Anatomy of the elbow joint’>
Anatomy of the elbow joint
The elbow joint is the articulation of three bones: the humerus, ulna and radius. The shoulder-elbow joint is a trochlear joint; it is formed by the trochlea of the medial condyle of the humerus and the lunate notch of the ulna. The ulnar and coronoid processes, which deepen the semilunar notch, contribute to an increase in the area of the articular surface. The humeroradial joint is formed by the head of the radius and the head of the condyle of the humerus. The joint between the ulna and radius is formed by the head of the radius and the radial notch of the ulna. These joints, together with the ligamentous and muscular apparatus, provide flexion and extension at the elbow joint, as well as pronation and supination of the forearm.
Biomechanics of the elbow joint on x-ray
Biomechanics of the elbow joint’>
Anatomy of ligaments
Elbow ligaments’>
Elbow ligaments
Ligaments are thickened areas of the joint capsule that provide stability to the joint. The elbow joint is surrounded by a complex network of ligaments. The lateral part of the joint is strengthened by a complex of four ligaments: the radial collateral ligament, the annular ligament of the radius, the accessory lateral collateral ligament, and the lateral ulnar collateral ligament. The radial collateral ligament begins from the lateral epicondyle of the humerus and, expanding in the distal direction, merges with the deep fibers of the annular ligament of the radius, strengthens the latter and ensures stability of the elbow joint under varus load (adduction of the forearm). The annular ligament of the radius attaches to the anterior and posterior surfaces of the radial notch of the ulna, forming a ring around the head and neck of the radius; it provides stability during pronation and supination. The distal end of the accessory lateral collateral ligament is attached to the tubercle of the supinator crest of the ulna; at its proximal end the ligament merges with the fibers of the annular ligament of the radius. The lateral ulnar collateral ligament is attached with its proximal end to the lateral epicondyle of the humerus, and its distal end to the crest of the supinator of the ulna under the fascia of the said muscle. It provides stability to the lateral aspect of the elbow joint, reduces stress during forearm rotation, and supports the radial head posteriorly.
The medial part of the elbow joint is also strengthened by a ligamentous complex. It includes the anterior, posterior and transverse (Cooper's ligament) portions of the ulnar collateral ligament. The anterior portion of the ulnar collateral ligament is of greatest importance in counteracting the valgus load on the elbow joint (forearm abduction). It is attached to the medial epicondyle of the humerus and to the tip of the coronoid process and provides static and dynamic stability of the elbow joint during throwing movements, accompanied by flexion from 20 to 120°. The posterior portion of the ulnar collateral ligament strengthens the medial sections of the elbow joint during pronation. Its attachment points are the lateral epicondyle of the humerus and the olecranon process. The ulnohumeral joint, radial and ulnar collateral ligaments are the three main stabilizing structures of the elbow joint. Damage to any of them leads to an increase in the load on secondary stabilizing structures, which include the head of the radius, the anterior and posterior parts of the capsule of the elbow joint, the attachment points of the anterior and posterior group of muscles of the forearm, as well as the ulnaris, triceps and brachialis muscles.
Muscle anatomy
Muscles of the elbow joint’>
Muscles of the elbow joint
Balanced muscle contraction is necessary to ensure precise, coordinated movements at the joint. Movement in the elbow joint is provided by the following muscles. Attached to the coronoid process of the ulna along the anterior surface brachialis muscle, while its antagonist, the triceps muscle, is attached by a flat broad tendon to the olecranon process of the ulna. The extensor muscles of the superficial layer of the posterior muscle group of the forearm originate from the lateral epicondyle of the shoulder; these include the extensor carpi radialis longus, extensor carpi radialis brevis, extensor digitorum, and flexor carpi ulnaris muscles. On the other side of the distal epiphysis of the humerus, from the medial epicondyle and the medial epicondylar crest, the anterior group of muscles of the forearm (flexors and pronators) originates. It includes the pronator teres, flexor carpi radialis, palmaris longus, flexor digitorum superficialis, and flexor carpi ulnaris muscles.
