The whole truth about: the muscles of the elbow joint and other interesting information about the treatment.
elbow joint(Latin name - articulatio cubiti, articulation cubiti) formed by three bones - the distal epiphysis (end) humerus, proximal epiphysis of the ulna and radius. Its anatomy is arranged in such a way that the elbow joint is complex, as it is formed from three simple joints at once: humeroulnar, humeroradial, 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 later.
The elbow joint can move in two planes:
- Flexion and extension (frontal plane);
- Rotation (vertical plane). This movement provides only the humeroradial joint.
As can be seen in the photo atlas, the joint capsule surrounds all three joints. It originates in front above the edge of the radial and coronal fossae, on the sides almost at the edge of the trochlea and condyle of the humerus, behind just below the upper edge of the olecranon and is attached to the edge of the radial and trochlear notches on the ulna and to the neck of the radius.
Ligaments of the elbow joint
The elbow joint is surrounded by four ligaments (a diagram is shown 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 like a fan.
- Radial collateral ligament. It originates on the lateral epicondyle of the humerus, descends, dividing into two bundles, where they go 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 from the lateral side and goes to the anterior and posterior edges of the radial notch of the ulna. The ligament holds the position of the radius relative to the ulna.
- Square link. 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 relative to each other. The membrane has small holes through which the vessels and nerves pass.
Elbow muscles
The muscles of the elbow joint, which 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 hands.
Biceps brachii
The biceps of the shoulder, thanks to which the arm can bend, has two heads - long and short. The long head originates from the supraarticular tubercle of the scapula and ends in the muscular abdomen formed by both heads, which can be seen by looking at the figure. The abdomen passes into the tendon, which is attached to the tuberosity of the radius. short head originates at the apex of the coracoid process of the scapula.- Flexes the arm at the elbow joint;
- The long head is involved in the abduction of the arm;
- The short head is involved in bringing the hand.
shoulder muscle
A broad fleshy muscle located under the biceps of the shoulder. 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 articular capsule, and is attached to the tuberosity of the ulna.
- Stretches the articular bag.
Triceps brachii
This is a major 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. The lateral head of the muscle originates on rear 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 head, but only below the groove of the radial nerve. All these three heads go down and connect, forming a muscular belly, turning into a strong tendon, which is attached to the olecranon.
- Extension of the forearm in the elbow joint;
- Abduction and adduction of the shoulder to the body.
Elbow muscle
The ulnar muscle is a kind of continuation of the medial head of the triceps brachii. It originates from the lateral epicondyle of the humerus and the collateral ligament and is attached to the posterior surface of the olecranon, weaving into the articular capsule.Function - unbends the elbow due to the forearm.
Round pronator
It's thick and short muscle, which has two heads: shoulder and elbow. The humeral head is attached to the medial epicondyle of the humerus, the ulnar head is attached to the medial edge of the tuberosity of the ulna. Both heads form a muscular belly, passing into a thin tendon and attached 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 runs down to the base of the palmar surface.
- Flexion of the brush;
- Participates in flexion of the forearm at the elbow joint.
long palmar muscle
As well as radial flexor originates from the medial epicondyle of the humerus, goes down and passes into the palmar aponeurosis.
- Participates in flexion of the forearm in the elbow joint;
- Bends the brush;
- Stretches the palmar aponeurosis.
In addition, it is worth noting such muscles as the acting superficial flexor of the fingers, the ulnar flexor of the wrist, the extensor of the fingers and the ulnar extensor of the wrist, which are also indirectly involved in movements in the elbow joint.
The structure and functions of different parts of the body, including bone joints, are studied by anatomy. The elbow joint refers to the bone joints of the free upper limb and is formed as a result of articulation separate 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 us to attribute the joint to a complex and combined articulation.A compound joint is one in which more than two articular surfaces take part. There are three of them in the elbow:
- articular surface distal epiphysis of the humerus (block 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 one joint capsule. In the ulna, three independent capsules 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, block-shaped;
- humeroradial - spherical, but the 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. This is flexion, extension, rotation (pronation and supination).
joint capsule
The articular capsule surrounds 3 joints. It is fixed in front and on the sides.
It is rather thin in front and behind, slightly stretched, but on the sides it is protected by the ligaments of the elbow joint. The anatomy of the synovial membrane includes bones that are not covered by cartilage but are located in the joint.Ligaments of the elbow joint
Each bone connection is a complex and thoughtful anatomy. The elbow joint is reinforced with ligaments that provide its protection and movement in different planes.
The ulnar collateral ligament starts 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), divides into 2 bundles, which diverge and go around the head of the radius, attached to the ulna (radial notch).The annular and square ligaments fix the radius and ulna.
Tuberous protrusions are attached to the tendons of the elbow joint. The anatomy of this joint is called the "head of the ulna". It is she who most often suffers from injuries and injuries.
