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What to do about a hyperextended elbow

Hyperextended elbow occurs when the elbow joint moves outside its normal range of motion.
This injury can be painful and take several weeks to heal.
Although anyone can experience a hyperextended elbow, it tends to occur among those who play contact sports or engage in other strenuous physical activities.
People who trip and fall may also hyperextend their elbow when they reach out to cushion their fall.
 
A popping sound and immediate pain are two of the main symptoms of a hyperextended elbow.

 

What are the symptoms

man holding his elbow in pain due to a hyperextended elbow
Signs of hyperextended elbow may include swelling, stiffness, and pain when touching the elbow.
The popping sound can help people distinguish the injury from other elbow conditions, such as tennis elbow.
Other signs include:
  • pain when moving or touching the elbow
  • swelling
  • redness
  • stiffness
  • loss of strength in the arm
  • limited mobility
  • muscle spasms

Severe injuries can lead to a deformity in the elbow or reduced circulation in the affected arm and hand.


Causes and risk factors

A hyperextended elbow occurs when one of the joints in the elbow (known medically as the humeroulnar joint) bends backward.

This is a movement that is outside the normal range of motion.

It is most likely to happen when a person is:

  • playing contact sports, including boxing and football
  • engaging in other types of physical activity, including gymnastics and weightlifting
  • bracing themselves against the impact of a fall

Factors that increase the risk of elbow hyperextension include:

  • Involvement in vigorous activities: Sports and other exercises increase the likelihood of traumatic injury to the elbow.
  • Advancing age: The bones and ligaments become weaker with age, so are more easily moved out of their natural range of motion.
  • History of injury: A previous injury to the elbow can make the joint weaker than usual, increasing the risk of re-injury.


How is it diagnosed?

American football may cause a hyperextended elbow
Playing football may be a cause of hyperextended elbow.
A doctor will usually take a medical history and carry out a physical examination of the arm to diagnose a hyperextended elbow.
During the physical exam, the doctor may check for pain or discomfort.
They will do this by asking the person to hold their arm in different positions, with the elbow bent at different angles.
The doctor will also look for signs of bruising or swelling.
Doctors may order imaging scans, such as magnetic resonance imaging (MRI) or X-rays, to check for any damage to the soft tissues or bones.


Treatment

Treatment for a hyperextended elbow involves managing the symptoms and allowing the joint time to heal.

Treatments include RICE:

Rest

Rest allows the elbow joint time to heal.

Avoid flexing and extending the elbow in the days after the injury, where possible.

Take time off from sports or other activities that involve the use of the elbow.

A doctor or physical therapist can suggest the best time to return to these activities.

Ice

Applying an ice pack to the joint immediately after injuring the elbow alleviates pain and swelling.

To make an ice pack, wrap ice in a thin cloth. Apply it to the elbow for up to 20 minutes at a time.

Repeat several times daily for the first few days.

Never apply ice directly to bare skin.

Compression

Applying compression to the elbow joint can restrict its movement and reduce inflammation.

Elastic compression bandages specially designed for the elbow are available in pharmacies and drugstores.

There are also many available online.

Alternatively, wrap a regular elastic bandage firmly around the joint to provide compression.

It should never be so tight that it causes pain or numbness in the arm or hand.

Elevation

Raising the elbow above heart level is another way to reduce swelling.

Hold the arm as high as possible in the first few days after hyperextending the elbow.

The simplest way to do this is to prop the elbow up on some cushions while sitting or lying down.

Consider using a sling when moving around.

Other forms of treatment include:

Pain relief medications

Several over-the-counter (OTC) anti-inflammatory medications will reduce swelling and pain including:

  • aspirin
  • ibuprofen (Advil, Motrin IB)
  • naproxen (Aleve)

Elbow brace

A person might choose to wear an elbow brace to immobilize their arm and elbow joint, which encourages healing.

People can wear a brace for the first few days following injury.

However, they should check with their doctor after that, as doctors do not usually recommend the long-term use of a brace.

However, some doctors may suggest using the brace during certain sporting activities to prevent re-injury.

Surgery

Severe cases of a hyperextended elbow may require surgery.

This is especially true if there is damage to the surrounding bones or ligaments.

People who undergo surgery may need to wear a brace and see a physical therapist.

 

Stretches and exercises

The following stretches alleviate pain and increase the range of motion and flexibility:

Wrist flexion

  • Stand with legs shoulder-width apart.
  • Raise the injured arm, palm facing down, until it is parallel to the ground.
  • Press on the wrist of the injured arm using the other hand.
  • Do not let the hand drop.
  • A stretch should be felt in the forearm and elbow.
  • Hold for 10 to 15 seconds before relaxing.
  • Repeat as recommended by a doctor.

Wrist extension

  • Raise the injured arm until it is parallel to the ground.
  • Rotate the arm until the palm faces upward.
  • Take hold of the hand of the injured arm with the other hand and gently push hand on the injured arm down and backward.
  • Keep the injured arm relaxed.
  • A stretch should be felt in the elbow and forearm.
  • Hold for 10 to 15 seconds before relaxing.
  • Repeat as recommended by a doctor.

Bicep contraction

  • Stand with the injured arm by your side.
  • Bend the arm at the elbow, so the forearm is parallel to the ground.
  • The palm should be facing downward.
  • Using the other hand, press down on the hand of the injured arm.
  • Resist any movement in the elbow.
  • Hold for 5 seconds before relaxing.
  • Repeat as recommended by a doctor.


Prevention

man weightlifting with a spotter
Proper form and technique during exercise may help to reduce the risk of injury.
Not all cases of elbow hyperextension can be prevented, such as those caused by an awkward fall.
Using proper form and technique when engaging in activities can reduce the risk of injury.
Some people may benefit from wearing a brace or supportive sleeve while working out.
It is important to avoid repetitive hyperextension injuries as some research suggests these can cause pathological changes in the bones and joint.

 

Takeaway

Recovery times can range from several days to several weeks.

The time it takes depends on the treatments used and how severe the injury is.

Most people recover within 3 to 4 weeks.

Those who suspect they have a hyperextended elbow should see their doctor for a diagnosis.

Apply ice immediately after the injury to alleviate pain and swelling.

Keep the joint immobilized for several days.

If surgery is required, the injury will take longer to heal, and physical therapy may be necessary.

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