Elbow Olecranon Fracture Recovery and Rehabilitation Challenges

Olecranon fracture rehabilitation questions?

Hello, doctor.
I previously sustained an injury while exercising, resulting in a fracture of the olecranon in my elbow.
After having a cast for over a month, it was removed, and the doctor indicated that although the fracture line is still visible, the area should have healed.
However, due to joint adhesion, I am currently unable to extend my elbow to 180 degrees or bend it to touch my shoulder.
The doctor recommended that I start rehabilitation exercises on my own or seek assistance from a physical therapist.
After not seeing results with self-rehabilitation, I sought help from a physical therapist, who used modalities such as electrical stimulation, heat therapy, and manual therapy.
I was aware that the manual therapy process could be quite painful, so I did not question it.
However, three days after the treatment, I have not seen any improvement in my elbow's range of motion (perhaps because treatment has just begun), but the pain level when bending to the limit has significantly increased compared to before the manual therapy.
I would like to ask the doctor if this situation is normal.
Could it be that the manual therapy caused inflammation and increased pain when attempting to extend my arm? Besides occasionally seeing the physical therapist, what other methods can I use for self-rehabilitation?

Chen, 20~29 year old female. Ask Date: 2015/07/27

Dr. Shi Guozheng reply Orthopedics

Rehabilitation after an elbow fracture can be quite challenging, and it is common to experience pain for a period of time.
During rehabilitation, bending the elbow can be particularly painful due to the force required.
Applying a warm compress before attempting to bend the elbow may help soften the tissues, making it easier to achieve flexion.
If pain persists, nonsteroidal anti-inflammatory drugs (NSAIDs) can be taken to alleviate discomfort.
Improving joint mobility through rehabilitation is essential and cannot be avoided.

Reply Date: 2015/07/27

More Info

Elbow olecranon fractures can be quite challenging to recover from, especially when complications such as joint adhesion arise. The olecranon is the bony prominence of the elbow, and fractures in this area can significantly impact the range of motion and functionality of the arm. Given your situation, it’s essential to understand the recovery process and the rehabilitation challenges you may face.

After a fracture, the healing process typically involves immobilization, often with a cast or splint, to allow the bone to mend. In your case, after over a month in a cast, your doctor indicated that while the fracture line is still visible, the bone has likely healed. However, the presence of joint adhesion can lead to stiffness and limited range of motion, which is a common issue following immobilization.

The pain you are experiencing during rehabilitation is not uncommon. When you begin to mobilize a joint that has been immobilized for an extended period, it can lead to discomfort and pain as the tissues are stretched and manipulated. This pain can be exacerbated by inflammation, which may occur if the joint is not yet fully ready to handle the stress of movement. It’s important to communicate with your physical therapist about the level of pain you are experiencing. They can adjust the treatment plan accordingly, possibly incorporating gentler techniques or modalities to manage pain and inflammation.

In terms of rehabilitation, it’s crucial to follow a structured program that gradually increases the range of motion and strength of the elbow. Here are some strategies that may help you in your recovery:
1. Gentle Range of Motion Exercises: Start with passive range of motion exercises, where you or a therapist move the arm without exerting force on the joint. This can help maintain mobility without causing excessive pain.

2. Gradual Progression: As you gain more comfort with movement, you can begin to incorporate active range of motion exercises, where you actively engage the muscles to move the joint. Start slowly and increase the intensity as tolerated.

3. Strengthening Exercises: Once you have regained some range of motion, you can begin to introduce strengthening exercises. This could include isometric exercises (contracting the muscle without moving the joint) and eventually moving to resistance exercises as your strength improves.

4. Heat and Cold Therapy: Applying heat before exercises can help relax the muscles and improve blood flow, while cold therapy afterward can reduce inflammation and pain.

5. Self-Massage: Gentle massage around the elbow and forearm can help reduce tension and improve circulation, which may aid in recovery.

6. Consistency is Key: Regularly performing your rehabilitation exercises, even if they are mild, is crucial for recovery. Aim for short, frequent sessions rather than infrequent, longer sessions.

7. Consultation with Specialists: If pain persists or worsens, it may be beneficial to consult with an orthopedic specialist or a pain management specialist. They can assess for any underlying issues that may be contributing to your pain and provide additional treatment options.

8. Alternative Therapies: Some patients find relief through alternative therapies such as acupuncture or chiropractic care, which may help alleviate pain and improve function.

In conclusion, while the recovery from an olecranon fracture can be fraught with challenges, especially with joint adhesion, a structured rehabilitation program tailored to your specific needs can significantly improve your outcomes. It’s essential to remain patient and consistent with your rehabilitation efforts, and don’t hesitate to seek further medical advice if your symptoms do not improve.

Similar Q&A

Effective Rehabilitation Strategies for Elbow Olecranon Fractures

Hello, Doctor. I fell in September this year and sustained an olecranon fracture. Currently, I am unable to bend my right arm normally, so I have just started rehabilitation. However, each time I go to therapy, it is very painful for me, and I feel scared every time. Are there al...

Dr. Shi Guozheng reply Orthopedics
If there is surgical fixation of the fracture, rehabilitation can proceed. However, if there is no surgical fixation, caution must be taken during rehabilitation to avoid bending, as this could cause the fracture site to reopen. During rehabilitation, applying heat can help relax...

Rehabilitation Challenges After Elbow Olecranon Fracture Surgery

On September 5th, my child suffered an injury from climbing a wall, resulting in a comminuted fracture of the left elbow. Surgery was performed on the same day, and a metal plate was installed for stabilization. The cast was removed on October 31st. Rehabilitation began on Novemb...

Dr. Li Wenlin reply Orthopedics
Hello, Yuning. 1. The area around the olecranon of the elbow does not have thick muscle or soft tissue; beneath the skin is the bone. Therefore, after a fracture is stabilized with pins and wires, it is indeed easy to feel a protrusion under the skin. In principle, if there is ...

Post-Surgery Recovery for Olecranon Fracture: What to Expect

Hello doctor, I am one week post-surgery. My elbow is currently immobilized with a splint and a triangular bandage. I would like to know when I can stop using the immobilization devices and when I will be able to move freely. Additionally, I have bone screws; how long will it tak...

Dr. Zhan Xian reply Orthopedics
Hello Ms. Chen, your attending physician is the most familiar with your fracture condition, please consult your attending physician!

Understanding Ulnar Fractures: Recovery, Surgery, and Rehabilitation

Hello Dr. Chen, my younger brother suffered a comminuted fracture of the ulnar olecranon in a car accident. He underwent surgery for internal fixation with metal screws and had a cast applied. It has been less than three months from his wrist to elbow, and the screws were removed...

Dr. Chen Houquan reply Orthopedics
Thank you for your inquiry. Based on your description, the patient's ulnar olecranon comminuted fracture should be classified as an intra-articular fracture of the elbow joint. Generally, intra-articular fractures tend to have poorer outcomes after healing. Although this typ...