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. One of these bundles goes in the opposite direction from the others, called an oblique chord. It has openings through which the vessels and nerves pass. The oblique chord is the beginning 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 framework. The coordinated work of all muscles ensures the smooth operation of this bone connection.
All muscles that affect the elbow joint can be divided into 3 groups: extensors, flexors, rotators (perform pronation and supination).
The extensors of the joint are the triceps muscle of the shoulder (triceps), the tensor fascia of the forearm and the ulnar muscle.
Joint flexors - the biceps of the shoulder (biceps), brachioradialis and brachialis muscles.Pronators - brachioradialis muscle, pronator round, pronator square make rotational movements in and out.
Arch support - the biceps of the shoulder, the arch support, the brachioradialis muscle rotate the forearm from the inside.
Fulfilling physical exercise that strengthen the listed muscles, it is important to remember safety precautions. The elbow joint is very often injured in athletes.
Blood supply of 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 comes to all joints and muscles from a group of arteries. They consist of 8 branches, which are located on top of the joint capsule.
The network of arteries that supply blood to the joint consists of vessels called "anastomosis".
The topographic anatomy of the elbow joint is a very complex pattern of vascular connections. Thanks to this scheme, blood flow to the joint is uninterrupted. The outflow is carried out through the veins.
Muscle innervation
What is the process of movement in the joint possible? There are special nerve formations that innervate the muscles. These are the radial and median 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 pain, the doctor prescribes additional studies. This may be radiography, MRI, ultrasound, tomography, arthroscopy, elbow puncture.
These examinations will reflect the current condition of the bones and ligaments, the joint space. A picture of a particular study will reflect its entire anatomy. The elbow joint is a complex articulation that requires care and detailed study with the help of additional equipment.The main method for diagnosing diseases of the elbow 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.
Injury and illness
Regular pain in the elbow area may indicate that there are some disorders. After examination, the most common diagnosis is arthrosis. There is also arthritis, and much more.
arthrosis
It occurs much less frequently than in the knee or hip joints. The risk group includes people whose work is associated with increased loads on the elbow joint, who have undergone an injury or surgery on the elbow, with endocrine or metabolic disorders, with arthritis.
Main symptoms: constant aching pain that occurs after physical activity. Passes after rest. Clicking or crunching in the elbow. Limitation of the range of motion.
Arthritis
Inflammatory damage to the joint. Possible reasons a bunch of. They can be infections, allergic reactions, high stress on the joint, malnutrition.
The form of arthritis can be acute or chronic.
Main symptoms: persistent pain, skin hyperemia, swelling, limitation of joint mobility.
Rheumatoid arthritis
Most often, the elbow joint affects rheumatoid arthritis. Its symptoms: stiffness of movements 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 frequent disease in people whose activities are associated with 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 extends to the muscles of the forearm (anterior or posterior). At the beginning of the disease, pain occurs after exertion. In the future, pain is felt even from minimal movements.
Bursitis
Inflammation of the articular bag. Most often occurs in people whose activities are associated with permanent 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 dislocation, bone fractures, sprain, hemorrhage into the joint (hemarthrosis), muscle damage, rupture of the joint capsule.
These injuries and illnesses are the most common 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, you need moderate physical training and articular 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, microtrauma, 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, pain is expressed along the outer surface of the elbow, with medial - on the inside. Symptoms of the disease are pain in the affected area, radiating to the forearm and aggravated by movement of the affected arm.
Tennis Elbow Treatment
The biggest mistake of a person with epicondylitis of the elbow joint is not starting treatment in a timely manner or stopping treatment at the first sign of improvement.
To permanently get rid of epicondylitis disease, it is necessary to ensure complete rest for the hand for the entire period of treatment. If the tendon that has not had time to heal is damaged, the hand will start to hurt again, and the epicondylitis will develop into a chronic form, which is much longer and more difficult to treat.
Medical treatment
Since pain in epicondylitis of the elbow joint is caused by an inflammatory reaction, anti-inflammatory therapy is used. Experts recommend using local 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 is recommended without overloading the diseased joint.
Physiotherapy
IN acute period diseases lateral epicondylitis for anti-inflammatory and analgesic effects are used:
- high-intensity pulsed magnetotherapy;
- diadynamic therapy;
- percutaneous electroanalgesia (Eliman-401 device);
- infrared laser light.
In the subacute period of the disease "tennis elbow" are used:
- ultraphonophoresis of hydrocortisone and anesthetic mixture on the damaged area;
- paraffin-ozocerite applications at a temperature of 45 degrees C;
- naphthalon applications;
- extracorporeal shock wave therapy (apparatus "Medolit"); applied 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
In the treatment of "tennis elbow" (epicondylitis of the elbow joint), it is widely used 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 methods of treatment.