Nerve
The innervation of the muscles of the elbow joint is carried out by three main nerves of the free lower limb: the radial nerve (including the posterior interosseous), passing in front and lateral to the joint, the median nerve, passing along the midline in front, and the ulnar nerve, passing along the posteromedial surface of the ulnar region. The radial nerve is formed by the posterior bundle brachial plexus(roots C6, C7 and Thl); it innervates triceps muscle, supinator, as well as wrist and finger extensors. The ulnar nerve is formed from the medial fascicle of the brachial plexus (C7 and Thl roots) and innervates the flexor carpi ulnaris, deep digital flexors and lumbrical muscles ring finger and little fingers, dorsal and palmar interosseous muscles, adductor muscle thumb hands, as well as the muscles of the eminence of the little finger (the muscle that opposes the little finger, the muscle that leads the little finger, and the flexor of the little finger). The median nerve is formed by the lateral and medial bundles of the brachial plexus (roots C6, C7 and Thl) and innervates the long nerve. palmaris muscle, pronator teres, flexor carpi radialis, deep flexors of the index and middle fingers, superficial flexor digitorum, flexor longus thumb, pronator quadratus, lumbrical muscles of the thumb and index finger, as well as the muscles of the eminence of the thumb (the oppons pollicis muscle, the abductor pollicis muscle and the flexor pollicis muscle).
Compression of these nerves, usually reversible, is a common cause of elbow pain. The radial nerve may be compressed by the fibrous arch of the lateral head of the triceps muscle, the arcade of Froese, the insertion of the extensor carpi radialis brevis, and adjacent structures. Compression of the ulnar nerve is possible in the area of the supracondylar process of the humerus, in the area of the Arcade of Straders, at the insertion of the flexor carpi ulnaris, in cubital canal wrist (see section “Cubital tunnel syndrome”). The median nerve can be compressed by the supracondylar process of the shoulder and its fascial sheets, the ligament of Straders, the arch of the superficial flexor digitorum, the biceps brachii aponeurosis, or the pronator teres muscle. Compression of the median nerve is also possible in the carpal tunnel.
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Flexion is carried out by three main muscles.
- Brachial 1 , originating on the anterior surface of the lower half of the humerus and attaching to the tuberosity of the ulna (Fig. 49). This muscle acts exclusively as an elbow flexor, being one of the few muscles that perform only one function.
- Brachioradial 2 , running from the outer supracondylar crest of the humerus (Fig. 49) to the styloid process of the radius. This muscle primarily acts as a flexor of the forearm and only with extreme pronation it becomes a supinator, and with extreme supination it becomes a pronator.
- Biceps brachii 3 is the main flexor of the elbow joint (Fig. 50). It ends on the tuberosity of the radius, and begins not on the shoulder, but on the scapula (therefore it is a biarticular muscle). Her long head 4 originates from the supraglenoid tubercle of the scapula and extends onto the shoulder, and the short head 5 begins on the coracoid process.
Thanks to its origin on the shoulder bladebicepsholds articular surfaces shoulder joint in contact, but its main function is to flex the forearm at the elbow joint. It also plays an important, although secondary, role in supination. With a flexed forearm, its pull can lead to dislocation of the radius. The flexors realize their function to the greatest extent when bending the elbow joint at an angle of 90°.
During extension (Fig. 51), the direction of forces developed by these muscles is almost parallel (pink arrow) to the axis of the lever arm. The centripetal component C, acting towards the center of the joint, is more powerful but mechanically less important, while the weak transverse tangential component T is the only effective force in flexion.
On the other hand, whenelbow jointhalf-bent (Fig. 52), muscle traction acts perpendicular to the lever arm (pink arrow - biceps muscle, green - brachioradialis), so that the centripetal component is zero, and the tangential component is equal to muscle traction, which is used for flexion.
This flexion angle of maximum effectiveness is 80-90° for the biceps muscle and 100-110° for the brachioradialis, i.e. for the latter muscle this angle is greater than for the biceps. Flexor muscles in their function obey the laws of physics, namely the law of the Type III lever and therefore prefer the amplitude and speed of movement to force.
Additional flexors:
- extensor carpi longus (RI), which lies deeper than the brachioradialis muscle;
- anconeus muscle 6 (Fig. 49) stabilizes the elbow joint from the outside;
- pronator teres, whose fibrous retraction (Volkmann's contracture) limits full extension of the elbow joint.
"Upper limb. Physiology of joints"
A.I. Kapandji
Elbow joint (Latin name - articulatio cubiti, articulatio cubiti) formed by three bones - the distal epiphysis (end) of the humerus, the proximal epiphysis of the ulna and radius. Its anatomy is designed in such a way that the elbow joint is complex, as it is formed from three simple joints at once: the humeroulnar, brachioradial, proximal radioulnar, thanks to which a person can move his arms. We will consider them, as well as the structure of the elbow joint, in more detail below.
