Your elbow is important because it allows you to move your hand into almost any position so you can perform various activities.

When your forearm moves toward your body by bending at your elbow, it’s called elbow flexion. The opposite movement is called elbow extension.

The three bones involved in elbow flexion are the:

  • humerus, in your upper arm
  • ulna, on the little finger side of your forearm
  • radius, on the thumb side of your forearm

There are three muscles involved in flexing your elbow. They connect your upper arm to your forearm. When they contract, they become shorter and pull your forearm toward your upper arm. The muscles are:

  • brachialis, which attaches to your humerus and your ulna
  • brachioradialis, which attaches to your humerus and your radius
  • biceps brachii, which attaches to an outcropping of your shoulder blade and your radius

Elbow flexion is considered impaired when you can’t flex your elbow as much as you want to. You may not be able to flex it enough to perform an activity like combing your hair or bring food to your mouth. Sometimes you can’t flex it at all.

The most common way to assess elbow flexion is for someone to gently move your forearm toward your upper arm as much as possible. This is called passive movement.

You can also move your forearm yourself, which is called active movement. This is usually done with your palm facing towards you.

The angle between your upper and lower arm, known as the degree of flexion, is then measured with a tool called a goniometer.

If your doctor determines there’s a problem with elbow flexion, other tests might be performed to figure out why. Different tests are used based on whether your doctor thinks your bones, nerves, or other structures are involved.

  • X-rays. These images are used to identify injury such as a fracture or dislocation.
  • MRI. This scan provides detailed images of the structures in your elbow.
  • Electromyography. This test is used to assess electrical activity in a muscle.
  • Nerve conduction study. This test is used to determine the speed of signals in your nerves.
  • Ultrasound. This test uses sound waves to produce images and helps to evaluate elbow structures and function and may also be used to facilitate treatment.
activities that may cause an elbow injury

Some activities increase the likelihood of getting an elbow flexion problem. This includes:

The normal range of motion of your elbow from full extension to full flexion is 0 degrees to about 140 degrees. For most activities, you need a range of motion of 30 degrees to 130 degrees.

Depending on the cause, symptoms you might have include:

  • pain that interferes with your ability to use your arm for daily activities like getting dressed and cooking
  • numbness, tingling, or burning sensation from a nerve entrapment syndrome
  • weakness in your arm and hand
  • swelling in your elbow

Inflammation

When something in your elbow is inflamed you may avoid flexing your elbow because of the pain. Inflammation can occur in a:

Injury

Some conditions damage a structure in your elbow that interferes with your ability to flex. They may also cause pain. These include:

  • fracturing or dislocating a bone
  • stretching or tearing a ligament (sprained elbow)
  • stretching or tearing a muscle (strained elbow)

Two conditions make it physically impossible for you to flex your elbow.

Elbow contracture

A contracture is when muscle, ligaments, tendons, or skin loses its ability to stretch. Without this ability, it becomes permanently stiff and tight. When this happens in your elbow, your movement becomes very limited. You will have limited ability to flex or extend your elbow.

Causes include:

  • immobilization or lack of use
  • scar tissue that forms during healing from an injury or burn or from inflammation
  • nervous system condition, such as cerebral palsy and stroke
  • genetic conditions, such as muscular dystrophy
  • nerve damage

Erb’s palsy

Injury to the nerve network (brachial plexus) running from your neck to your shoulder can cause paralysis of your arm. This is referred to as Erb’s palsy.

It’s often caused when a baby’s neck is stretched too far when it’s born. In adults, it’s usually caused by an injury that stretches the nerves in your brachial plexus. This happens when your neck is forced to stretch up while your shoulder is pushed down. Causes of this type of injury include:

  • contact sports like football
  • motorcycle or car accidents
  • fall from a great height

Other ways your brachial plexus can be injured include:

  • gunshot wound
  • mass growing around it
  • radiation to your chest to treat cancer

Treatment of an elbow flexion problem depends on the cause.

Tendonitis, bursitis, and nerve entrapment are almost always treated conservatively with:

Occasionally nerve entrapment is treated surgically.

Treatments for other causes of elbow flexion problems include:

  • sprains and strains: ice packs and rest
  • fractures: surgical repair or casting
  • dislocation: manipulation back into place or surgery
  • contracture: stretching, splints, casting, or surgery may be used to improve elbow flexion but sometimes it can’t be fixed
  • Erb’s palsy: mild nerve injuries often heal on their own but severe injuries can be permanent

Stretches and exercises can be helpful after the pain from inflammation or broken bones have healed. Stretches help maintain flexibility and avoid stiffness. Exercises help strengthen your muscles.

Many of the causes of impaired elbow flexion respond well to physical and occupational therapy. This can be done before, along with, or after other treatment such as bracing and surgery.

Most elbow flexion problems are temporary and get better with conservative treatment.

Problems caused by overuse or repetitive motion can often be fixed by reducing the amount of time you spend on the activity or modifying your hand or arm position.

Taking frequent breaks from the activity and stretching occasionally can also be helpful. Physical therapy, occupational therapy, stretches and exercises can help you protect or improve your elbow flexion.