Also helps a lot special gymnastics aimed at relaxing the 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 a significant improvement when treated with medical leeches (hirudotherapy). After 5-6 sessions, the pain is noticeably reduced. Leeches are placed on certain points of the body, while 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 treatments
They are used in rare cases when other types of treatment do not bring a positive result. Surgical methods include:
- tunneling;
- excision of the hypertrophied ligament of the joint.
Traditional medicine recipes
Horse sorrel root tincture
They take half a liter jar of roots + half a liter of vodka, insist 10 days and apply it as compresses at night for 10 days.
Laurel oil
4 tbsp chopped bay leaf is poured into 200 g of vegetable oil, mixed, poured into an airtight container and infused for a week in a warm place.
Then filter and use as compresses or rub into a sore spot.
These prescriptions can be used to relieve pain, but they should not replace the competent treatment of epicondylitis (tennis elbow) by a specialist!
Watch a useful and interesting video about epicondylitis with Elena Malysheva:
Prevention
Any disease is easier to prevent than to cure. This is completely true with such a disease as tennis elbow. To prevent the development of epicondylitis, it is necessary:
- before physical activity, carry out a warm-up, warming up the muscles and tendons;
- fix the elbow joints with elastic bandages during heavy physical exertion;
- take breaks during long monotonous workouts or when doing monotonous work.
Important fact:
joint diseases and excess weight are always connected to each other. If you effectively reduce weight, then your health will improve. Moreover, this year it is much easier to reduce weight. After all, there was a tool that ...
Renowned doctor says
Inflammation of the elbow joint leads to a sharp decrease in human performance. Mostly young and middle-aged people face this problem. Inflammation in most cases develops in the right elbow, as the right-handed working arm is injured.
To understand what can become inflamed in a joint, you need to know its structure.
How is the elbow joint arranged?
Compared with other joints, the ulna is more complicated, because 3 bone ends of the ulna, radius and humerus are connected at once in it. It can only perform flexion-extension, as it is limited to block-like contact surfaces.
From above, the joint is protected by a thin capsule, which is supported by ligaments and tendons. Inside the joint capsule, a special liquid is always produced to lubricate the moving parts (bone heads). In addition, it delivers nutrients.
The bones end with a periosteum. It protects and periodically renews tissues, useful components from the synovial fluid pass through it. A 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 - tissues inside the joint become inflamed, and the articular bag is involved in the process, which produces synovial fluid into the cavity of the diseased joint. This causes the patient to experience 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 an increase in body temperature. In this case, the treatment will be aimed at extracting the pus that has accumulated in the joint cavity. In exceptional situations resort to surgical intervention.
- Psoriatic arthritis.
- Gouty arthritis.
Usually the last 2 forms are asymptomatic for a long time, so the disease goes unnoticed for a long time. Gradually, patients begin to feel slight pulling pains, stiffness after a long stay at rest.
Symptoms of psoriatic arthritis include plaque formation and peeling of the skin around the elbow.
Why does inflammation start?
In each individual case, the inflammatory process can begin at different 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 actions that lead to serious stress on the joints.
- Injuries can also cause inflammation. Quite often elbows suffer from bruises, sprains, blows or dislocations.
- Too high load on the joint in athletes, especially weightlifters.
- infection factor. In the body, an infectious focus may arise and spread to the elbow area.
A separate group consists of the causes that cause the disease. Tuberculosis, measles, gonorrhea, and trauma can contribute to the development of elbow arthritis.
What are the symptoms of diseases?
The symptoms of arthritis depend on the site of the lesion. Bursitis symptoms:
- there is a sharp sharp pain in the elbow;
- the skin around the elbow turns red, becomes hot;
- swelling and edema appear;
- the normal operation of the tendons is difficult;
- a seal is formed on the elbow, which remains movable when pressed;
- the patient seems to carry the arm in a bent position at an angle of 90 degrees.
With bursitis, fluid is released and penetrates into the joint bag, and this makes it difficult for any hand movements. Also, the symptoms include muscle resistance during movement, tendons do not work well.
Epicondylitis is characterized by the following symptoms:
- pain occurs only during physical activity;
- mild swelling of the joint;
- crunching or crackling when performing movements.
Treatment is carried out after diagnosis. The surgeon or traumatologist, based on the results of the data obtained during the examination, makes a diagnosis. The doctor can send for additional research: X-ray, analysis of intra-articular fluid, blood and biochemical tests for protein.
Treatment Methods
Treatment is always complex. To begin with, the elbow is fixed with a bandage from a scarf, bandages, and an elbow pad. This ensures maximum rest for the affected areas.
If, after studying the joint fluid, pathogenic microflora is found, then antibiotics are used for oral administration or as intramuscular injections.
