Elbow Angle Issues: Treatment for Persistent Injury After Rehab

Angle issue

It has been over six months since the elbow injury, and I have been continuously undergoing rehabilitation.
Why is the elbow angle still not normal, especially in the flexion area? What treatment should be pursued?

Nìmíng, 40~49 year old female. Ask Date: 2015/11/18

Dr. Shi Guozheng reply Orthopedics

Are you referring to the range of motion of the joint? Generally, after an injury, the joint's ability to fully extend or flex can be affected, resulting in limited extension or flexion.
Regular rehabilitation exercises are often necessary for improvement.
Typically, the elbow joint can achieve slight hyperextension when fully extended, and during flexion, it should be able to touch the same side shoulder.

Reply Date: 2015/11/18

More Info

After six months of rehabilitation following an elbow injury, it is understandable to be concerned about persistent issues with elbow flexion and overall function. The elbow is a complex joint that can be affected by various factors, including soft tissue injuries, joint stability, and muscle strength. Here’s a comprehensive overview of potential reasons for your ongoing issues and treatment options to consider.

Possible Reasons for Persistent Elbow Issues
1. Soft Tissue Injury: Injuries to the ligaments, tendons, or muscles surrounding the elbow can lead to stiffness and limited range of motion. If you had a sprain or strain, it may take longer than expected for the soft tissues to heal completely.

2. Joint Capsule Tightness: Following an injury, the joint capsule may become tight, leading to a condition known as capsular stiffness. This can restrict movement and cause pain during flexion.

3. Scar Tissue Formation: After an injury, scar tissue can form in the elbow joint, which may limit the range of motion. This is particularly common if there was significant swelling or if the joint was immobilized for a period.

4. Muscle Weakness: If the muscles around the elbow have not regained their strength, this can affect the joint's ability to move freely. Weakness in the biceps or triceps can lead to difficulties in bending or straightening the elbow.

5. Joint Alignment Issues: If there was any misalignment of the bones in the elbow during the healing process, this could lead to functional limitations.
6. Underlying Conditions: Conditions such as tendinitis, bursitis, or even arthritis can contribute to ongoing pain and limited range of motion.

Treatment Options
1. Physical Therapy: Continuing with physical therapy is crucial. A physical therapist can provide targeted exercises to improve flexibility, strength, and range of motion. They may also use modalities such as ultrasound or electrical stimulation to promote healing.

2. Manual Therapy: Techniques such as joint mobilization or soft tissue manipulation can help reduce stiffness and improve range of motion. A skilled therapist can assess your elbow and apply appropriate techniques.

3. Stretching and Strengthening Exercises: Focus on both stretching the muscles around the elbow and strengthening the surrounding musculature. This dual approach can help restore function and alleviate pain.

4. Heat and Cold Therapy: Applying heat can help relax and loosen tissues, while cold therapy can reduce inflammation and numb pain. Alternating between the two may provide relief.

5. Bracing or Splinting: If there is significant instability or pain, using a brace or splint may help support the elbow during activities and prevent further injury.

6. Injections: If conservative treatments are not effective, corticosteroid injections may be considered to reduce inflammation. Platelet-rich plasma (PRP) injections are another option that some patients find beneficial for healing soft tissue injuries.

7. Surgical Options: In cases where conservative management fails and there is significant structural damage or persistent pain, surgical intervention may be necessary. This could involve arthroscopy to remove scar tissue or repair damaged structures.

Conclusion
It is essential to communicate openly with your healthcare provider about your ongoing symptoms. They may recommend further imaging studies, such as an MRI, to assess the soft tissues around the elbow and determine if there are any underlying issues that need to be addressed. Additionally, if you have not seen improvement with your current rehabilitation program, it may be worth seeking a second opinion or consulting a specialist in sports medicine or orthopedic rehabilitation.

Remember, recovery from an elbow injury can be a gradual process, and patience is key. With the right approach and continued effort, there is a good chance of regaining full function in your elbow.

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