Struggling with Elbow Flexibility: Is Arthroscopy the Solution?

Q: Struggling with Elbow Flexibility: Is Arthroscopy the Solution?

Hello： Your issue is quite complex. <br>It's important to maintain a positive mindset. <br>In terms of medical direction, indeed, elbow arthroscopy for debridement and release is typically indicated for cases with a smaller range of motion deficit. <br>If there is significant or

The elbow can only bend up to 100 degrees, making it impossible to touch my own shoulder?

When I was a child, after a fracture was fixed and the cast was removed, I was unable to bend my elbow.
At that time, I did not undergo rehabilitation; instead, I was taken to a martial arts school where my arm was painfully forced to 100 degrees and then secured with a cloth.
About a month later, when the cloth was removed, I found that I could not regain mobility through rehabilitation methods.
I also visited another martial arts school where the instructor used brute force to push my arm up to my shoulder, but it immediately snapped back.
This has caused me considerable trouble in my daily life.
Recently, I consulted an orthopedic specialist and underwent an MRI, which revealed that I had developed small bone spurs from the previous injury.
However, the doctor said it did not appear to be a bone issue but rather related to adhesions and tendons.
He mentioned that if I were to undergo arthroscopy, it is uncertain whether it would resolve the problem since it has been over five years since the injury.
Arthroscopy could only help to clean up the small bone spurs and adhesions, and if the postoperative results were poor, I might need a major surgery to release the tendons.
Currently, the only option I can accept is arthroscopy.
I have been hoping that arthroscopy could help lengthen the tendons, but I have been diligently pushing myself every day with no improvement.
I am starting to feel like this is how my life will be forever.
I am uncertain whether to proceed with an arthroscopy that may or may not be effective or to seek another opinion from a doctor.
Sigh.

Ru Ling, 30~39 year old female. Ask Date: 2020/08/22

Dr. You Dianqi reply Orthopedics

Hello: Your issue is quite complex.
It's important to maintain a positive mindset.
In terms of medical direction, indeed, elbow arthroscopy for debridement and release is typically indicated for cases with a smaller range of motion deficit.
If there is significant or severe elbow stiffness, it may be necessary to investigate the underlying cause (bone? soft tissue? a combination of both?), and then consult with a trusted physician to discuss appropriate treatment options.
Good communication is essential to evaluate the potential benefits and drawbacks of various interventions, as well as your level of acceptance, before making a decision.
Wishing you a speedy recovery.

Reply Date: 2020/08/22

More Info

It sounds like you have been dealing with a challenging situation regarding your elbow flexibility for quite some time. Given your history of a fracture and subsequent immobilization, it is understandable that you are frustrated with the limited range of motion you are experiencing.
From what you've described, it seems that the primary issue is not just the bone itself but also the soft tissue surrounding the elbow joint, including the ligaments and tendons. After a prolonged period of immobilization, it is common for the soft tissues to become stiff and adhere to one another, a condition known as "adhesive capsulitis" or "frozen shoulder" in the shoulder context, but it can occur in other joints as well. This can lead to significant limitations in movement, which appears to be the case for you.

You mentioned that you have undergone various treatments, including manual therapy at martial arts schools, which may not have been effective and could have even exacerbated your condition. It's crucial to approach rehabilitation with care, especially after a long period of disuse. Aggressive stretching or manipulation can sometimes lead to further injury or inflammation.

Regarding the possibility of arthroscopy, it is a minimally invasive surgical procedure that can be used to diagnose and treat various joint issues. In your case, it could potentially help in removing bone spurs and addressing adhesions. However, as your doctor mentioned, the results are not guaranteed, especially since this is a long-standing issue. The concern is that if the arthroscopy does not yield the desired improvement, you may need to consider more invasive procedures, such as open surgery to release the soft tissues.

Before making a decision about surgery, it might be beneficial to explore other conservative treatment options. Physical therapy is often the first line of treatment for improving range of motion and function. A physical therapist can design a tailored rehabilitation program that focuses on gentle stretching, strengthening exercises, and modalities to reduce pain and inflammation. They can also provide guidance on how to perform exercises safely and effectively, which might be more beneficial than the aggressive techniques you've experienced in the past.

Additionally, you might consider seeking a second opinion from an orthopedic surgeon who specializes in elbow injuries. They can provide further insight into your condition and discuss the potential risks and benefits of arthroscopy versus continued conservative management.
In summary, while arthroscopy may offer some potential benefits, it is essential to weigh these against the risks and consider all available treatment options. Engaging in a structured rehabilitation program with a qualified physical therapist could provide you with the best chance of improving your elbow flexibility without the need for surgery. Remember, recovery from such injuries can take time, and patience is key.

Similar Q&A

Is Arthroscopic Surgery the Right Choice for My Tennis Elbow?

Dear Doctor, I have tennis elbow and have received several steroid injections, but there has been no improvement even after the medication wore off. My elbow continues to swell and hurt, even when I'm not working. Am I a suitable candidate for arthroscopic surgery? My job re...

Dr. Li Wenlin reply Orthopedics
Hello: In response to your question, what is commonly known as "tennis elbow" is actually caused by repetitive motions of the wrist, leading to inflammation at the tendon attachment point on the lateral epicondyle of the elbow. Treatment methods include: 1. Rest. 2. Med...

Understanding Elbow Pain: Insights on Surgery and Treatment Options

Hello, Doctor. I have been experiencing elbow pain for a year and have been undergoing treatment at a rehabilitation clinic for six months, including glucose injections, but there has been no improvement. There is a persistent noise in the joint, and the tendons and ligaments are...

Dr. You Dianqi reply Orthopedics
Hello: As mentioned in the text, you likely have osteochondritis dissecans (OCD) of the elbow. Arthroscopic surgery is an option if conservative treatment is ineffective. Although the incisions from arthroscopic surgery are small, proper technique is crucial for your recovery. Th...

Managing Elbow Dislocation Recovery: Overcoming Pain and Stiffness

Hello, on March 16, I dislocated my right elbow while exercising. I was treated in the emergency department and had a cast applied at a 120-degree angle. Two weeks later, the cast was removed (X-rays indicated it had healed). However, my elbow still has limited mobility (it can o...

Dr. Shi Guozheng reply Orthopedics
Based on your description, it is possible to experience limited joint mobility two weeks after an elbow dislocation. Continuing rehabilitation therapy may help improve this condition; however, it is essential to first confirm that the joint is properly reduced. It may be necessar...

Understanding Elbow Fractures: Surgery and Hyaluronic Acid Injections

Hello, Doctor! Thank you for your previous response! I am currently continuing with outpatient treatment, but the rehabilitation results are still not satisfactory. My left arm can bend normally but cannot reach my shoulder; it can extend to about 160 degrees. After rehabilitatio...

Dr. Shi Guozheng reply Orthopedics
Continuous rehabilitation is necessary; hyaluronic acid may not necessarily improve joint mobility. It primarily serves to lubricate the surface cartilage and has some effect in delaying the progression of osteoarthritis.