The distal epiphysis of the humerus has a trochlea and a condylar head. The proximal end of the ulna has the trochlear and radial notches. The radius has a head and an articular circumference, which can be seen by looking at the drawing. The humeral-ulnar joint is formed by the articulation of the trochlea of the humerus and the trochlear notch of the ulna. The humeroradial joint is formed by the articulation of the head of the condyle of the humerus with the articular circumference of the radius. And the proximal radioulnar joint is formed by the articulation of the radial notch of the ulna and the head of the radius.
The elbow joint can move in two planes:
- Flexion and extension (frontal plane);
- Rotation (vertical plane). This movement is provided only by the humeroradial joint.
As can be seen in the anatomical atlas with photos, the articular capsule surrounds all three joints. It originates in front above the edge of the radial and coronoid fossae, on the sides almost at the edge of the trochlear and condyle of the humerus, behind just below the upper edge of the olecranon process and is attached to the edge of the radial and trochlear notches on the ulna and to the neck of the radius.
Elbow ligaments
The elbow joint is surrounded by four ligaments (a diagram is provided for visualization):
- Ulnar collateral ligament. It originates on the medial epicondyle of the humerus and ends at the edge of the trochlear notch of the ulna. The ligament descends fan-shaped.
- Radial collateral ligament. It originates on the lateral epicondyle of the humerus, descends downwards, dividing into two bundles, where they bend around the radius in front and behind, attaching to the notch of the ulna.
- Annular ligament of the radius. It covers the articular circumference of the radius in front, behind and on the lateral side and is directed to the anterior and posterior edges of the radial notch of the ulna. The ligament maintains the position of the radius relative to the ulna.
- Square ligament. Connects the lower edge of the radial notch with the neck of the radius.
In addition to the annular ligament, there is also an interosseous membrane of the forearm, which also fixes the position of the ulna and radius bones relative to each other. The membrane has small holes through which blood vessels and nerves pass.
Muscles of the elbow joint
The muscles of the elbow joint that carry out movement in the elbow joint include a group of flexors, extensors, pronators and supinators, due to which the structure of the elbow joint ensures the movement of the human arms.
Biceps brachii
The biceps brachii muscle, thanks to which the arm can bend, has two heads - long and short. The long head originates from the supraglenoid tubercle of the scapula and ends in the muscle belly formed by both heads, as can be seen by looking at the figure. The abdomen passes into a tendon, which is attached to the tuberosity of the radius. The short head originates at the apex of the coracoid process of the scapula.
- Bends the arm at the elbow joint;
- The long head is involved in abduction of the arm;
- The short head is involved in adducting the arm.
Brachialis muscle
A broad, fleshy muscle located under the biceps brachii. It originates on the anterior and lateral side of the distal end of the humerus, passes through the elbow joint, where the tendon fuses with the joint capsule, and attaches to the tuberosity of the ulna.
- Tenses the joint capsule.
Triceps brachii
This is a large long muscle, the structure of which has three heads: lateral, long and medial. The long head of the muscle originates from the subarticular tubercle of the scapula. The lateral head of the muscle originates on the posterior surface of the humerus above the groove of the radial nerve from the medial and lateral intermuscular septa of the humerus. The medial head originates in the same way as the lateral one, but only below the groove of the radial nerve. All these three heads are directed downwards and connect to form a muscle belly, which turns into a strong tendon, which is attached to the olecranon process.
- Extension of the forearm at the elbow joint;
- Abduction and adduction of the shoulder to the body.
Elbow muscle
The anconeus muscle is a kind of continuation of the medial head of the triceps brachii muscle. It originates from the lateral epicondyle of the humerus and the collateral ligament and is attached to the posterior surface of the olecranon, woven into the articular capsule.
Function: Extends the elbow using the forearm.
Pronator teres
It is a thick and short muscle that has two heads: the brachialis and the ulna. The humeral head is attached to the medial epicondyle of the humerus, the ulna is attached to the medial edge of the tuberosity of the ulna. Both heads form a muscle belly, which passes into a thin tendon and attaches to the lateral surface of the radius.
- Pronation of the forearm;
- Flexion of the forearm at the elbow joint.
Brachioradialis muscle
The muscle is located laterally. It originates just below the lateral epicondyle of the humerus, goes down and attaches to the lateral surface of the radius.
