Rehabilitation Challenges After Elbow and Neck Injuries

Rehabilitation issues

Hello, doctor.
I accidentally slipped and fell backward at the end of August, hitting my elbow.
A few days later, I started experiencing stiffness and soreness in my neck and shoulders.
After treatment, I still have a few questions:
(1) Regarding my elbow: After the fall, I accidentally bumped into a door, which resulted in an inability to bend my elbow.
I had an X-ray done at an orthopedic clinic, and they said it was a periosteal injury.
After three sessions of rehabilitation and taking anti-inflammatory medication and muscle relaxants for a week, I can now bend my elbow normally.
However, the protruding part of my elbow still hurts when I bump it.
Should I just wait for it to heal on its own?
(2) Regarding my neck: I had one session with a rehabilitation doctor who performed a full-body massage.
My neck can now turn, but occasionally it still feels a bit stiff and gets stuck, and there is still some tightness when I turn it.
Will I fully recover from this?
(3) Regarding my shoulder: After being treated by the doctor, I feel much better, but I still experience soreness more easily than before.
Since the treatment, my shoulder joint makes a sound when I lift my arm, and when I move my arm, I feel a popping sensation near the indentation on the front of my left shoulder (it does not hurt or feel uncomfortable).
This concerns me because I didn't experience this before.
I hope the doctor can help clarify this for me.
Additionally, do you recommend that I schedule a follow-up appointment?

mā, 10~19 year old female. Ask Date: 2018/09/17

Dr. Xu Zhenrong reply Rehabilitation

1.
Persistent tenderness at the elbow prominence (olecranon) after trauma, in the absence of fractures, may indicate traumatic olecranon bursitis as a common complication, in addition to local contusions.
Treatment must be tailored based on the underlying causes and conditions.

2.
After a fall, if there is limited neck mobility, it is essential to rule out issues with the cervical spine, such as spondylolisthesis or facet joint dislocation.
If the condition is due to muscle or fascia strain, physical therapy (either modalities or manual therapy) often provides satisfactory symptom relief.
3.
There are many potential causes for a popping or cracking sound in the shoulder when raising the arm after trauma, including cartilage wear, shoulder instability, or adhesions following tendon or ligament injuries.
It is advisable to consult your treating physician for further evaluation.

Reply Date: 2018/09/17

More Info

Rehabilitation after elbow and neck injuries can be a complex process, often requiring a multifaceted approach to address pain, mobility, and overall function. Based on your description, it seems you have experienced a series of injuries that have led to discomfort and limitations in movement. Let's break down your concerns regarding each area of injury and discuss the rehabilitation challenges you may face.

1. Elbow Injury
You mentioned that after your fall, you experienced difficulty bending your elbow, which was diagnosed as a periosteal injury. It’s encouraging to hear that after three sessions of rehabilitation and medication, you can now bend your elbow normally. However, the persistent pain when the protruding part of your elbow is touched suggests that the healing process is still ongoing.
In cases of periosteal injuries, it is common for the area to remain sensitive for some time, especially if there was significant trauma. The periosteum is a dense layer of connective tissue that covers the bones and is rich in nerve endings, which can contribute to pain. It’s essential to allow adequate time for healing, which can vary from person to person. Continuing with physical therapy can help strengthen the surrounding muscles and improve flexibility, which may alleviate some discomfort. If the pain persists or worsens, it would be wise to consult your orthopedic specialist for further evaluation.

2. Neck Injury
Regarding your neck stiffness and occasional locking sensations, it’s good to hear that you have seen improvement in your range of motion. Neck injuries can often lead to muscle tightness and spasms, which may cause the symptoms you describe. The fact that you have undergone physical therapy is beneficial, as targeted exercises can help strengthen the neck muscles and improve flexibility.

Complete recovery from neck injuries can take time, and while many individuals do regain full function, some may experience lingering tightness or discomfort. It’s crucial to continue with your rehabilitation exercises and possibly incorporate stretching routines to enhance mobility. If you find that your symptoms do not improve or worsen, a follow-up with your healthcare provider may be necessary to reassess your condition.

3. Shoulder Pain
You noted that after treatment, your shoulder feels better but still experiences soreness, and you hear popping sounds when moving your arm. This could be due to several factors, including muscle imbalances, tendonitis, or even issues related to the shoulder joint itself. The popping sound, known as crepitus, can be common in shoulders, especially after an injury. It often occurs when tendons move over bony structures or when there is a change in the joint mechanics.

While the absence of pain during these movements is a positive sign, it’s essential to monitor the situation. Continuing with physical therapy focused on shoulder stability and strength can help address these concerns. If the popping becomes painful or if you experience a decrease in function, it would be prudent to return to your healthcare provider for further assessment.

Conclusion
In summary, rehabilitation after elbow and neck injuries requires patience and consistent effort. It is essential to follow through with your physical therapy sessions and communicate any changes in your symptoms to your healthcare provider. Each injury is unique, and recovery can vary significantly among individuals. If you have ongoing concerns or if your symptoms do not improve, consider scheduling a follow-up appointment to discuss your rehabilitation plan and any additional interventions that may be necessary. Remember, the goal of rehabilitation is not only to alleviate pain but also to restore function and improve your quality of life.

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