Generally, elbow fracture is due to overuse or trauma. Repetitive motions of your arm can stress your elbow joint, mainly if other structures such as your core or shoulder are weak. If you are experiencing severe pain following a traumatic injury, do not wait longer to seek medical attention. A broken elbow can result in loss of range of motion, permanent disability, heterotopic ossification, infections, or post-traumatic arthritis. At Suarez Physical Therapy, we can help you exercise your injured limb and other body parts to restore strength and range of motion in your elbow muscles and joints. Our goal is not only to treat your injury but also to educate our Las Vegas patients. So, in the section below, we discuss different types of elbow fractures, the causes of the injury, how a physiotherapist can help you, and how to prevent the fracture.
An Overview of Elbow Fracture
Elbow fractures cut across all age groups. All severe elbow fractures require immediate medical attention. Early diagnosis and medical treatment of the injury can lower the danger of developing complications or even permanent disability.
Your elbow straightens and bends like a hinge, allowing the forearm rotation (the ability to turn your hands up and down).
An elbow allows the following motions:
Severe elbow injuries can damage your bones and other structures, resulting in blood vessels functioning, nerve function, and movement challenges. In children, a fracture can impact bone growth and development. Children have several bone growth centers. If a growth center is involved in an injury, it can impact bone development.
An Elbow's Anatomy
Below is a quick overview of your elbow's anatomy. It will help you understand different types of fractures and what occurs after the fracture.
An elbow is a complex joint in the center of the arm with three bones, namely:
- The humerus is the single bone in the upper arm that runs from the shoulder to the elbow. Its end is called the distal humerus. It makes the elbow's top portion and offers the forearm rod to pivot around when straightening or bending it.
- Radius is the bone on the inside of your arm towards your thumb. It runs from your elbow to your wrist. Its radial head is this bone's end where it meets the elbow. It moves back and forth and rotates when moving the arm differently.
- The ulna is the lower bone of the forearm connecting your elbow to your wrist. Olecranon is a part of the ulna (part of your elbow that you can see and feel under your skin). It scoops around the humerus' end, creating a hinge and allowing your arm to move at the joint.
You also have ligaments, tendons, and muscles that hold everything together. They maintain the elbow's stability and permit joint movement.
Types of Elbow Fractures
A broken elbow can be defined as a break involving at least one of the three-arm bones working together to form your elbow joint.
There are three main categories of elbow fractures. They include:
- Distal humerus fracture happens due to a direct blow to your elbow, falling on a bent elbow, or using your hand to break a fall. These injuries are rare. Their symptoms include swelling and elbow pain.
- Olecranon fracture — Typically, the fracture happens when your triceps muscle above your elbow suddenly contracts during a fall. Your olecranon is susceptible to fracture because tissues and muscles do not cover it.
- A radial head fracture occurs when you put your arm out to break a fall. The impact can result in your radial head pushing into your humerus so hard that it leads to a fracture.
Causes of Elbow Fractures
You can injure the elbow in different ways, ranging from acute traumatic events like direct blows or falls to overuse from athletic injuries. Everyday events that can lead to an elbow fracture include the following:
- Trauma from a car-related accident
- A direct blow on an elbow can break the limb if someone falls off and lands on their elbow.
- A sideswipe injury happens when your elbow is struck while your elbow is resting out of an open motor vehicle window.
- Direct injuries to your hand, elbow, shoulder, or wrist can affect your elbow.
- When falling backward, a person can try to brace their fall with their arm outstretched and hand open.
Elbow Fracture Risk Factors
The following factors increase the risk of developing a broken fracture:
- Engaging in sports
- Suffering from a condition that weakens bones
Symptoms of a Broken Elbow
Some elbow fractures cause intense and sudden pain and visible deformity, while others exhibit subtle symptoms. Common fractured elbow symptoms include:
- Deformation of the elbow or near the elbow
- Swelling on the elbow or in the region below and above the elbow
- Discoloration (redness indicate infection while a black, purple, or blue color means bleeding near or into the elbow)
- Challenges moving the elbow through the complete range of motion — A person should straighten their arm bends the elbow to touch the shoulders with the fingertips (flexion and extension). Also, they should rotate the hand outward so that the palms face the ceiling when the arm is at their side with the elbow at 90 degrees (inward and outward rotation).
- Severe pain following the elbow injury
- On open wound or cut on your elbow following a traumatic injury
- Decreased sensation or numbness of your fingers, hands, or forearm due to blood vessels or nerves damage
- A tight sensation in your forearm or elbow
Complications of a Fractured Elbow
A complication is a challenge with the recovery process. Here are some of the common elbow fracture complications:
- Stiffness — Typically, a broken elbow causes bleeding into your joint, and when this blood clots, it remains in your joint. The clot becomes scar tissue. If your joint is immobile when the scar tissue forms, it will adhere to various joint parts, resulting in loss of range of motion.
