Physical Therapy After an Elbow Fracture

An elbow fracture can be a painful injury. It leads to decreased mobility in your arm, shoulder, or wrist which can limit your ability to work and perform simple daily tasks. Physical therapy can help you restore range of motion, joint mobility, strength, and functional use of your arm. 

This article discusses some of the goals of physical therapy for a broken elbow, and what types of exercises you might expect to do during your recovery.

Why You May Need Physical Therapy

The elbow is a joint where the arm bone, called the humerus, meets the radius and ulna bones of the forearm. The bony end of the ulna is called the olecranon process. This is the bone you feel when you are leaning your elbow on a table. The bones of the elbow are connected by ligaments on the inner and outer parts of your arm.

The most common cause of an elbow fracture is trauma to your arm near your elbow. This can happen after a fall on your elbow or outstretched arm, or during a car crash or sports-related accident.

These injuries usually happen suddenly. A blunt force impact can fracture one of the following bones:

• The radial head, located at the top of the smaller forearm bone
• The distal humerus, located at the lower part of the upper arm bone
• The olecranon, which is the ball of the elbow joint

Compound fractures and dislocations can also occur. A fracture with dislocation is especially problematic, causing long-term pain and stiffness. Moreover, many people will develop excessive bone growth called ossification and joint impairment.

While your elbow heals, it is important to keep it from getting too stiff or weak. This is why you should work with a physical therapist early on, even while you are still wearing a brace or sling.

Elbow Fracture Treatment

After diagnosing your elbow fracture, your healthcare provider will reduce the fracture. During this process, your elbow bones are put in the correct position so that optimal healing can take place.

If the fracture is severe, your surgeon may recommend an open reduction internal fixation (ORIF). During this surgical procedure, the bones are manually realigned. Screws, plates, or wires are inserted to hold the bones in place.

After your elbow fracture is reduced, you may need to wear a brace or a sling. Occasionally, an elbow fracture will be put in a cast. Usually, though, it's thought that immobilizing an elbow fracture is too risky. This is because it may lead to severe stiffness and permanent loss of mobility.

Physical Therapy

A major problem with an elbow fracture is stiffness that limits the range of motion. Sometimes, this stiffness persists long after the bones have healed. To prevent this, your healthcare provider may have you start physical therapy soon after the injury.

Your physical therapist will work with you to help you regain normal use of your elbow and arm. They may use many different physical therapy treatments and modalities to help you quickly return to normal activity.

Range of Motion

One of the main goals of physical therapy after an elbow fracture is to restore normal range of motion (ROM). The elbow is a complex joint that allows you to bend your arm or turn your hand over. To regain normal use of your arm, you need full ROM of the elbow and forearm.

As a rule, the early introduction of ROM therapy achieves better and faster results. A 2016 study found that even elderly people who started ROM exercises soon after immobilization required fewer days of therapy. Those who delayed needed 17 days of therapy vs. 6.5 days for those who started early.

If your ROM loss is severe, your physical therapist may have you wear a dynamic splint. This is a spring-loaded splint worn throughout the day. It provides a low-load stretch to your elbow joint to help improve your ROM. The splint can be used to improve the bending and straightening of your elbow.

Strength Exercises

After an elbow fracture, pain and swelling in your elbow may keep you from using your arm. Wearing a sling can also limit the use of your elbow, wrist, and hand.

If you have had an ORIF, the muscles around the surgical incision may need time to heal. This period of disuse may cause a significant loss of strength around your elbow, shoulder, wrist, and hand.

Your physical therapist can also teach you the proper way to wear your sling and can ensure it fits correctly. They can also prescribe exercises for your hand. Hand exercises can help ensure your grip strength returns to pre-injury levels.

Pain Management

After an elbow fracture, you may have swelling around your elbow. Your physical therapist can help you manage the pain and swelling. For example, you might use ice or electrical stimulation.

A case report found that joint mobilization and shortwave diathermy could help restore normal ROM. Shortwave diathermy is a kind of heat treatment.

Scar Tissue Management

If you have had an ORIF, your physical therapist can help you manage scar tissue that may have formed. Scar tissue massage and mobilization can help improve scar mobility. Your therapist can also teach you self-massage techniques.

Ongoing Care

Most people should be able to return to normal activities within four months. For some, full healing can take up to a year. It's common to still have a mild loss of mobility after this time. That's why it's important to continue the range of motion and strength exercises that you learned in physical therapy.

Keep going with your home exercise program after you've finished physical therapy. Be sure to ask your healthcare provider about the expected outcomes for your specific case.

Summary

If not properly cared for, an elbow fracture can lead to loss of mobility. This is why it's important to work with a physical therapist early on. Your physical therapist can teach you the right exercises to help you strengthen your elbow and shoulder and regain normal use of your arm.

A Word From Verywell

Physical therapy after an elbow fracture can help you safely begin early mobility. It can also help you restore normal strength and function in your arm. Physical therapy can also play an important role in the management of pain and swelling.

After an elbow fracture, make sure to work closely with your healthcare provider and physical therapist. This will help you quickly and safely return to normal activity.