Non-steroidal anti-inflammatory drugs are effective for stopping pain attacks and for relieving inflammation, swelling. Such substances are included in the composition of 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 the pain well when other drugs and methods no longer work.
Treatment of inflammation is also carried out by physiotherapeutic methods, massage. The exception is acute purulent processes.
The following methods are applied:
- electrophoresis with the addition of anti-inflammatory substances;
- magnetic therapy;
- shock wave therapy;
- applications with paraffin and ozocerite;
- laser irradiation.
Operations are indicated exclusively for the purulent nature of the disease.
Folk methods of treatment
Treatment at home folk methods before visiting the doctor will help muffle the pain and reduce the size of the bumps on the elbow. There are many ways to treat a sore elbow:
- The most commonly used tincture of propolis. It is used for compresses.
- For the next method, you need to take an old agave (at least 3 years old), honey and 96% alcohol. Grind aloe leaves in a meat grinder or blender, and then squeeze the juice out of the gruel. 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 apply also in the form of compresses. Store the tincture in the refrigerator. Warm to room temperature before use.
- Heating with salt is very effective. You need to heat the table salt (1/2 cup) in a pan. Then pour into a canvas bag, bandage well. In the evening, apply to the sore joint, bandaging it with something warm on top. This method must be used very carefully, because with purulent arthritis, the condition may worsen and the pain intensify.
- Elbow bursitis is effectively treated with the golden mustache plant. It is necessary to grind about 20 g of antennae, place in an enameled container and pour 300 ml of water. Put the dishes on the fire, boil the liquid for 7 minutes, then cool and strain. Moisten a cotton napkin in the decoction and apply to the affected area. Place a plastic bag over the top cling film and well wrap everything up with a woolen scarf. Do this procedure at night. The duration of treatment in this way is 20 days.
- At home, burdock root will help relieve pain. To prepare a decoction, you need 1 tbsp. l. boil dried roots in 500 ml of water, let it brew and cool. Then strain the infusion. Soak a clean cloth in the decoction and apply to the sore elbow. Be sure to wrap a warm scarf over it.
- An old and effective way to treat inflammation of the elbow joint is a cabbage leaf. It is washed, dried well, all veins are removed. Then beat with a heavy hammer until juice appears. A wet cabbage leaf is applied to the inflamed elbow, fixed with a bandage and insulated with a scarf.
Methods of treatment of 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 are attached 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 the presence of inflammation in the tendons, which are located on the outside of the 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 presented inflammation 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 were only 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 (weightlifters, wrestlers, weightlifters, boxers).
By themselves, the activities presented do not contribute to the development of epicondylitis.
Most of all goes to the dominant hand. Therefore, the main reason for the development of epicondylitis is tendon overload, tissue microtrauma, which causes 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 joint. Passive movements in this pathology are not painful and not difficult.
The pain is aching in nature, can radiate to the middle third of the forearm and outer part shoulder. Worried about pain in the lateral epicondyle. The epicondylus itself hurts when it is felt.
Pain may become stronger with simple movements such as shaking hands, clenching the hand into a fist. Pain may increase even with slight resistance to supination and extension.
At first, it disappears at rest. But in the future it becomes constant and intense. In connection with the defeat of the ligamentous apparatus, the range of motion is limited or pathological mobility of the joint occurs.
Types of epicondylitis
There are two types of epicondylitis.
Lateral epicondylitis (external)
A disease characterized by the development of inflammation at the site of attachment of the muscle to the lateral epicondyle of the bone.
As a rule, such a 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 the overstrain of the muscles at the point of their attachment to the epicondyle of the shoulder bone.
This overvoltage often occurs while playing tennis or when performing other monotonous work (sawing firewood, painting walls, and so on). This pathology occurs in a person aged 30 to 50 years.
Medial epicondylitis (internal)
The condition is often referred to as "golfer's elbow". But this does not mean that only people who play golf can suffer from this disease. Just golf is one of the common causes of medial epicondylitis.
Also, this disease can cause other frequently repetitive movements.
Such movements include: playing sports, throwing, the consequences of injuries, using different kinds hand tools.
Treatment of the disease
The treatment of lateral and medial epicondylitis of the elbow joint is largely similar.
Therapy of epicondylitis is carried out in a complex manner, depending on the duration of the disease, changes in tendons and muscles in the area of the hand and forearm, as well as the level of joint impairment.
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 it was not possible to achieve recovery, surgical intervention is used.
Therapeutic measures help unload muscles, relieve pain and suppress inflammation. Localization of the process in order to determine the choice of the method of therapy is of no fundamental importance.
To unload muscles, you can use the following methods:
- Wearing orthoses, the fixation of which is carried out in the upper part of the forearm. Such orthopedic clamps “turn off” the inflamed area of the muscle, preventing it from contracting. Such devices must be used at the time of wakefulness; at night, orthoses must be removed.
