Dislocated Elbow: Overview

The elbow forcibly hyperextends, causing the ligaments to rupture, and sometimes a fracture will result. In some situations, the displaced bones may compress the nerves and blood vessels around the elbow requiring immediate reduction (repositioning) of the dislocation to relieve pressure. A physician can usually perform this procedure on the playing field or in the emergency department.

Dislocated elbows are common among children and adolescents.

Diagnosis

The symptoms of a dislocated elbow are quite obvious and you will know when it happens. You'll feel immediate intense pain, your elbow won't bend, and it will swell. Because nerves run along your elbow, it is possible that they have been injured and you might lose feeling in your arm or hand..

Treatment Options

If you think your elbow is dislocated, try to immobilize it and go to a doctor immediately for evaluation and treatment. Your doctor or emergency room physician will put your dislocated elbow back into place right away. You may need a local anaesthetic. If your injury is more than several hours old, you may need general anaesthesia because of swelling and muscle spasm.

Once your elbow joint is back in place, your doctor may flex, extend, and rotate your arm to make sure it is stable and capable of all its motions. Your doctor may also take x-rays to check for other injuries such as fractures and nerve damage. In some cases, these injuries may require additional treatments, including surgery.

Assuming your elbow was stable after your doctor put it back in place and you have no other major injuries such as a fractured bone in the elbow, you will wear a splint for only a few weeks. You may take nonsteroidal anti-inflammatory medications such as ibuprofen to ease any pain. Your doctor will tell you when you’re ready to begin exercises to work your elbow back to full function. Depending on the severity of the injury, it may take many months of physical therapy for your elbow to return to normal function.

How can I prevent a dislocated elbow?

Since elbow dislocations are nearly always results of falls or blows, there is not much that can be done to prevent them. However, use of proper protective equipment, such as elbow pads, is preventive.

The best way to prevent reoccurrences of a dislocated elbow is to only return to practice and competition when all symptoms of the injury are gone and strength of the affected arm has returned to normal. Furthermore, the rehabilitation exercises should be continued to ensure protective strength, range of motion, and stability of the injured joint.

Improving Sports Performance

The key to improving sports performance after recovering from a dislocated elbow is a proper rehabilitation program, and adhering to some of those same principles after the injury is gone.

Keep in mind that a dislocated elbow is most often the result of a fall or blow, and you can better prepare yourself for these incidences by paying close attention to the rehabilitation exercises listed above. These will not only keep you in the game, but will also help you perform better and with more confidence.

Dislocated elbow rehabilitation

As an athlete, your number one concern is getting back to full strength as soon as possible so that you can return to training and competition. That is why appropriate rehabilitation is extremely important. Rehabilitation for a dislocated elbow often includes the following:

• reduce activity during the acute phase
• ice injury multiple times per day
• compression of the injured shoulder with a secure wrap or ACE bandage
• elevation of the injured shoulder above heart level
• use anti-inflammatory medications such as ibuprofen to reduce inflammation and speed up recovery

Strengthening Exercises

The major objectives of rehabilitation from a dislocated elbow are to increase flexibility, obtain pain-free range of motion, and strengthen the muscles of the arm. In severe cases, you should avoid activity that causes elbow pain altogether. In these cases, you can still maintain cardiovascular fitness by cycling, unless otherwise prescribed by your doctor.

Rehabilitative exercises should be performed on both sides of the body to maintain symmetry in the strength and range of motion of the arms. In many individuals, the tendency to dislocate an elbow is present on both sides, so doing these exercises to increase the pain-free range of motion and improve strength of both arms may help prevent injury to either elbow.

Rehabilitation exercises often prescribed by your doctor may include:

• Wrist flexor stretch
  Extend affected arm forward with palm up and elbow straight. Place fingers and palm of opposite hand across palm and fingers of the extended hand and draw back with it until stretch is felt in the forearm. Hold this position for 3 to 5 seconds, then relax for 3 to 5 seconds. Perform this exercise 10 times.
• Wrist extensor stretch
  Extend affected arm forward with palm down, elbow straight, and fingers slightly curled. Grasp the affected side hand with other hand and draw affected side hand down until stretch is felt in the forearm. Hold this position from 3 to 5 seconds, then relax for 3 to 5 seconds. Perform this exercise 10 times.
• Pronation/Suppination stretch
  Extend affected arm forward in a hand-shaking position with palm facing up. Slowly rotate the hand from a palm-up position to a palm-down position. Hold for 3 to 5 seconds and then rotate back. Perform this exercise 10 times. When you work your way up to strength training, you may use a small weight while rotating the hand and wrist.
• Tricep stretch
  Stand erect with feet at about shoulder width. Raise injured arm at the shoulder with elbow bent and place the forearm behind the head. Grasp the injured elbow with opposite hand and draw it toward the center of the body until stretch is felt. Hold this position for 3 to fi5ve seconds, then relax for 3 to 5 seconds. Perform this exercise 10 times.
• Bicep stretch
  Stand erect with arms raised to shoulder height and palms up. Press arms backward until stretch is felt. Hold this position for 3 to 5 seconds, then relax for 3 to 5 seconds. Perform this exercise 10 times. The bicep is stretched by this exercise as well as the muscles of the shoulder and upper chest.
• Strengthening exercises
  The following exercises develop strength of the muscles of the forearm and upper arm. To maintain symmetry of the arms in terms of strength and appearance, perform these strength exercises with the uninjured arm as well as the injured arm.
• Wrist extension
  Sit in a chair with forearm resting on the end of a table, palm down. Grasp a light weight dumbbell and raise the weight up as high as possible while maintaining contact with the table top. Hold this position for 3 to 5 seconds. Relax for 3 to 5 seconds. Repeat this exercise 5 to 10 times. Substitute a heavier dumbbell as strength increases.
• Arm curls
  Either standing or sitting, grasp a 2- to 4-pound dumbbell in one hand. With palm up, flex elbow and draw the dumbbell up to the same side shoulder while maintaining erect posture. Do not bend at the waist or swing the dumbbell. Lower dumbbell slowly and with control to the starting position. Repeat this exercise 10 times. Use a heavier dumbbell as strength increases.

Alternative exercises

During the period when normal training should be avoided, alternative exercises may be used. These activities should not require any actions that create or intensify pain at the site of injury. They include:

• swimming (if pain allows)
• jogging
• stationary bicycle

How long will the effects of my injury last?

Ligaments and tendons are the structures that suffer the main injury in most elbow dislocations, and often these tissues take longer to completely heal.

You can probably expect to experience pain upon certain movements of the arm, swelling, and discoloration for six weeks. But, it's not unusual for symptoms of the dislocation, particularly pain upon forceful movements of the arm, to last as long as 12 weeks. To some extent, the time to fully recover is influenced by your dedication to your rehabilitation program

When can I return to my sport or activity?

Return to full participation should be avoided until you are symptom free and can perform all skills and other requirements of your sport without pain. To return earlier is to invite further injury to the elbow, making subsequent dislocations more likely. This is especially true when the sport involves heavy contact, such as in football or rugby.

Generally, the athlete who wishes to return to a contact sport should expect to be out of action for 6 to 12 weeks. Again, the time to return to full activity depends on the dedication toward your rehabilitation program.

Remember: the goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your activity is determined by how soon your dislocated elbow recovers, not by how many days or weeks it has been since your injury occurred.