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How to Identify and Treat a Hyperextended Elbow

What is elbow hyperextension?

Elbow hyperextension happens when your elbow joint is bent beyond its normal range of motion. This type of injury can damage the ligaments and bones of your elbow. It can also cause your elbow to dislocate.

Elbow hyperextension can happen to anyone, but it’s most common among players of contact sports, such as football, judo, or boxing. Gymnasts, tennis players, and weight lifters are also susceptible to this injury.

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Symptoms

What are the symptoms of elbow hyperextension?

You will likely hear a “popping” sound and feel instant pain when your elbow is hyperextended. Other potential symptoms include:

  • dull to sharp pain when you move your elbow
  • pain when you touch your elbow
  • swelling around your injured elbow
  • stiffness in your elbow and arm
  • loss of elbow and arm strength
  • muscle spasms in your biceps when you try to straighten your arm

Your skin may become red and blotchy around the injured area. Depending on the severity of your injury, you may also experience elbow deformity, circulation problems in your hand, or both.

Causes

What causes elbow hyperextension?

Each one of your elbows is made of three joints: your humeroulnar joint, humeroradial joint, and superior radioulnar joint. You’re able to flex and extend your arm because of your humeroulnar joint. This joint connects the bones of your upper arm, known as your humerus, and your forearm, known as your ulna.

Your elbow is hyperextended when your humeroulnar joint bends backward and out of its natural range of motion. You’re most likely to experience this when you’re playing contact sports, such as football, or performing other vigorous physical activity, such as gymnastics or weightlifting. You can also hyperextend your elbow when you catch yourself during a fall. In this instance, your body weight and the impact of your fall can cause your elbow to bend the wrong way.

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Diagnosis

How is elbow hyperextension diagnosed?

If you suspect you have hyperextended your elbow, make an appointment with your doctor. To diagnose elbow hyperextension, your doctor will start by taking your medical history and carefully examining your arm. They may also order an X-ray to rule out any fractures or an MRI or CT scan to check for soft tissue damage. Your doctor can use the images produced by an MRI or CT scan to determine where your elbow is injured and how badly your muscles, tendons, or other soft tissues are damaged.

If your elbow is visibly deformed or you have fragments of bone protruding through your skin, go to the emergency department for treatment.

Treatment

How is elbow hyperextension treated?

Immediately following the injury, place a cold compress on your elbow to help reduce pain and swelling. To make a cold compress, wrap some ice or an ice pack in a cloth. You can also take over-the-counter anti-inflammatory pain relievers, such as aspirin, to help ease swelling and discomfort.

Depending on the severity of your injury, your doctor may also prescribe one or more of the following treatments.

Rest

In the first couple of days following your injury, avoid flexing and extending your elbow as much as possible. This can help it heal. You should also stay away from activities that could cause swelling, such as drinking alcohol or using heating pads on the injured area.

Depending on the severity of your injury, your doctor may advise you to start moving your elbow after a couple of days or recommend a longer period of rest.

Ice therapy

Wrap ice or an icepack in a cloth and place it on the injured area. Apply this cold compress for 10 to 20 minutes at a time. Do this every few hours for the first few days following your injury. Never apply the ice directly to your skin.

Elastic bandage

Wrapping an elastic bandage around your injured elbow can help prevent and relieve swelling. It can also help limit your movement, allowing your elbow to heal more easily. To apply an elastic bandage, wrap it around your elbow firmly enough to provide compression, but not so tightly that it causes pain or reduces feeling in your arm or hand.

Elbow brace

Wearing an elbow brace can also help immobilize your elbow. This can help it heal properly. Your doctor can let you know how long should wear the brace. In some cases, they may encourage you to wear a brace on an ongoing basis when you’re participating in certain activities.

Elevation

Elevating your elbow above your heart level can help prevent and relieve swelling. This is particularly helpful in the first couple of days after your injury. Consider elevating your elbow on some pillows when you’re lying down or a stack of cushions when you’re sitting. Wearing a sling can also help elevate your elbow.

Physical therapy

When you can move your elbow again without acute pain, your doctor may advise you to perform some gentle stretches or exercises to help heal it. For example, they might encourage you to perform one or more of the following exercises.

Extend your injured arm so it’s parallel to the ground, with your palm facing down. With your other hand, gently press down on the wrist of your injured arm. Resist moving your arm downward in response to this pressure. You should feel a gentle stretch in your forearm and elbow. You can do this stretch sitting down or standing up.

Extend your injured arm so it’s parallel to the ground, this time with your palm facing up. With your other hand, gently press the hand of your injured arm down and backward. You should feel a stretch in your elbow and forearm.

Bend your injured arm at the elbow, so your upper arm is down at your side and your forearm is extended forward, parallel to the ground. Your palm should face downward. With your other hand, gently press down on the top of the hand of your injured arm. Resist moving your hyperextended elbow down in response to this pressure. Hold for five seconds, then relax. Repeat 10 more times. Do this three times a day. Make sure to keep your elbow by your side the entire time.

Surgery

In some cases, elbow hyperextension can cause damage to your ligaments, tendons, bones, or other structures of your elbow. Your elbow joint be fractured or severely torn. In this case, you might require surgery to fix the injured area. Follow surgery, you will need to keep your arm immobilized for a few weeks. Then you may need to undergo physical therapy to help restore your elbow function.

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Outlook

What is the outlook for elbow hyperextension?

You should see your doctor right away if you experience symptoms of elbow hyperextension. They can help diagnose the extent of your injury. They can also suggest the best treatment options to help your elbow heal correctly.

In the short term, you should expect to keep your elbow immobilized for at least a few days. If your elbow is severely injured and you require surgery, your will need to keep it immobilized for longer. In most cases, it should heal within a month. You may need physical therapy to help regain your full strength and range of motion.

If your elbow doesn’t heal properly or you injure it repeatedly, you might develop chronic elbow instability. Over time, this can raise your risk of arthritis.

Ask your doctor for more information about your specific condition, treatment options, and long-term outlook.

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Prevention

How can you prevent elbow hyperextension?

The best way to prevent elbow hyperextension is by practicing proper form when participating in contact sports or other strenuous physical activities. For example, you may need to perfect your form when practicing gymnastics or adjust your hitting technique during boxing. A qualified coach or instructor can help you learn how to practice good form and lower your risk of injury.

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