Stiff elbow after arm surgery? Basically I broke my arm aug 27. I broke it in half, next day I got surgery. I broke both of the bones in half. One bone had plates and screws. The other has a rod? Anyways, it's September 20 and I got my cast removed. The doctor told my I should try to bend it back and fourth. I can bend it about a 75 percent of the way. It feels incredibly stiff. Is this normal? Please help
Yes, this is usual after the elbow has been immobilized for a period of time.
If you did not have a fracture which involved the ulnohumeral joint (elbow), then you should regain your range of motion. However, if the surgery to place the intramedullary (IM) nail violated the elbow joint, then that can cause some problems in regaining motion.
As long as the surgeon has released you to begin therapy on your elbow, then you can work on the elbow range of motion. You should do active range of motion exercises. These are the ones where you use your own muscles to move the elbow. You can also do active-assisted range of motion. Here, you use your other hand to help move the joint. You should go to the end point of the motion, then hold that position for a count of ten. You can use your other hand to push a little of the end point, while you are holding for the ten count. Then, go the other direction and do the same. Repeat the motion exercises for about 10 to 15 reps. You should do the range of motion exercises several times a day.
Sometimes, it helps to warm up the soft tissues before doing your therapy. Warm tissues are more pliable and stretchable. So, you can take a hot shower or use some hot packs. Then, after the therapy session, if you are having some aching, you can use ice at that time.
But, yes, it is very common for joints to be stiff after immobilization. Your muscles will also have atrophied and will have to be rebuilt. You have some work cut out for you in regaining your motion and strength.
The functional arc of motion for the elbow is between 25 and 125 degrees. In that range, you can reach the important areas of the body (mouth and groin). Some patients never regain complete extension of the elbow (making it completely straight) after a significant injury or period of immobilization. But, in most this is not a problem, because there are not very many activities which require a completely extended elbow (military pushups are about it). All other activities involving the upper extremity are done with slight flexion of the elbow.
But, do work on getting as much motion as you can. Again, since the fracture did not involve the joint itself, you should be able to regain your full motion, but it will take some time and effort.
Thank you so much! I was getting really nervous. But yeah hopefully it does heal soon. I did infact join the airforce but will be delayed. I begin rehab in 2 weeks I believe for my arm. Would you suggest I leave it in the sling when walking around? He left me with my cast also.
I assume your cast is a short arm cast, so that the elbow is free.
If you are more comfortable in a sling when moving about, that is okay, as long as you do not have a significant amount of swelling in the fingers/hand. If you are having problems with swelling, then the hand should be elevated above the head. It looks a little silly to rest the cast on top of the head, but in situations where swelling is a problem, it helps tremendously.
When you are resting, or just sitting around, you should have the hand elevated. Having the hand in a dependent position (hanging down) increases problems with edema and swelling, due to gravity pulling the fluids into the distal portions of the limb.
So, use of a sling is fine when you are up and about. Some patients prefer to just tuck their thumb into their pants' pocket or use a belt loop. But, you can use whatever is most comfortable for you.
Also, moving the fingers will reduce the swelling in the hand and will also reduce the chances of the fingers getting stiff. All of the fingers should be placed through a full range of motion at least every hour when awake. The muscle action is required to pump the venous blood, lymphatic fluid, and edema back to the body's core. Also, by using the muscle, the tendons continue to glide within their sheaths. This helps reduce the chances of the tendons becoming adherent or scarred down around the injury site.
You should also work on the elbow range of motion. Again, using your muscles to move the joint through the arc of motion, holding for a ten count at the ends, is the recommended method. Assisting with the other hand is allowed. However, passive motion (where someone else places the joint through its range of motion, pushing on the joint at the end points) is usually not recommended, as this can sometimes cause injury to the patient. It is best for patients to use their own muscle power and do their own assisting. That way they are always in total control of how much pressure is applied to the joint.
As to joining the Air Force, you may have to get a waiver to enter the service with hardware in place. Of course, you will also have to show that you have full range of motion of all of your joints and “normal” strength in the injured limb. You will have to be able to pass the medical eligibility requirements. Your local Air Force recruiter has a general guideline of medical conditions that can render someone ineligible for entrance into the Air Force. The doctor at the Military Entrance Processing Station (MEPS) is the source for making a determination on any condition. If you are interested in joining and are otherwise eligible, your local recruiter can have the medical records for your condition prescreened by the doctor at the MEPS for you to find a preliminary ruling in your particular situation.
So, this is a good goal to work for. Work hard in regaining your motion and strength. You will have your work cut out for you once the cast comes off for good and you start rehab in earnest.
Hello there. Thanks again for clearing many questions. My cast is the type where it just hardens after getting wet. It makes me bend my elbow to fit into the sling. I have been doing the motion exercise with myself. (Already saw little improvements) as for the airforce, I'm actually in the dep program. (Delayed entry program) Also to clarify, swelling is no problem at all. But thank you for all the advice! He left me with the cast and wrap if I need it.
Okay, that makes sense. Casting materials come is several varieties, but all are activated by water. You can get rolls of fiberglass or plaster impregnated cloth, which are rolled on over some cast padding. The rolls are submerged in water to start the curing process, before applying them to the injured limb. Then, as the material dries, it becomes hard.
There are also several types of splinting material, which have the padding and the casting material all sewn together. All that has to be done, is wet the whole thing, apply it to the desired area, wrap it with an Ace wrap, and allow it to dry. These splinting materials are much easier to use and are frequently seen in emergency rooms.
So, if you are out of your cast, you can start to work on range of motion (within the limits set by your surgeon). One thing you might want to look into is getting into a pool for therapy. The warmth of the water makes the soft tissues more pliable. And, the buoyancy helps with supporting the upper extremity while working on the motion. You can also use the resistance of the water to help regain strength. And, besides, it is fun to get into the water.
The pool therapy sounds awesome! I've done a few exercises today and my motion had gotten better. I'd say about 80% there. I feel tension on my muscle on the inside of my arm near my elbow. But thank you again for all the advice and help. Hopefully I'll heal up quick so I can get ready for my deployment.
my sister was got fractured at distal humerous site and went for surgery now (after 3 months) she was ok. But the problem was her elbow became stiffed and there is flexion and extension also still remains 30 degrees. what to do?