Rehabilitation After Elbow Dislocation: Key Questions Answered

Elbow dislocation

Hello, doctor.
Thank you for taking the time to answer my question amidst your busy schedule.
I am asking on behalf of my friend, who dislocated his elbow while playing basketball by landing on his hand.
He went to the emergency room, and the doctor was able to reduce the dislocation.
He returned for follow-up visits and had X-rays taken, which showed no issues.
Now, a month later, the swelling has mostly subsided, and he can almost fully extend his arm, but he can only flex it to about 90 degrees and cannot bend it inward any further.
He visited an orthopedic specialist, who only took X-rays and did not provide further recommendations.
Today, my friend suggested that he might need to see a rehabilitation specialist.
I would like to ask: 1.
Is it appropriate to start rehabilitation after one month, or is it too early or too late? 2.
Can he try to gently bend his arm inward at home? 3.
Given his work schedule, he has limited time to see a doctor frequently.
Are there rehabilitation exercises he can do at home? Thank you very much for your assistance!

mm, 20~29 year old female. Ask Date: 2012/02/20

Dr. Pan Yingda reply Rehabilitation

1.
You can start now! Generally, the earlier you begin, the better, but be extra cautious! It's already been a month, which is a bit late, so hurry up and get started!
2.
Yes, try to stay active; in addition to the elbows, pay attention to the shoulders and wrists as well.

3.
Basically, you can do it, but if you don't see improvement after a month of your own efforts, you should go to a hospital or clinic for rehabilitation.
When doing it on your own, people often feel scared and hesitant, which slows down progress; typically, when doing it alone, it's rare to overdo it, so focus on bending and straightening, as well as strength training.
Go ahead, don't be afraid!
Department of Rehabilitation, Taitung Hospital, Pan Ying-Da

Reply Date: 2012/02/20

More Info

Rehabilitation after an elbow dislocation is crucial for restoring function and preventing long-term complications. Based on your friend's situation, here are some insights and recommendations regarding the rehabilitation process.

1. Timing for Rehabilitation: It is generally advisable to start rehabilitation exercises as soon as the initial swelling and pain have subsided, which typically occurs within a few weeks post-injury. Since your friend is about a month post-dislocation and has seen some improvement in swelling, it is a good time to begin rehabilitation. However, it is essential to proceed cautiously and ideally under the guidance of a healthcare professional, such as a physical therapist. They can provide a tailored rehabilitation program that considers the specific nature of the injury and the individual's healing progress.

2. Home Exercises: Your friend can begin gentle range-of-motion exercises at home, but it is crucial to avoid any movements that cause pain. A common exercise is to gently bend and straighten the elbow within a pain-free range. For instance, they can try to perform wrist flexion and extension while keeping the elbow bent at 90 degrees to maintain mobility. Gradually, they can work on bending the elbow further, but they should listen to their body and not push beyond their comfort zone. It's also beneficial to perform these exercises multiple times a day for short durations rather than in one long session.

3. Self-Rehabilitation Techniques: There are several exercises that can be performed at home to aid recovery. Here are a few examples:
- Elbow Flexion and Extension: While seated, your friend can rest their arm on a table and gently bend and straighten the elbow. They can use a light weight (like a water bottle) to add resistance as they progress.

- Wrist Rotations: Holding a lightweight in hand, they can rotate the wrist in circles to maintain mobility and strength in the forearm.

- Stretching: Gentle stretching of the triceps and biceps can help maintain flexibility. For example, they can stretch the triceps by raising the arm overhead and bending the elbow, using the opposite hand to gently push down on the elbow.

- Isometric Exercises: These involve contracting the muscles without moving the joint. For example, they can press the palm of their hand against a wall or table without moving the elbow.

4. Professional Guidance: While home exercises are beneficial, it is highly recommended that your friend consults a physical therapist. They can assess the elbow's range of motion, strength, and stability, and provide a structured rehabilitation program. A therapist can also introduce modalities like ultrasound or electrical stimulation if necessary, which can aid in reducing pain and swelling.

5. Monitoring Progress: It is essential for your friend to monitor their progress closely. If they experience increased pain, swelling, or any unusual symptoms during or after exercises, they should stop and consult a healthcare professional. Regular follow-ups with an orthopedic specialist are also important to ensure that the elbow is healing correctly and to adjust the rehabilitation plan as needed.

In conclusion, starting rehabilitation about a month after an elbow dislocation is appropriate, and your friend can begin gentle exercises at home. However, professional guidance is crucial for optimal recovery. With consistent effort and the right approach, your friend can regain full function of their elbow.

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