- Gentle mode. If the labor activity of a person is accompanied by constant movements in the wrist joint (painters, deboners, locksmiths), then it is extremely important to abandon labor activity for the duration of treatment.
- Immobilization of the upper limbs using splints. The wrist joint is fixed in order to immobilize the hand. This is necessary for advanced processes that are accompanied by severe pain.
- Special gymnastics. For these purposes, apply static exercises, which contribute to the stretching of the tendons. It is necessary to perform with the maximum possible abduction and adduction of the hand, so that an angle of 90 degrees is formed with the forearm. In this position, the brush should be held for 10-15 seconds. The number of repetitions is 7-10, 2 times a day.
- Application wrist simulators for 3D exercises. Classes begin to be performed with simulators that have minimal rigidity. The duration of classes should increase gradually. The selection of exercises should be carried out in such a way that the muscles do not overstrain.
In order to eliminate pain and inflammation, it is necessary to use:
- Taking medication. In most cases, the doctor prescribes the patient to take anti-inflammatory drugs. In the treatment of epicondylitis of the elbow joint with ointments, on the skin in place pain an ointment is applied, which contains indomethacin, ibuprofen, diclofenac and other nonsteroidal agents. You need to apply it 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 an anesthetic. Make lotions 1 time per night. To achieve a quick and lasting effect, the focus of inflammation is treated with diprospan.
- Physiotherapy, which includes drug electrophoresis using anti-inflammatory drugs, galvanization, phonophoresis, magnetotherapy, paraffin therapy, application of therapeutic mud.
- Cooling the area of the elbow joint using devices that accumulate cold or irrigation with chloroethyl. Can be replaced 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 compaction of the muscles. The duration of the massage is 10-15 minutes. Massaging movements should not give the patient discomfort. Massage is performed daily 1-2 times, duration 10-12 days.
- Shock wave action is based on the effect of infrasound directly on inflamed tissues. Presented modern technique gives very good result, restoring microcirculation in the inflamed muscle tissue. You need to perform 5-7 sessions. After that, there is a pronounced positive trend.
If you use the above recommendations, then the disease recedes. If positive effect is not observed and it is not clear how to cure epicondylitis of the elbow joint with conservative methods, then doctors resort to surgical intervention.
Surgical impact
Surgical intervention is used in case of failure of conservative therapy. In most cases, this applies to those people whose work activity is accompanied by daily stress on the muscles of the forearm.
Surgical treatment includes the following techniques:
- dissection of the tendon of the meek extensor of the hand;
- tendoperiostetomy;
- arthroscopic effect.
- lengthening of the tendon of the short extensor of the hand
Its main advantage, in comparison with the rest, is low trauma. After arthroscopic surgery, patients can perform light work after 2 weeks.
Disease prevention
Any disorder is always better to prevent than to cure. This just applies to such a disease as epicondylitis of the elbow joint.
The main methods of prevention include:
- before implementation physical activity a warm-up should be performed, which is aimed at warming up the muscles and tendons;
- rationally distribute the load without overstraining the muscles;
- fix the elbow joints with an elastic bandage during heavy physical exertion;
- take breaks during long monotonous workouts or during monotonous work.
Epicondylitis of the elbow joint is not a very dangerous disease. But this does not mean that it should be launched. Therefore, if you experience the slightest symptoms, immediately contact a specialist for proper treatment.
Video: How to help yourself with elbow pain?
Anatomy of the elbow joint
Elbow bones’>
Elbow bones
Bone Anatomy
Elbow anatomy’>
Anatomy of the elbow joint
The elbow joint is the articulation of three bones: the humerus, ulna and radius. The shoulder-elbow joint belongs to the block-like, it is formed by the block of the medial condyle of the humerus and the semilunar 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 shoulder joint is formed by the head of the radius and the head of the condyle of the humerus. The joint between the ulna and the 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 in 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’>
Ligaments of the elbow joint
Ligaments are thickened areas of the joint capsule that provide stability to the joint. The elbow joint is surrounded by a complex interlacing of ligaments. The lateral part of the joint is reinforced with 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 starts from the lateral epicondyle of the humerus and, expanding distally, merges with the deep fibers of the annular ligament of the radius, strengthens the latter and ensures the stability of the elbow joint during varus loading (adduction of the forearm). The annular ligament of the radius is attached to the anterior and posterior surface 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 crest of the supinator of the ulna; the proximal end of 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 with 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 part of the elbow joint, relieves rotational stress on the forearm, and supports the head of the radius posteriorly.
