Elbow valgus represents one of the most frequent injury mechanisms in the sports world, particularly in disciplines involving throwing, striking, or rotational movements. This biomechanical stress, when repeated or excessive, threatens the integrity of the ligamentous and neural structures of the elbow. Understanding this phenomenon constitutes an essential step in preventing injuries that can drastically compromise performance and the longevity of an athletic career.
Elbow Valgus: A Mechanism Often Neglected in Sports Practice
The elbow is one of the most stressed joints in many sports, particularly those involving throwing or rotational movements. Elbow valgus corresponds to a mechanical stress exerted on the inner part of the joint, causing excessive opening of this area. This phenomenon particularly affects athletes practicing baseball, tennis, golf, handball, or volleyball.
The natural valgus angle of the elbow generally varies between 5 and 10 degrees in adults. This slight physiological deviation becomes problematic when the forces exerted exceed the resistance of the anatomical structures. The medial collateral ligament, the first barrier against valgus stress, undergoes repeated microtraumas that can evolve into a serious injury if not given attention.
High-level athletes, especially throwers, often develop a structural adaptation with an increase in this valgus angle, sometimes up to 15 degrees. This modification, although temporarily improving performance, considerably weakens the joint in the long term.
Which Anatomical Structures Are Impacted by Excessive Valgus?
Understanding the structures stressed during valgus stress allows for a better understanding of the risks involved. The medial collateral ligament (MCL), composed of three distinct bundles, represents the main stabilizing structure against valgus forces. Its partial or complete rupture constitutes one of the most frequent injuries among throwers.
Beyond the MCL, several other structures suffer the consequences of excessive valgus:
- The ulnar nerve, which passes through the epitrochleo-olecranon groove, can be compressed or irritated, causing paresthesia in the nerve territory
- The posterior face of the joint undergoes a compression phenomenon that can lead to osteochondral lesions
- The flexor muscles of the wrist and fingers, which insert on the medial epicondyle, are excessively stressed
These structural damages manifest as progressive pain on the inner face of the elbow, sometimes accompanied by tingling sensations in the fourth and fifth fingers. Grip strength gradually decreases, directly impacting sports performance well before the onset of an acute injury.
High-Risk Sports for Valgus Stress on the Joint
Certain sports disciplines particularly stress the elbow in valgus. Baseball represents the most emblematic example, with an incidence of valgus-related injuries that can reach 50% among professional pitchers over a career. The pitching gesture generates considerable forces, especially during the acceleration phase where the elbow can undergo valgus stress equivalent to more than 60 Newton-meters.
Tennis, especially during the serve and topspin forehand, also imposes major constraints on the elbow. The modern hitting technique, favoring topspin effects with a significant pronation-supination amplitude, accentuates this phenomenon. Amateur players, whose technique is often less refined, present a higher risk of developing pathologies associated with valgus than professionals.
Combat sports, particularly martial arts involving percussion techniques such as karate or taekwondo, also expose the joint to valgus stress during certain poorly executed blocks or strikes. Muscle fatigue at the end of training significantly increases the risk of excessive joint stress.
How to Prevent Injuries Related to Elbow Valgus?
Prevention constitutes the most effective approach to the risks associated with elbow valgus. An adapted training program must include specific strengthening of the joint stabilizing muscles. The wrist flexors and the pronator teres play a crucial role in protecting the medial collateral ligament.
Biomechanical analysis of the sports gesture represents a fundamental step in injury prevention. Correcting technical flaws allows for considerably reducing the constraints exerted on the joint. In throwing sports, optimizing the global kinetics of movement, involving the entire muscle chain from the lower limbs to the upper limb, decreases the isolated stress on the elbow.
Training planning must also integrate sufficient recovery periods. Muscle fatigue alters the active protection capacity of the joint. A fatigued athlete presents an increased risk of valgus-related injury, as the stabilizing muscles no longer ensure their protective role optimally.
When Should You Consult for Elbow Pain?
The persistence of pain on the inner face of the elbow, even slight, requires particular attention. This symptomatology, often trivialized by athletes, can indicate the beginnings of a more serious lesion. The appearance of sensations of weakness in the hand or tingling in the fingers constitutes an additional warning signal.
Self-medication with anti-inflammatories temporarily masks the pain without treating the underlying cause. This dangerous approach allows the continuation of sports activity despite an evolving lesion, potentially aggravating structural damage. A medical consultation is necessary as soon as persistent symptoms appear.
In the presence of signs suggestive of valgus-related damage, a specialized medical evaluation allows for the implementation of an adapted treatment. Imaging, particularly dynamic ultrasound, offers a precise visualization of the damaged structures. Early rehabilitation, associated if necessary with temporary sports rest, prevents evolution towards more disabling chronic forms or those requiring surgical intervention. In case of persistent pain or worrying symptoms, it is imperative to quickly consult a sports physician or specialist who will be able to make the appropriate diagnosis and propose an adapted management.
Basketteur de moins d’1m80, je prends la plume pour parler basket, cyclisme ou football. Je ne crie pas “Go Spurs Go” mais je suis Wemby de près. Et tant pis pour mes Trail Blazers qui végètent à l’Ouest…