Elbow Injuries

Overview

Everyone has had a minor elbow injury. You may have bumped your "funny bone" at the back of your elbow, causing shooting numbness and pain. The funny-bone feeling can be intense, but it's not serious. It will go away on its own. Maybe your elbow has become sore after activity. Elbow injuries can be minor or serious. They may include symptoms such as pain, swelling, numbness, tingling, weakness, or decreased range of motion. Home treatment often can help relieve minor aches and pains.

Injuries are the most common cause of elbow pain. Some people may not recall having had a specific injury, especially if symptoms began slowly or during everyday activities.

Elbow injuries occur most often during:

• Sports or recreational activities.
• Work-related tasks.
• Work or projects around the home.
• Falls.

Most elbow injuries in children occur during activities, such as sports or play, or are the result of accidental falls. The risk for injury is higher in contact sports such as wrestling, football, and soccer. The risk is also higher in high-speed sports such as biking, in-line skating, skiing, hockey, snowboarding, and skateboarding.

An elbow injury in a child or teen may injure the growing end (growth plate) of the upper arm bone. Any elbow injury that's worse than a minor bump, scrape, or bruise needs to be checked by a doctor.

Older adults have a higher risk for injuries and fractures. That's because they lose muscle mass and bone strength (osteoporosis) as they age. They also have more problems with vision and balance, which increase their risk for accidental injury.

Sudden (acute) injury

An acute injury may be caused by a direct blow, penetrating injury, or fall. Or it can happen when you twist, jerk, jam, or bend an elbow in a way that isn't normal. Pain may be sudden and severe. Bruising and swelling may occur soon after the injury. Acute injuries include:

• Bruises from a tear or rupture of small blood vessels under the skin.
• Injuries to ligaments. These are the ropy fibers that connect bones to bones around joints.
• Injuries to tendons. They connect muscles to bones.
• Injuries to joints (sprains) that stretch or tear the ligaments.
• Pulled muscles (strains) caused by overstretching the muscles.
• Muscle tears or ruptures, such as your biceps or triceps in your upper arm.
• Broken bones (fractures) of the upper arm bone (humerus) or the forearm bones (ulna or radius) at the elbow joint.
• Dislocations of the elbow joint. (This means it's out of its normal position.)

Overuse injuries

Overuse injuries occur when too much stress is placed on a joint or other tissue. This can happen when you overdo an activity or repeat an activity over and over. Overuse injuries include:

• Bursitis. Swelling behind the elbow may be olecranon bursitis. This affects the olecranon bursa at the back of the elbow.
• Tendinosis or tendinopathy. This is when a tendon is injured and doesn't heal as it should.
  • Soreness or pain felt on the outside (lateral) part of the elbow may be tennis elbow (lateral epicondylitis or epicondylopathy). This is the most common type of tendinopathy that affects the elbow. It's most often caused by overuse of the forearm muscles. This overuse may occur during sports, such as tennis, swimming, golf, and sports involving throwing. Or it may occur when you do certain jobs, such as carpentry or plumbing, or when you do daily activities, such as lifting objects or gardening.
  • Soreness or pain in the inner (medial) part of the elbow may be golfer's elbow. In children who do sports that involve throwing, the same elbow pain may be called Little Leaguer's elbow.
• Pinched nerves, such as ulnar nerve compression. This is the pinching of the ulnar nerve near the elbow joint. It usually occurs with repeated motions.

An infection of the elbow may cause pain, redness, swelling, warmth, fever, chills, pus, or swollen lymph nodes in the armpit on that side of your body. "Shooter's abscess" is an infection often seen in people who inject illegal drugs into the veins of their arms.

Elbow injuries such as bruises, burns, fractures, cuts, or punctures may be caused by abuse. Suspect possible abuse when an injury can't be explained or doesn't match the explanation, repeated injuries occur, or the explanations for the cause of the injury change.

Treatment

Treatment for an elbow injury may include first aid and a brace, splint, or cast. It also may include physical therapy and medicines. In some cases, surgery is needed. Treatment depends on:

• The location and type of injury, and how bad it is.
• How long ago the injury occurred.
• Your age, health condition, and activities, such as work, sports, or hobbies.

Self-Care

First aid for a possible broken bone

Most minor elbow injuries will heal on their own, and home treatment is usually all that's needed. But if you think that you might have a more severe injury, use first aid until you can be seen by a doctor.

