December 22, 2014

Why Won’t My Elbow Straighten?

elbow stretching for gradual straightening
On one occasion while playing basketball, I was knocked off of my feet, and I landed onto my left elbow. Thankfully, my elbow was not fractured, although it did bruise up substantially.

In addition to some swelling, I soon noticed an inability to straighten out my elbow. For many months my elbow remained unable to completely straighten. I ended up consulting an orthopedist and a physical therapist, and their advice was invaluable…

Elbows respond to slow and gentle stretching.

Elbow fractures, elbow surgeries, and general elbow trauma all can have the unfortunate consequence of “contractures,” or lags in range of motion. I have found that the soft tissue of the elbow does not respond favorably to aggressive stretching. Aggressive pushing of the ranges of motion will actually cause the elbow to become more inflamed, and in many cases, the contracture will worsen.

The soft tissue of the elbow tends to agree with a slower, gentler stretch imposed over a longer period of time. If you cannot fully straighten your elbow, try this simple exercise. (See photo above)

1. Lie on the floor “face upwards” and place a pillow under your forearm so that your arm may rest with a slight amount of stretch. Make sure that your shoulder does not lift off the floor as you lie in this position. Adjust the amount of support under the forearm if necessary.

2. Allow your elbow to rest into extension over ten to fifteen minutes. Gently press your forearm down into the pillow for ten seconds every minute by contracting your triceps muscles.

3. As your range of motion improves, use less of a support under your forearm.

4. The level of stretch imposed on your shoulder during this exercise should be a “one or two” out of a scale of ten. If you are encountering too much stretch, adjust the pillow under your forearm to allow a more comfortable amount of flexion.

About Dan Baumstark, MSPT, CHT

Dan is a physical therapist who specializes in sports medicine & upper extremity rehabilitation. He is certified by the American Society of Hand Therapists, and he has extensive continuing education in manual therapy from the Michigan State University School of Osteopathic Medicine. Google+

Comments

  1. Vanessa Moreland says:

    I have a small radial head fracture from coming off my horse almost 4 weeks ago. I’ve regained quite a bit of motion since it initially happened and can slowly turn my wrist over now, not completely but certainly much better. Is it too soon to begin this exercise to help extend and straighten my arm?

    • The window for typical fracture healing is six weeks. Radial head fractures are often allowed to have range of motion performed on the elbow and wrist prior to the 6 weeks full healing window, but I would ask your doctor when you can start the stretches. Better to be safe than sorry.

  2. Hi. I had a bad supracondylar fracture and i had a surgery with plate and screw. After sex weeks i took a x ray there was some evidence of healing but not completely healed. My orthopedic dr told me that there is no need of splint. But now i cannot completely extend and flex my elbow. He told me that try to do your habitual works. I want to know what should i do? Thanks

    • Start with working the elbow with active ranges of motion. Bend and straighten the elbow ten times every few hours during the day. Try to use the arm with light functional tasks as well such as typing and using silverware with the arm while eating.

      One of our blogs should show you how to lie down on the floor and allow the elbow to relax into extension. Give it a look.

      • Thanks for ur reply. I have another question. Sometimes i feel movement in fractured area. In this case should i do these exercise? Thanks alot

        • The only way to be sure that it is totally healed is to have another x-ray. If you feel a bit of movement along the fracture line ask the doctor about it.

  3. Gayle Bowlby says:

    Hello,
    I am in very good physical condition- ive done farmwork all of my life, at sixty yrs old, I still unload a hundred bales of hay , stack and restack it , as well as fifty pound bags of horse feed , etc.. I was doing house work and something “twanged? while i was scrubbing a door , my elbow was in a bent position.. after that- the “funny bone” area, where you might hit it on your elbow, was very touchy and sore, I still had to do farmwork after that, as of today, i can not put my hand to my face as in drinking a coffee etc.. I did ice the area for a short time.. i need to keep doing my work , but i don’t want this to be perm either.. any suggestions? Could this be actually in my back rather than the actual joint of the elbow?

    • Gayle I obviously can’t diagnose you over the internet, but it sounds like one of the major nerves (ulnar nerve) that passes right through that “funny bone” area might have slid a bit to the side and then back into place. It can be quite painful. You need to baby the arm for at least a few days. I wouldn’t bend the elbow more than seventy degrees or so, even when you sleep.

      If the pain doesn’t start to go away within a few days, or if you get numbness in your ring or pinky fingers as a result of this I would see the doc, sooner rather than later.

  4. Hi,
    i am in good health condition and do only light works. I cant straighten my arms fully since my elbow got a blow and swelled for 4 days. That was almost a month a go and until now, i cant extend my aarms in its full capacity. When i try to extend it, it hurts and slightly trembling. What should i do?

  5. Nearly six months passed .I did not get all movements.suggest remedies.

  6. Elbow surgery successful.But mobility of my elbow not improved fully.

  7. Hey! Ok so I play volleyball for my school and now that the seasons over, I play club volleyball until school starts again, so it’s year round. Anyway, I don’t remember doing anything that just pops out of my head and says “that’s what you did”, but now I can’t open my elbow fully. I try to slowly force it open and when I get to a certain spot it begins to shake while I try to open it. It doesn’t hurt at all when its bent but now it hurts a lot when I open. It’s affecting my passing and I am an attacker so I need my elbow. Do you think you know what’s going on or what I should do?

    • That type of thing sometimes happens from falling directly onto the elbow, which sounds like a possibility given what you do. It is also possible that you are simply overusing one of the muscles that crosses the elbow joint, maybe the biceps. In either case, I would see your doc and see what is up. I don’t think that it will get better easily if you are playing through it.

  8. I had a bad fall. I was operated on 9 weeks ago for fractured humeral bone and dislocated shoulder. 5 screws and a plate. xrays show that everything is healing. the problem is my elbow will only bend to 90 degrees. Surgeon is suggesting manipulating elbow under anesthesia. I would like to continue p t. instead but worried that progress is slow what is your opinion

    • Elbows are cranky, they don’t like to be aggressively forced into flexion or extension. A manipulation might help, but it will cause inflammation in the elbow in the short term.

      Realize that I am a physical therapist, so my opinion is at times going to differ from that of a surgeon. I would try getting a brace that places a gradual flexion force on the elbow, and give it some time. Unfortunately these things do not go away overnight. You need to be patient. There is a company called “JAS” that we use here at PhysioDC for patients with elbows that don’t move well. It might be worth your while to talk to a physical therapist about it.

  9. Hi
    I fractured my radius near to the elbow some years ago I have not been able to straighten it properly since the injury and at the moment I will get a lump pop out under my tricep right neat the elbow when this happens I cannot straighten my arm past 90 degrees until I push the hard lump back in any ideas what this I and how I can get my arm to fully extend

    • Jason I would definitely see an orthopedist and get a good x-ray to see what is obstructing things. It is probably scar tissue but you should be sure. The fact that it has been years since the injury will make it a bit more difficult to correct. Start with an orthopedist.

  10. Norman Jaravata says:

    Hi! Fractured my distal radius and olecranon due to a bike accident 11 weeks ago. Had surgery/ORIF on both and was on a sling and cast for 6 weeks. I have been doing rehab since pins came off. Hand and wrist range of motion has improved but I still could not straigthen my elbow. Have been given aggressive stretching for flexion and extension but not much gain. I want to go back to work asap but it has been a little frustrating despite all the PT sessions. Read about the light stretching over time. Any other ideas?
    Many thanks!

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