The medial part of the elbow joint is also reinforced with 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 for counteracting the valgus load on the elbow joint (abduction of the forearm). It is attached to the medial epicondyle of the humerus and to the apex 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 elbow during pronation. Its points of attachment are the lateral epicondyle of the humerus and the olecranon. The glenohumeral joint, the radius and the 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 sections of the capsule of the elbow joint, the attachment sites of the anterior and posterior groups of muscles of the forearm, as well as the ulnar, triceps and brachial muscles.
Muscle Anatomy
Muscles of the elbow joint
Elbow muscles
A balanced contraction of the muscles is necessary to ensure accurate coordinated movements in the joint. Movement in the elbow joint is provided by the following muscles. On the anterior surface to the coronoid process of the ulna is attached shoulder muscle, while its antagonist, the triceps muscle, is attached by a flat broad tendon to the olecranon of the ulna. The extensor muscles of the surface layer of the posterior group of muscles of the forearm originate from the lateral epicondyle of the shoulder; these include extensor carpi radialis long, extensor carpi radialis brevis, extensor digitorum and flexor carpi ulnaris. On the other side of the distal epiphysis of the humerus, from the medial epicondyle and the medial supracondylar ridge, the anterior group of muscles of the forearm (flexors and pronators) originates. It includes the pronator teres, flexor carpi radialis, long palmar, flexor digitorum superficialis, and flexor carpi ulnaris.
Nerves
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 posterior medial surface of the ulnar region. The radial nerve is formed by the posterior bundle brachial plexus(roots C6, C7 and Thl); it innervates the triceps muscle, the arch support, and the extensors of the wrist and fingers. The ulnar nerve arises from the medial bundle of the brachial plexus (roots C7 and Thl) and innervates the flexor carpi ulnaris, deep flexors of the fingers, and lumbrical muscles. ring finger and the little finger, the dorsal and palmar interosseous muscles, the adductor thumb muscle, and the muscles of the little finger elevation (the muscle that opposes the little finger; the muscle that adducts the little finger and the little finger flexor). The median nerve is formed by the lateral and medial bundles of the brachial plexus (roots C6, C7 and Thl) and innervates the long palmar muscle, pronator teres, flexor carpi radialis, deep flexors of the index and middle fingers, flexor digitorum superficialis, flexor pollicis longus, pronator quadratus, vermiformes thumb and index finger, as well as the muscles of the elevation of the thumb (the muscle that opposes the thumb; the muscle that removes the thumb and the flexor of the thumb).
Compression of these nerves, usually manageable, is a common cause of elbow pain. The radial nerve can be compressed by the fibrous arch of the lateral head of the triceps muscle, Froze's arcade, at the site of attachment of the short radial extensor of the wrist, as well as by neighboring structures. Compression of the ulnar nerve is possible in the region of the supracondylar process of the humerus, in the region of Straderz's arcade, at the site of attachment of the ulnar flexor of the wrist, in cubital canal wrist (see section "Cubital Canal Syndrome"). The median nerve can be compressed by the supracondylar process of the shoulder and the fascial sheets attached to it, Straderz's ligament, the tendon arch of the superficial flexor of the fingers, the aponeurosis of the biceps of the shoulder, or the round pronator. Compression of the median nerve is also possible in the carpal tunnel.
13167 0
Flexion is carried out by three main muscles.
- Brachial 1 , originating on the anterior surface of the lower half of the humerus and attached to the tuberosity of the ulna (Fig. 49). This muscle acts solely as an elbow flexor, being one of the few muscles that performs only one function.
- brachioradialis 2 , going from the external supracondylar crest of the humerus (Fig. 49) to the styloid process of the radius. This muscle mainly acts as a flexor of the forearm and only with extreme pronation becomes an arch support, 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 does not begin on the shoulder, but on the shoulder blade (therefore, it is a biarticular muscle). Her long head 4 originates from the supraarticular tubercle of the scapula and extends to the shoulder, and the short head 5 starts on the coracoid process.
Thanks to her start 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, albeit secondary, role in supination. With a bent forearm, her thrust can lead to a dislocation of the radius. The flexors realize their function to the greatest extent when the elbow joint is flexed at an angle of 90°.
During extension (Fig. 51), the direction of the 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 flexion force.
On the other hand, whenelbow jointbent (Fig. 52), the muscle pull acts perpendicular to the arm of the lever (pink arrow - biceps, green - brachioradialis), so that the centripetal component is zero, and the tangential component is equivalent to muscle pull, which is used for flexion.
This flexion angle of maximum efficiency is 80-90° for the biceps and 100-110° for the brachioradialis, i.e. for the last muscle, this angle is greater than for the biceps. The 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 longus wrist joint (RI), lying deeper than the brachioradialis muscle;
- ulnar muscle 6 (Fig. 49) stabilizes the elbow joint from the outside;
- round pronator, fibrous retraction of which (Volkmann's contracture) limits full extension in the elbow joint.