• If a bone is sticking out of your skin, don't try to push it back into your skin. It's better to leave the bone alone and cover the area with a clean bandage.
• Control bleeding with direct pressure to the wound.
• Remove all rings, bracelets, watches, and any other jewelry from the injured arm right away. It may be hard to remove the jewelry after swelling starts. And that can cause other serious problems, such as a compressed nerve or restricted blood flow.
• Splint your injured arm without trying to straighten it. Loosen the wrap around the splint if there are signs that the wrap is too tight. Signs include numbness, tingling, increased pain, swelling, and cool skin below the wrap. A problem called compartment syndrome can occur.

Minor elbow injury

Try the following tips to help relieve elbow pain, swelling, and stiffness.

• Remove all jewelry.

  Remove rings, bracelets, watches, and any other jewelry that goes around the wrist or fingers of the injured arm. It will be hard to remove the jewelry after swelling starts.

• Rest.

  It's important to rest and protect the injured or sore area. Stop, change, or take a break from any activity that may be causing your pain or soreness.

• Use ice.

  Put ice or a cold pack on your elbow for 10 to 20 minutes at a time. Try to do this every 1 to 2 hours for the next 3 days (when you are awake).

• Wrap the injured or sore area.

  Compression, or wrapping the area with an elastic bandage (such as an Ace wrap), will help reduce swelling. Don't wrap it too tightly, because that can cause more swelling below the affected area. Loosen the bandage if it gets too tight. Signs that the bandage is too tight include numbness, tingling, increased pain, coolness, and swelling in the area below the bandage.

• Elevate the injured or sore area.

  Try to keep the area at or above the level of your heart to help reduce swelling. Prop up the area on pillows while you apply ice and anytime you sit or lie down.

• Support your elbow.

  Wear a sling for the first 48 hours after the injury if it makes you more comfortable and supports the injured area.

  Use an elbow support, such as an elbow sleeve or forearm wrap. It may help rest your elbow joint, relieve stress on your forearm muscles, and protect your joint during activity. A counterforce brace may be helpful for tennis elbow symptoms. Follow the directions on the package for using the brace.

• Apply heat.

  After 2 or 3 days, you can try applying heat to the area that hurts. Apply heat for 10 to 20 minutes at a time, several times a day. You might also try switching between ice and heat.

• Rub the area.

  Gently massage or rub the area to relieve pain and encourage blood flow. Don't massage the injured area if it causes pain.

• Start exercises using the MSA process (gentle exercise).

  MSA stands for movement, strength, and alternate activities.

  • Movement. Resume a full range of motion as soon as you can after an injury. After 24 to 48 hours of rest, start moving the injured area. Stop any activity if it causes pain, and give the injured or sore area more rest. Gentle stretching may prevent scar tissue that can decrease movement.
  • Strength. When the swelling is gone and range of motion is restored, slowly start to strengthen the injured or sore area. Hand grip exercises can help you regain elbow strength. Using a small ball, such as an old tennis ball, squeeze the ball 20 to 25 times. Hold each squeeze for about 5 seconds. After 2 to 3 weeks of hand grip exercises, you may start forearm exercises of extending or bending the elbow.
  • Alternate activities. After the first few days but while the injury is still healing, slowly add in regular exercise. This includes activities or sports that don't strain the injured or sore area. If certain activities cause pain, stop doing them. But keep doing your other exercises.
• Don't smoke or use other tobacco products.

  Smoking slows healing because it decreases blood supply and delays tissue repair.

If you need to use a wrap or sling for more than 48 hours, you may have a more serious injury that needs to be checked by a doctor.

Signs of possible abuse

Most injuries are not caused by abuse. But bruises are often the first sign of possible abuse. Suspect physical abuse of a child or vulnerable adult when:

• Any injury cannot be explained or does not match the explanation.
• Repeated injuries occur.
• Explanations change for how the injury happened.

You may be able to prevent further injuries by reporting abuse. Seek help if:

• You suspect child abuse or elder abuse. Call your local child or adult protective agency, police, or a health professional, such as a doctor, nurse, or counselor.
• You or someone you know is experiencing intimate partner violence (IPV).
• You have trouble controlling your anger with a child or other person in your care.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

• New or worse pain or swelling.
• New signs of infection, such as redness, warmth, pus, or a fever.
• New or worse numbness, tingling, or cool and pale skin.
• Movement or strength decreases.
• Symptoms occur more often or are more severe.

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