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Elbow Dislocation: Causes, Symptoms, Treatment and Exercises

elbow dislocation - physiotherapy and chiropractic treatment in torontoThe elbow joint consists of three bones: humerus (arm bone), radius and ulna (forearm bones). A dislocated elbow occurs when these bones are forced out of their normal position. It is the most commonly dislocated joint in children, and the second most common in adults after the shoulder.

The signs and symptoms are difficult to miss:

  • Sudden onset of extreme pain following a trauma
  • Visibly deformed elbow
  • Unable to bend or straighten arm
  • Swelling and possible bruising around the elbow

Elbow dislocations are quite often reducible without surgery, but do not attempt it on your own. In addition to the dislocation, broken bones, muscle, vascular or nerve damage may happen. If you think you have dislocated your elbow, seek medical attention promptly.

A partial dislocation on the other hand can be easily missed as the bones can slip back into place. Book an appointment with a sports medicine doctor or a physiotherapist if you have lasting elbow pain following a trauma.

What Causes an Elbow Dislocation?

Commons causes of an elbow dislocation include:

  • Landing on an outstretched hand as a result of a fall (i.e. football, skiing, volleyball, cycling, slipping on ice)
  • Hard direct blow to the joint (i.e. Motor Vehicle Accident)

How can Physiotherapy or Chiropractic Help with Elbow Dislocations?

Following the assessment in the hospital, the doctor will decide if the joint is reducible or additional surgery is needed (broken bones, damaged nerve/blood vessels may need repair).

If the dislocation is stable, surgery will not be required. The joint will be reduced (put back into place), and splinted for 7-10 days to allow the ligaments and muscles to heal and to prevent re-dislocation. Early mobilization is important, so make sure you book an appointment with a physiotherapist or chiropractor within that time frame. Most elbow joints become stiff as a result of prolonged immobilization, which will require longer recovery and more therapy.

During the assessment, the therapist will assess your current range of motion, and provide you with exercises to help you regain range and function. Performing home exercises 3-4x a day is the cornerstone of a successful outcome. During this session, they will also provide you with exercises to the surrounding joints to avoid disuse injuries. They can also help you find safe alternatives to continue exercise and stay active.

In the subsequent therapy sessions, manual therapy techniques may be applied to the joint and surrounding connective tissues. Joint stability and ligament healing will be monitored over time, and range of motion, stretching and strengthening exercises are progressed based on guidelines and tolerance. If needed, your therapist can use taping or bracing. If pain is an issue, they can use modalities such as acupuncture and interferential current to help control pain.

What Should be Avoided with an Elbow Dislocation?

Avoid excessively moving and using your arm while in a sling. Pushing it too hard early on may result in a re-dislocation, but keeping it from moving at all afterwards could result in range of motion and functional loss. Follow the guidance of your healthcare professional closely. You will have a gradual return to sport, gym etc.

How Long Does it Take to Recover from an Elbow Dislocation?

Every case is different, but following a non-surgical elbow dislocation, most people able to return to activities within 4-8 weeks. It may take longer if the dominant hand is involved, or there are high sport specific demands (i.e.: gymnast or volleyball player). Ligamentous healing will continue long after the initial healing time of 4-6 weeks. If surgery was required following the dislocation, recovery may take longer, up to 3-5 months.

During the initial few weeks, the goal is regaining functional range of motion, followed by strengthening and work hardening/return to sport training. The length of each stage will depend on the type of dislocation and whether it required surgical treatment. The key to recovery is performing the prescribed exercises post dislocation at home as prescribed.

Patients following simple dislocations typically do well with recovery, and report high levels of satisfaction and high functional level. However, some residual stiffness and pain is possible in the long term. Unlike the shoulder, where the chance of re-dislocation is high, the elbow tends to stiffen up and become tighter after the dislocation has healed.

What are Safe Home Exercises for an Elbow Dislocation?

Following a dislocation, exercises are vital in order to restore range of motion, function and strength. It is always important to be assessed and prescribed individualized exercises by your Physiotherapist and/or Chiropractor.

Unless the surgeon directed otherwise, the following range of motion exercises are safe to start with. Perform them 10x each, 3-4x a day:

Elbow flexion and extension active range of motion (AROM) in neutral forearm

  • Turn your wrist so your thumb is facing up
  • Bend and straighten your elbow in the available range
  • Some pain is expected at the end of range
  • Don’t shy away from a little pain but also don’t push into sharp pain

Elbow AROM in supination

  • Turn your wrist and forearm so the palm is facing up to the ceiling
  • Bend and straighten your elbow in the available range
  • Some pain is expected at the end of range
  • Don’t shy away from a little pain but also don’t push into sharp pain

Elbow AROM in pronation

  • Turn your wrist and forearm so the palm is facing down to the floor
  • Bend and straighten your elbow in the available range
  • Some pain is expected at the end of range
  • Don’t shy away from a little pain but also don’t push into sharp pain

Key Points:

  • If you think you dislocated your elbow, go to a hospital
  • Following the initial splinting, EARLY mobilization is key, because the elbow joint tends to stiffen up
  • Patients do well long term, but special focus needs to be on regaining functional range of motion to avoid chronic stiffness and pain

If you need to rehab your elbow dislocation, book an appointment with one of our experienced physiotherapists or chiropractors today.

References:

  1. Anakwe, Raymond E., et al. “Patient-reported outcomes after simple dislocation of the elbow.” JBJS 93.13 (2011): 1220-1226.
  2. Hackl, Michael, et al. “The Treatment of Simple Elbow Dislocation in Adults: A Systematic Review and Meta-analysis.” Deutsches Ärzteblatt International 112.18 (2015): 311.
  3. https://www.physio-pedia.com/Posterior_Elbow_Dislocation

Orsi Timar, FCAMPT Physiotherapist

Orsi Timar is a FCAMPT physiotherapist practicing at Rebalance Sports Medicine in downtown Toronto.

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YONGE & ADELAIDE
UNIVERSITY & KING
Yonge & AdelaideRebalance Clinic Yonge Adelaide
110 Yonge Street Suite 905
Toronto, ON M5C 1T4
T: (416) 777-9999
E: [email protected]
University & KingRebalance Clinic University King
155 University Avenue Suite 303
Toronto, ON M5H 3B7
T: (416) 306-1111
E: [email protected]

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