- Flexes the forearm at the elbow joint;
- Fixes the position of the radius in a relaxed state.
Flexor carpi radialis
It is a flat, long muscle that originates from the medial epicondyle of the humerus and passes down to the base of the palmar surface.
- Wrist flexion;
- Participates in flexion of the forearm at the elbow joint.
Palmaris longus muscle
Just like the flexor radialis, it originates from the medial epicondyle of the humerus, goes down and passes into the palmar aponeurosis.
- Participates in flexion of the forearm at the elbow joint;
- Flexes the hand;
- Stretches the palmar aponeurosis.
In addition, it is worth noting muscles such as the flexor digitorum superficialis, flexor carpi ulnaris, extensor digitorum, and extensor carpi ulnaris muscles, which are also indirectly involved in movements of the elbow joint.
The elbow joint is a trochlear joint; its bursa is located in the upper part of the arm, between the forearm and shoulder.
It is formed at the point of contact of three bones: shoulder shoulder, ulnar and radial forearm.
Like all other hinge joints, the elbow joint allows movement in one plane, namely flexion and extension of the forearm relative to the shoulder.
However, the elbow allows rotation of the wrist as the radius rotates around the ulna. [Read below]
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The muscles of the elbow joint work together to perform many movements, providing greater strength and flexibility to the arm. There are seven major muscles present in the elbow that are responsible for flexion and extension of the arm as well as rotation of the forearm.
Nine more muscles of the elbow joint act on the wrists and joints of the hand. These muscles can be grouped into forearm flexors and extensors. A group of flexors, including the biceps brachii muscle (biceps), provide flexion of the arm by reducing the angle between the forearm and top part arms (shoulder).
The biceps brachii is the primary flexor of the elbow joint and is located in the upper part of the arm, between the shoulder and elbow joints. The biceps primarily functions as a flexor of the arm at the elbow joint, but it is also capable of supinating the forearm and rotating the palm forward. Although it is located in the forearm, the brachioradialis is the third flexor muscle of the elbow, running from the distal end of the humerus to the distal end of the radius.
Two muscles, the triceps brachii and the anconeus muscle, act as forearm extensors. The triceps brachii (triceps) is a long muscle that runs posterior to the humerus, from the shoulder blade to the olecranon process of the ulna. The olecranon is a much smaller muscle that begins at the distal end of the humerus near the elbow and ends at the olecranon process. Working together, these two muscles increase the angle between humerus and the ulna with the radius bones, straightening the arm until the olecranon process fixes the humerus in the ulnar fossa when it is fully extended.
Rotation of the forearm is accomplished by two muscles that cross the elbow joint: the pronator teres and the supinator. The pronator teres crosses the elbow at an acute angle from the medial epicondyle of the humerus to its insertion on the radius.
When the pronator teres muscle is tense, the radius rotates the forearm inward so that the palm faces posteriorly.
Its antagonist, the supinator, crosses the elbow at right angles to the pronator and connects the lateral epicondyle of the humerus to the radius.
Nine large muscles the forearms originate at the elbow and move the wrist as well as the fingers. The flexor bands originate from the medial epicondyle of the humerus and extend along the front of the forearm into the palm and fingers.
These muscles help flex your fingers into a fist and also flex your wrist to move your hand closer to the front of your forearm.
Extensor group - starts from the lateral epicondyle of the humerus and passes through back forearms to the back of the hand and fingers. Contraction of the extensor muscles extends the hand and fingers to open the closed palm and extend the wrist toward the back of the forearm.
In our body, freedom of movement is provided by about 180 different joints. The special structure of this biological mechanism, reminiscent of a hinge, provides tilting, bending, and extension of body parts. Protects bones from friction and self-destruction, and performs a shock-absorbing function. Important role The elbow joint plays a role in the movement of the arms. It is considered complex because it combines three articular mechanisms at once. To understand the principle of operation of the elbow, you need to understand what bones, muscles, and ligaments make it up, what vessels and nerve endings provide nutrition and innervation.
The elbow is formed by three bones:
- shoulder;
- ulnar and radial.
At the junctions, three simple joints are formed:
- humeroulnar;
- brachioradial;
- proximal radioulnar.
The names of the compounds speak for themselves and correspond to the elements included in the composition.