"Upper limb. Physiology of joints"
A.I. Kapanji
Elbow joint (Latin name - articulatio cubiti, articulation cubiti) formed by three bones - the distal epiphysis (end) of the humerus, the proximal epiphysis of the ulna and radius. Its anatomy is arranged in such a way that the elbow joint is complex, as it is formed from three simple joints at once: humeroulnar, humeroradial, 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 later.
The distal epiphysis of the humerus has a block and head of the condyle. The proximal end of the ulna has trochlear and radial notches. The radius has a head and articular circumference, which can be seen by looking at the figure. The glenohumeral joint is formed by the articulation of the trochlea of the humerus and the trochlear notch of the ulna. The shoulder 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 provides only the humeroradial joint.
As can be seen in the photo atlas, the joint capsule surrounds all three joints. It originates in front above the edge of the radial and coronal fossae, on the sides almost at the edge of the trochlea and condyle of the humerus, behind just below the upper edge of the olecranon and is attached to the edge of the radial and trochlear notches on the ulna and to the neck of the radius.
Ligaments of the elbow joint
The elbow joint is surrounded by four ligaments (a diagram is shown 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 like a fan.
- Radial collateral ligament. It originates on the lateral epicondyle of the humerus, descends, dividing into two bundles, where they go 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 from the lateral side and goes to the anterior and posterior edges of the radial notch of the ulna. The ligament holds the position of the radius relative to the ulna.
- Square link. 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 relative to each other. The membrane has small holes through which the vessels and nerves pass.
Elbow muscles
The muscles of the elbow joint, which 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 hands.
Biceps brachii
The biceps of the shoulder, thanks to which the arm can bend, has two heads - long and short. The long head originates from the supraarticular tubercle of the scapula and ends in the muscular abdomen formed by both heads, which can be seen by looking at the figure. The abdomen passes into the tendon, which is attached to the tuberosity of the radius. The short head originates at the top of the coracoid process of the scapula.
- Flexes the arm at the elbow joint;
- The long head is involved in the abduction of the arm;
- The short head is involved in bringing the hand.
shoulder muscle
A broad fleshy muscle located under the biceps of the shoulder. 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 articular capsule, and is attached to the tuberosity of the ulna.
- Stretches the articular bag.
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 head, but only below the groove of the radial nerve. All these three heads go down and connect, forming a muscular belly, turning into a strong tendon, which is attached to the olecranon.
- Extension of the forearm in the elbow joint;
- Abduction and adduction of the shoulder to the body.
Elbow muscle
The ulnar muscle is a kind of continuation of the medial head of the triceps brachii. It originates from the lateral epicondyle of the humerus and the collateral ligament and is attached to the posterior surface of the olecranon, weaving into the articular capsule.
Function - unbends the elbow due to the forearm.
Round pronator
This is a thick and short muscle that has two heads: the shoulder and the elbow. The humeral head is attached to the medial epicondyle of the humerus, the ulnar head is attached to the medial edge of the tuberosity of the ulna. Both heads form a muscular belly, passing into a thin tendon and attached 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 runs down to the base of the palmar surface.
- Flexion of the brush;
- Participates in flexion of the forearm at the elbow joint.
long palmar muscle
Just like the radial flexor, it originates from the medial epicondyle of the humerus, goes down and passes into the palmar aponeurosis.
- Participates in flexion of the forearm in the elbow joint;
- Bends the brush;
- Stretches the palmar aponeurosis.
In addition, it is worth noting such muscles as the acting superficial flexor of the fingers, the ulnar flexor of the wrist, the extensor of the fingers and the ulnar extensor of the wrist, which are also indirectly involved in movements in the elbow joint.
The elbow joint is a trochlear joint, its synovial 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 forearms.
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 by rotating the radius around the ulna. [Read below]
[Start from above]
The muscles of the elbow joint interact to perform many movements, providing greater strength and flexibility to the arm. There are seven major muscles present in the elbow, responsible for flexion and extension of the arm, as well as rotation of the forearm.
Another nine muscles of the elbow joint act on the wrists and joints of the hand. These muscles can be grouped into the flexors and extensors of the forearm. A group of flexors, including the biceps brachii (biceps), provide arm flexion by reducing the angle between the forearm and top hands (shoulder).
The biceps brachii is the main flexor of the elbow joint and is located in the upper 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 able to supinate the forearm and rotate the palm forward. Although located in the forearm, the brachioradialis is the third flexor 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 ulna - act as extensors for the forearm. The triceps brachii (triceps) is a long muscle that runs posterior to the humerus, from the scapula to the olecranon of the ulna. The ulna is a much smaller muscle that starts at the distal end of the humerus near the elbow and ends at the olecranon. Working together, these two muscles increase the angle between the humerus and the ulna with the radius, straightening the arm until the olecranon locks the humerus in the olecranon fossa when it is fully extended.
