Elbow Dislocation Recovery: Rehab Insights and Tips

Elbow dislocation

Hello, doctor.
On April 1st, I dislocated my left elbow while supporting myself on my hand.
After going to the emergency room for reduction, I was put in a cast and a sling for 10 days at a 90° angle.
When the cast was removed on April 10th, my elbow was still swollen and I couldn't fully extend or flex it.
I have now switched to a functional brace, and the doctor has limited the range of motion to 20° to 90°.
During my follow-up visit, X-rays were taken, and the doctor said the recovery looks good.

1.
The orthopedic doctor told me that I do not need to go to physical therapy and should rest more.
However, some friends were able to resume normal activities, rehabilitation, and exercise immediately after reduction.
My doctor wants me to wear the brace at all times except when showering, which significantly limits my activities.
I would like to hear your advice on whether I should seek rehabilitation at a clinic.
2.
If I decide to see a rehabilitation specialist, do I need to bring the initial X-rays from when I was injured for the new doctor to review? I am not fully aware of the details of my injury, only that it was an elbow dislocation.
What specific information should I provide to ensure the new doctor understands my condition?
3.
Within the range of motion allowed by the brace, is it beneficial to move as much as possible? If not, how many hours of exercise per day would be advisable? Is it better to wear the brace or not?
4.
When showering or removing the brace, I am hesitant to move my left hand and maintain the fixed position, allowing my right hand to do everything.
I would like to know if slightly moving or performing actions that exceed the brace's range of motion, such as drinking from a cup, washing my hair, or brushing my teeth, would be beneficial for recovery, or should I avoid these movements?
5.
My wrist was also immobilized for 10 days, with only finger and shoulder movements.
When the cast was removed, I mentioned to the doctor that my wrist also hurts and has a smaller range of motion than normal.
The doctor said this is normal as it can affect the elbow.
However, today, when bending my palm down, I still feel a sharp pain in the middle of my wrist (on the dorsal side).
Is this related to the elbow, or could there be an injury to the wrist as well? Do I need an X-ray?
6.
In the consultation room, I forgot to tell the doctor that my left wrist had been painful for five months before the elbow dislocation, with intermittent pain when pushing up from bed and during push-ups.
I had one session of manual therapy that helped, but the pain returned after a while.
What could be the cause of this?
7.
If I need to apply heat to my elbow, can I soak in a hot spring or a hot water pool? Would water that is too hot have adverse effects?
8.
What exercises can I do now? I had limited movement when it was more swollen, but now that the swelling has decreased significantly, can I go to the gym and do weight training or aerobic exercises without using my left hand?
9.
The doctor said the recovery looks good after the X-ray, but how can the doctor assess the recovery status of other soft tissues?
10.
I can't remember if my arm was fully extended when I fell, but I am curious: if the elbow had been bent, would it have dislocated?
Thank you for your patient response!

Tongluo Shao, 20~29 year old female. Ask Date: 2019/04/11

Dr. Wang Zhaomin reply Rehabilitation

1.
Currently, it is not suitable to undergo rehabilitation immediately after the injury.

2.
In the future, rehabilitation therapy may be necessary.
When visiting the doctor, bring relevant documents such as a medical history summary and X-rays, describe your symptoms, and patiently answer the physician's questions and undergo examinations.

3.
You should follow the physician's instructions regarding the use of protective gear and perform limited joint movements; both overdoing and underdoing can be detrimental.

4.
Do not exceed the activity limits set by the brace.
As for which movements to avoid, since each person's condition is different, you should consult your physician.

5.
Normal joints can become stiff and painful after prolonged immobilization.
X-rays are not immediately necessary, but if it cannot be ruled out that the initial injury is the cause, further examination may still be considered.

6.
There are many causes of pain, including lesions in soft tissues such as tendons and ligaments, joint damage, and inflammation of the bursae.
Please seek direct treatment from your physician.

7.
Soaking in hot springs or using a warm towel and electric heating pad for heat therapy is acceptable, with the temperature set to avoid burns.