- Malunion happens when the bone heals, but fragments are not in the right fracture. It would help if you avoided malunion at all costs since it can lead to loss of range of motion.
- Heterotopic ossification
- Post-traumatic arthritis
Elbow Fracture Treatment
Broken elbow treatment depends on your injury type. Also, adults and children have different injuries, and they heal differently.
Typical treatment options include:
- Medication — You can use oral medication for mild pain and injections into a vein or muscle for moderate and severe pain.
- Surgery — An operation is a practical choice to repair the elbow, particularly if you have a compound or open elbow injury.
- Physical therapy
How to Prevent Elbow Fracture
While it is impossible to prevent every elbow fracture, below are some of the steps you can take to lower the risk:
- Maintain strength and agility by exercising regularly
- Take steps to reduce the possibility of falling by lighting your dark hallways, clearing your floor of loose items, walking cautiously near wet signs, and keeping pets away from your feet when walking.
- Learn proper techniques for your sports
- Put on protective gear when engaging in sports.
- Always warm-up before beginning a heavy physical activity or sports
- Avoid hard hits to your wrist, elbow, or hand
When to Consult with a Doctor
Since a broken elbow comes with the likelihood of potentially severe and incapacitating complications, you must seek immediate medical attention if you believe your elbow is fractured.
If you experience mild swelling, open wounds, and loss of feelings, you can call your doctor before seeking immediate medical attention. On the other hand, if the elbow exhibits the following challenges following an arm injury, you ought to visit an emergency department:
- Swelling near or at your elbow
- Elbow deformity
- After comparing the uninjured elbow to the injured one, you have a new bump or lump.
- When you move the hand, wrist, or elbow, you feel or hear popping, clicking, or grinding.
- The elbow catches at your joint
- Discoloration of your elbow
- Temperature or color changes in the wrist, hand, forearm, or wrist
What to Expect When You Seek Medical Attention
First, the doctor will ask questions about the fractured elbow, including what caused the injury, when it occurred, your symptoms, and when did the symptoms manifest first.
Your physician will also want to know your health history. They will ask questions like:
- Your age
- Activity level (whether you are a desk employee or an athlete)
- The injuries or surgeries you have had
- Any medication you take
- Your social habits
The physician will then perform a physical exam, paying attention to the injured elbow. The medical doctor will also check your abdomen, lungs, heart, legs, and uninjured arms to ensure that you do not have more severe conditions or injuries.
The medical doctor can also order x-rays. Depending mainly on your treatment needs and health history, the medical expert can order lab tests, specialized x-ray, or other imaging diagnostic methods like MRI, CT scan, and ultrasound.
The physician can order an x-ray of your child's uninjured elbow. A child's elbow is not fully formed, and growing cartilages can be mistaken for broken bones.
If your medical doctor fears that the artery running by your elbow is cut, they can recommend an arteriogram.
How a Qualified Physical Therapist Can Help You
After a broken elbow, the skilled physical therapist will develop a personalized treatment plan to help boost the elbow strength and movement, ease swelling, and restore the use of the arm for athletic and everyday living activities.
While the Elbow is in a Sling or Cast
To ensure that the broken bone heals, the physical therapist will have your arm in a sling or cast to keep it immobile. Avoid as much swelling, weakness, or stiffness as possible during the recovery process. Depending on your level of activity allowed for your injury, the PT specialist will prescribe exercises to allow the shoulder, hand, and wrist to move while still in the sling or cast.
Your experienced physical therapist should also help you stay independent by teaching you how to perform daily activities, like grooming, dressing, housekeeping, typing, and exercising.
When the Sling or Cast is Removed
Bones take approximately six (6) weeks to recover to 50 percent of the average strength, three (3) months to have 80 percent strength, and continue to be stronger and better for a maximum of eighteen months following the injury. After six (6) weeks of continued use of cast or sling, your doctor will conduct an x-ray to assess your healing progress, and physical therapy will begin.
If you underwent a surgical procedure, rehabilitation with your physical therapist starts immediately after your physician recommends it. It can be after six weeks. Since surgical fixation intends to stabilize the injury site, simple exercises like finger and shoulder movement, rotation, gripping, and gentle bending are safe. However, sometimes no exercise is recommended until your bone shows evidence of recovery. Every surgeon has their limitations founded on elbow fracture type, surgery used, professional experience, and the healing progress.
Even though extensive physiotherapy for the injured limb does not start immediately, maintaining fitness for the rest of the body with exercising is highly recommended. If you have had surgery, you can maintain your cardiovascular fitness through lower extremity exercises like walking.