In the anatomy of the paired elbow joint, hyaline cartilage plays an important role, covering the entire articular surface of the epiphyses of the connecting bones. Cartilage tissue acts as a natural shock absorber, reduces friction, and provides an optimal contact area. Despite such significant functions, there are no blood vessels in the cartilage; nutrition is carried out by the forces of the joint fluid.
Outwardly it resembles a perfectly smooth, frosted glass surface. It has no nerve endings.
Composition of hyaline cartilage:
- 70-80% - water;
- up to 15% - organic compounds;
- about 7% are minerals.
The above composition clearly shows the importance of compliance water balance for the health of the joint mechanisms of our body.
Bones
The bursa of the elbow joint combines three joints into a single unit, formed by the lower part of the humerus and the upper (proximal) parts of the ulna and radius.
When considering the structure of the elbow, it is important to understand the anatomical features of the distal (lower) part of the humerus, which is directly involved in the formation of the articulation. The lower epiphysis has a condyle, on the sides of it there are two peculiar processes - the medial and lateral epicondyles, which serve as a support for attaching the ligamentous and muscular apparatus. In the area of the condyle there is an articular surface. The radial bone of the forearm is attached to it on the lateral side, and the ulna on the medial side.
The ulna is triangular, with a thickening at the top. At the site of the thickening there are two depressions (notches). The trochlear notch, the attachment point of the humerus, has two anatomical growths in front and behind - limiters, which are called coronoid and olecranon. In the radial cavity, a connection with the radius bone is formed.
The radius bone ends in the upper part with a head facing the humerus. Below the head is the narrowest place, called the neck, then there is a pronounced tuberosity. Articulates with the head of the condyle of the humerus through a depression in the upper part of the head.
The bones that form the biomechanism of the elbow joint are connected to each other by muscles, ligaments, and tendons.
Ligaments
Ligaments are made up of fibers connective tissue. Depending on the functions performed, elastic or collagen fibers may predominate in the structure. The strengthening ligaments of the elbow joint are woven directly into the joint capsule on the sides. There are no ligaments in the anterior and posterior parts of the capsule, which increases the risk and frequency of injuries in this area. The secretion formed by the inner layer of the articular cuff, synovium, reduces the friction of individual elements of the joint. Inhibiting and guiding ligaments play an important role in ensuring movement in the elbow joint. The former are designed to preserve the integrity of the biomechanism, the latter – functionality.
The quadrate ligament is attached at the lower edge of the radial notch and provides reliable articulation with the neck of the radius.
True anatomical position The radius and ulna are achieved through the annular ligament of the radius. The articulation is complemented by the interosseous membrane of the forearm. Thanks to the holes located there, blood supply and innervation of the joint is provided. The lateral epicondyle of the humerus and the head of the radius, the ulnar notch is held together by the radial collateral articular ligament. This is achieved by dividing the fibers into two bundles, tightly covering the bone surfaces.
The ulnar collateral originates at the internal (medial) epicondyle. Divided into bundles (fan-shaped), attached along the edge of the block-shaped notch.
Muscles
IN muscle tissue a complex process of energy transformation occurs. Under the leadership of the central nervous system, spinal cord, and brain, chemical energy transforms into a new quality - mechanical, providing motor activity.
There are 850 muscles in the human body that are constantly contracting. Thanks to this feature of muscle tissue, the vital functions of our body are ensured.
Mobility of the elbow joint provides quite large number various muscle fibers performing: flexion, extension, supination, pronation.
You can divide this group by location zones.
The shoulder muscles are represented by:
- Triceps brachii - back group, extensor, biarticular. IN anatomical structure Three separate beams are distinguished, each is attached to the blade independently, increasing the reliability of the structure. They are called muscle heads. In the canal formed by the median and outer heads of the muscle and the humerus, the radial nerve is located and a deep artery runs. Functions: performs medial adduction of the shoulder, extension at the elbow.
- Biceps muscle - anterior group, forearm supinator, elbow flexor.
- Shoulder - anterior group, flexor. Connects the humerus and ulna bones.
- Elbow – posterior group, extensor. Connects the lateral epicondyle of the humerus, the radial collateral ligament with the olecranon process at the top of the ulna.
The muscles of the forearm are also involved in the work of the elbow joint, they act as flexors, extensors, and are responsible for circular rotations, provide a buffer.
Presented:
- longus palmaris muscle;
- flexor brachioradialis;
- pronator teres and others.
Supination is a circular rotation performed at the elbow in the outer direction; pronation is a movement in the opposite, inner or medial direction.