The rotation of the forearm is carried out with the help of two muscles that cross the elbow joint: the round pronator and supinator. The pronator teres crosses the elbow at an acute angle from the medial epicondyle of the humerus to its insertion on the radius.
With tension on the pronator teres, the radius rotates the forearm inward so that the palm faces backwards.
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 big muscles the forearms originate at the elbow and move the wrist as well as the fingers. The flexion groups originate from the medial epicondyle of the humerus and extend along the front of the forearm into the palm and fingers.
These muscles help to flex the fingers into a fist, as well as flex the wrist to move the hand closer to the front of the forearm.
The extensor group - starts from the lateral epicondyle of the humerus and passes through the back of the forearm to the back of the hand and fingers. Contraction of the extensor muscles extends the hand and fingers to open the clenched hand and extend the wrist towards the back of the forearm.
In our body, about 180 different joints provide freedom of movement. The special structure of this biological mechanism, resembling a hinge, provides inclinations, flexion, and extension of body parts. Protects bones from friction, self-destruction, performs a shock-absorbing function. Important role in the movement of the arms plays the elbow joint. It is considered complex because it combines three articular mechanisms at once. To understand the principle of the elbow, it is necessary to imagine what bones, muscles, ligaments make up it, 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, they correspond to the elements that make up 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 provided by the forces of the joint fluid.
Outwardly, it resembles a perfectly smooth, frosted glass surface. 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 articular mechanisms of our body.
Bones
The articular bag of the elbow joint combines into a single knot three joints formed by the lower part of the humerus and the upper (proximal) parts of the ulna and radius.
Considering the structure of the elbow, it is important to represent 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 region of the condyle is the articular surface. On the lateral side, the radius of the forearm is attached to it, on the medial side, the ulna.
The ulna is trihedral, with a thickening in the upper part. In the place of thickening there are two depressions (cutouts). Block-shaped notch - the place of attachment of the humerus, in front and behind it has two anatomical outgrowths - limiters, which are called coronoid and olecranon. In the radial cavity, a connection with the radius is formed.
The radius in the upper part ends with a head facing towards the humerus. Below the head - the narrowest place, called the neck, then - 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 interconnected by muscles, ligaments, tendons.
Bundles
Ligaments are made up of connective tissue fibers. Depending on the functions performed, elastic or collagen fibers may predominate in the structure. Reinforcing ligaments of the elbow joint are woven directly into the joint capsule on the sides. There are no ligaments in the anterior and posterior part of the capsule, which increases the risk and frequency of injuries in this area. The secret formed by the inner layer of the articular cuff - the synovium, reduces the friction of the individual elements of the joint. An important role in ensuring movements in the elbow joint is played by inhibitory and guiding ligaments. 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, providing reliable articulation with the neck of the radius.
true anatomical position radius and ulna is achieved through the annular ligament of the radius. Complements the articulation of the interosseous membrane of the forearm. Thanks to the holes located there, blood supply and innervation of the joint are carried out. The lateral epicondyle of the shoulder and the head of the radius, the notch of the ulna is fastened 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. It is divided into bundles (fan-shaped), attached along the edge of the block-shaped notch.
muscles
IN muscle tissue there is a complex process of energy transformation. Under the direction of the central nervous system, spinal, brain, chemical energy passes into a new quality - mechanical, providing motor activity.
The 850 muscles in the human body are constantly contracting. Thanks to this feature of muscle tissue, the vital activity of our body is ensured.
The mobility of the elbow joint provides quite a large number of various muscle fibers performing: flexion, extension, supination, pronation.
You can divide this group into zones of location.
The muscles of the shoulder are:
- Triceps brachii - rear group, extensor, biarticular. IN anatomical structure three separate beams stand out, each is attached to the blade independently, increasing the reliability of the structure. They are called the heads of the muscles. In the canal formed by the median and external heads of the muscle and the humerus, is located radial nerve, lies a deep artery. Functions - performs medial adduction of the shoulder, unbends at the elbow.
- The biceps muscle is the anterior group, the arch support of the forearm, the elbow flexor.
- Shoulder - front group, flexor. Connects the humerus and ulna.
- Elbow - posterior group, extensor. Connects the external epicondyle of the humerus, the radial collateral ligament with the olecranon at the top of the ulna.
The muscles of the forearm are also involved in the work of the elbow joint, perform the role of flexors, extensors, are responsible for circular rotations, provide a buffer.
Represented:
- long muscle of the palm;
- brachioradialis flexor;
- pronator round and others.
Supination - circular rotations performed in the elbow to the outside, pronation is the movement to the opposite, internal or medial side.