8.
Since full-body movements can cause uncontrolled movements in the elbow, vigorous exercise is currently not suitable.
However, localized or more static training can be gradually initiated, such as purely lower limb exercises.

9.
There are many ways to assess the situation, but since various clinical conditions differ, you should consult your physician on-site.

10.
Hand positioning, impact angles, force, speed, and the condition of the impact surface can all affect the severity of the injury, and it cannot be generalized.

Reply Date: 2019/04/11

More Info

Recovering from an elbow dislocation can be a complex process, and it’s understandable to have many questions about the best practices for rehabilitation and recovery. Here’s a comprehensive overview based on your concerns:
1. Rehabilitation Needs: It’s not uncommon for orthopedic surgeons to recommend a conservative approach to rehabilitation after an elbow dislocation, especially if the dislocation was successfully reduced and there are no significant complications. However, physical therapy can be beneficial in restoring range of motion, strength, and function. If you feel that your recovery is slower than expected or if you have concerns about your mobility, seeking a consultation with a physical therapist could provide you with tailored exercises and guidance.
2. Medical Records for Rehabilitation: When visiting a rehabilitation specialist, it’s helpful to bring any relevant medical records, including X-rays and notes from your initial injury. This information will help the therapist understand the specifics of your injury and tailor a rehabilitation program to your needs. Be sure to communicate clearly about your injury, including the mechanism of injury (how it happened), the treatment you received, and any limitations you’re currently experiencing.

3. Activity Levels with the Brace: While wearing a brace, it’s important to follow your doctor’s recommendations regarding activity levels. Generally, gentle movements within the prescribed range of motion can be beneficial, but overexerting yourself can lead to setbacks. Aim for short, frequent sessions of movement rather than long periods of activity. If your brace allows for movement, you can gradually increase your activity as tolerated, but always prioritize safety and comfort.

4. Movement and Daily Activities: It’s natural to be cautious with your injured arm, but gentle movements that are within your comfort zone can aid recovery. Activities like drinking from a cup or brushing your teeth can help maintain mobility, but be careful not to push through pain. If you experience significant discomfort, it’s best to avoid those movements until you have more guidance from your healthcare provider.

5. Wrist Pain: The pain in your wrist could be related to the elbow injury, as the two joints are interconnected. If the pain persists or worsens, it may be wise to consult your doctor for further evaluation, including possible imaging to rule out any additional injuries.
6. Pre-existing Wrist Pain: If you had wrist pain prior to the dislocation, it could be due to a variety of factors, including overuse or underlying conditions such as tendinitis or carpal tunnel syndrome. It’s important to address these issues with your healthcare provider to prevent them from interfering with your recovery.

7. Heat Therapy: Applying heat can help relieve stiffness and improve circulation, but be cautious with the temperature. Warm baths or hot tubs can be soothing, but ensure the water isn’t too hot to avoid burns or exacerbating swelling.
8. Exercise Options: As swelling decreases and you feel more comfortable, you can engage in low-impact activities that don’t involve your left arm. Walking, stationary cycling, or using machines that focus on your lower body can help maintain fitness without stressing your elbow.

9. Soft Tissue Recovery: While X-rays are excellent for assessing bone healing, they don’t provide information about soft tissue recovery. Your doctor may evaluate your progress through physical exams and your reported symptoms. If there are concerns about soft tissue injuries, further imaging like an MRI may be warranted.

10. Mechanism of Injury: Regarding your curiosity about elbow dislocations, it’s true that the position of the arm can influence the likelihood of dislocation. A straight arm can be more susceptible to dislocation upon impact, whereas a bent arm may provide more stability. However, various factors contribute to dislocations, including the force of the impact and individual anatomical differences.

In summary, while recovery from an elbow dislocation can be challenging, following your doctor’s advice, engaging in appropriate rehabilitation, and listening to your body will help you regain function and strength. If you have ongoing concerns or feel uncertain about your recovery, don’t hesitate to seek further medical advice.

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