Following your surgical fixation, you can lift weight machines and weights for uninjured arm and lower extremity, provided you comply with restrictions on your recovering elbow. Since lifting even a lightweight with the injured arm is not allowed, you will require a loved one to help you with the workout setup. Your skilled physical therapy should discuss with you the most effective method to maintain fitness and develop a fitness plan tailored to your goals and needs while adhering to your physician's restrictions.
Following your surgery or when your doctor removes the cast, you will experience pain when moving your wrist, forearm, shoulder, or elbow. The pain originates from either not using your limb regularly, the surgical procedure itself, or soft tissue injuries that happened during the elbow fracture injury. The physical therapist will first pay attention to relieving the pain. They can use modalities like ultrasound, electrical current, heat, or ice to reduce any swelling or pain at or near the injury site. They can also massage your shoulder, forearm, elbow, wrist, or neck to relieve pain, making moving your upper extremity effortless, and boosting circulation.
Next, your physical therapist will pay attention to restoring the range of motion, agility, and strength in your hand, elbow, shoulder, and wrist. Once the cast is removed, the hand will feel atrophied and weak. The therapist will prescribe strengthening and stretching exercises that you can practice at your doctor's office and home. The exercise can include:
- Using lightweights
- Using gripping or softballs to boost the regain of the grip strength
If necessary, the physiotherapist will mobilize the joints. The technique encourages your stiff elbow joints to move steadily into their range of motion. Early range of motion exercises and mobilization play a significant role in elbow rehabilitation, and without them, your fractured limb can be stiff and lose a crucial range of motion. For instance, regaining the capacity to rotate the forearm and bend the elbow enables you to perform everyday activities like holding something or feeding yourself. Your physiotherapist will monitor all improvements in the ability to straighten and bend the elbow and rotate the forearm by regularly measuring angles.
The patient will realize improvements in their elbow functioning after a couple of physical therapy appointments. As the strength and range of motion improve, their therapist will gradually add endurance work and heavier exercises to ensure the patient can withstand the stresses.
The broken elbow injury affects receptors in ligaments and joints that help with proprioception (the body's ability to sense location, action, or movement). Duration of immobility also affects proprioception. Consequently, proprioceptive exercises play a significant role in your rehabilitation. Proprioceptive exercises include holding weights up above the head while straightening and bending the elbow, pushups on unstable surfaces, rolling a ball on the ground using your hand. On the other hand, advanced exercises can include ball catching or throwing. Your physiotherapist can recommend exercises that mimic your favorite activities or sports motions if you are an athlete. Your therapist will communicate with your doctor about the appropriate time to begin the progressive proprioceptive exercises.
Many fractured elbow injuries require activity limitation for three months as far as returning to activity is concerned. Patients who engage in labor-intensive work or sports that involve loading their arms can take significantly longer. As previously mentioned, sometimes an elbow fracture can result in severe joint damage, lost blood supply to bone fragments, or multiple bone fragments. All these fragments lead to lengthy recovery and rehabilitation, and total healing of strength and range of motion is not always possible, affecting the elbow function.
Luckily, the elbows return to their normal performance level in many minor elbow fractures. If pain persists or therapy is not progressing as the therapist's expectations, your qualified physiotherapist will consult with your physician to confirm the injury site is responding to therapy. If you had a surgical procedure, ensure no hardware problems hinder your recovery.
Home Exercises Following an Elbow Fracture
Below are some exercises you can try at home. Begin them gradually. Ease off your exercise if you feel pain.
Elbow Flexion Stretch
- Lift your injured arm and bend your elbow. The palm should face toward you.
- With your uninjured arm, gently push on your back the affected limb. Press the hand towards the shoulder until you feel a stretch in the upper arm back.
- Hold for about 25 seconds.
- Repeat the process twice.
Pronation and Supination Stretch
- Keep the injured elbow at your side and bend it to approximately 90 degrees. Make a fist or grasp something.
- Gradually turn the forearm as far as you can back and forth in all directions. The hand should face up and then down.
- Hold every position for 25 seconds until you feel a stretch in the arm.
- Repeat the process twice.
Find a Skilled Physiotherapist Near Me
After seeking medical attention following your elbow fracture, you would think that you are good to go. Well, that is not the case; your hand is still weak. Whether you broke your elbow due to overuse or accident, do not let the injury stop you from performing everyday and basic tasks or engaging in your favorite sport or activities. At Suarez Physical Therapy, we can assess the injury and develop a therapy plan. With a customized physical therapy program, you can restore your previous functioning level and strength, encourage lifestyle changes and activities to prevent further injuries, and improve your overall health and wellbeing. We take pride in going above and beyond for our Las Vegas patients and offering physiotherapy that can relieve pain, reduce chances of complications, and speed up the recovery process. Do not hesitate to contact us now at 702-368-6778 to schedule your appointment.