Elbow Pain In A Gymnast - Page #1

Author: Mary Solomon, DO
Co Author #1: Susannah M Briskin MD
Co Author #2: Amanda K Weiss Kelly MD
Co Author #3: Louis Leone DO

Patient Presentation:
A 10 year old female gymnast with right elbow pain

The patient, a level 8 female gymnast, reports feeling a pop in her right elbow during a back handspring 3 months ago. She has had intermittent pain over her anterior elbow ever since her injury. She reports overall improvement with rest, but her symptoms recurred 2 weeks ago when she hyper-extended her right elbow during another back handspring. Her pain has since worsened. She is using ice and taking ibuprofen as needed. She denies any significant past medical or family history. She is pre-menarchal.

Physical Exam:
Physical Exam
Well appearing, thin, and muscular
Vital signs
Ht:140.5 cm, Wt:32.3 kg, BMI:16.4
Inspection / Palpation
Right elbow tender to palpation along
anterior joint line
Mild tenderness at the medial
epicondyle, radiocapitellar joint,
and posterior capitellum
No erythema, ecchymosis, or swelling
Range of Motion
Bilateral flexion to 150º
Bilateral hyperextension of 8º
Supination and pronation full & equal
Bilateral 5/5 in flexors, extensors,
supinators, and pronators
Provacative Maneuvers
Valgus and varus stress tests
Milking maneuver negative
Valgus overload extension negative

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