Elbow Stiffness 

The elbow joint is a type of hinge joint. It bends (flexion) and straightens (extension), as well as rotating to position your palm up or down. The normal range of flexion and extension is from 0 to 145 degrees, although the range of motion that we work within for daily activities is only from 30 to 130 degrees. This means that for most people a bit of loss of motion does not cause problems with function. However, with a reduction of extension greater than 30 degrees and or a flexion less than 130 degrees most people will complain of loss of function. Loss of extension is usually less disabling than loss of same degree of flexion.

Cause

Factors that cause stiffness are divided into those that are within the elbow joint itself (intrinsic) and those in the tissues around the joint, such as the muscles and tendons (extrinsic).

Intrinsic

  • Post-traumatic Osteoarthritis

  • Primary Osteoarthritis

  • Rheumatoid

  • Joint Infection

  • Malunions

Extrinsic

  • Burns

  • Heterotopic Ossification

  • Congenital – arthrogryposis, congenital disloc radial head

The commonest cause of stiffness is after trauma and injury. In fact, some stiffness after an elbow injury is very common. Usually this improves, but sometimes it may not. The amount of stiffness isdirectly related to the degree of initial trauma and the degree of involvement of the joint surfaces is most important. The length of immobilisation after injury also leads to more long-term stiffness.

Conditions

  • Biceps Tendon Rupture
  • Bursitis
  • Coronoid Fracture
  • Distal Humerous Fracture
  • Elbow Arthritis
  • Elbow Dislocation
  • Elbow Epicondylitis
  • Elbow Fractures in Children
  • Forearm Fractures
  • Golfer’s Elbow
  • Olecranon Fracture
  • Radial Head Fracture
  • Rheumatoid Arthritis of the Elbow
  • Stiffness of the Elbow
  • Tennis Elbow
  • Throwing Injury
  • Ulnar Collateral Ligament (UCL) Tear

Treatments

  • Autograft (UCL) Tear
  • Biceps Tendon Rupture Surgery
  • Bursitis/Impingement Surgery
  • Coronoid Fracture Surgery
  • Closed Reduction (Elbow) Surgery
  • Distal Radial Fracture Surgery
  • Elbow Arthritis Surgery
  • Elbow Arthroplasty Surgery
  • Elbow Arthroscopy Surgery
  • Elbow Epicondlyitis Surgery/Tenex FAST Procedure
  • Elbow Fracture Surgery
  • Elbow Replacement Surgery
  • Olecranon Fracture Surgery
  • Radial Head Fracture Surgery
  • Tennis Elbow – Tenex FAST Surgery
  • Throwing Injury Surgery

Conservative Treatments

The Orthopedic physicians at Peninsula Bone & Joint Clinic provide conservative treatment options for Elbow conditions and injuries.

Symptoms

The most common symptoms is stiffness after trauma and injury. In fact, some stiffness after an elbow injury is very common.

Diagnosis

Physical Examination & Patient History

During your first visit, your doctor will talk to you about your symptoms and medical history. During the physical examination, your doctor will check all the structures of your injury, and compare them to your non-injured anatomy.  Most injuries can be diagnosed with a thorough physical examination.

Imaging Tests

Imaging Tests Other tests which may help your doctor confirm your diagnosis include:

X-rays. Although they will not show any injury, x-rays can show whether the injury is associated with a broken bone.

Magnetic resonance imaging (MRI) scan. If your injury requires an MRI, this study is utilized to create a better image of soft tissues injuries. However, an MRI may not be required for your particular injury circumstance and will be ordered based on a thorough examination by your Peninsula Bone & Joint Clinic Orthopedic physician.

Treatment Options

The aim is to give the patient pain-free, functional and stable elbow. This means 30-130 degrees flexion and 100 degrees of rotation.

Physiotherapy involves passive motion exercises and stretching (not too aggressive) and active exercises. Ideally this should be with a physiotherapist who has an interest in upper limb rehabilitation.

Splinting may be used and is well tolerated and is effective when performed in a static progressive fashion.

Surgery is indicated when patients are no longer improving in their original posttraumatic rehabilitation program. At least 3 to 6 months should be allowed for the inflammatory phase of soft tissue healing to resolve.

This may be performed via keyhole (arthroscopy) or open surgery. The decision depends on the surgeon’s experience and the type of stiffness.

Arthroscopic release is ideal for stiffness due to arthritis and when there has been no previous surgery. However, if there has been a previous internal fixation and there are extrinsic causes for the stiffness open surgery is required.

Conservative Treatment Options

  • Non-Operative Golfer’s Elbow Treatment

  • Non-Operative Olecranon Fracture Treatment

  • Non-Operative Tennis Elbow – Lateral Epicondylitis Treatment

  • Non-Operative Radial Head Fracture Treatment

  • Non-Operative Throwing Injury Treatment

  • Non-Operative Ulnar Collateral Ligament (UCL) Injury Treatment

Treatment Highlights

Tenex FAST Procedure

Tenex FAST Procedure

Tenex FAST procedure is an innovative procedure utilized by Dr. Paul Abeyta to address Tennis Elbow – Elbow Epicondylitis injuries and accelerate the treatment options available to patients.

Procedure Advantages:

  • Removes damaged tissue through a microincision and stimulates healing response. Uses gentle ultrasonic technology

  • Involves no general anesthesia or stitches. Local anesthetic (numbing medicine) only. Twenty minutes or less to perform. No need for physical therapy or additional treatments. Your individual results may vary.

  • Full return to normal activity in 6 weeks or less. Your individual results may vary.

Peninsula Bone & Joint Clinic

The Orthopaedic physicians at Peninsula Bone & Joint Clinic provide comprehensive services to all members of the family.
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