October 21, 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. Ajay singh says:

    Sir
    my hand doesnt staight bcause i have an elbow fracture in Child now any solution to look back my hand like original position …plzz help

  2. I hyper-extended and badly sprained my elbow at gymnastics practice in the beginning of June. I was in a cast for 2 weeks and have done physical therapy ever since. I still can’t fully straighten my elbow without using a weight to dangle it. How long do you think it will take for my elbow to get back to normal?

    • Marie if the elbow will straighten with the weights, you will probably get your range back. It may just take a few months to get there. It largely depends on how much inflammation there is in the joint and how severe the injury was.

  3. For Some reason my arms will not go straight at the elbow. Ive never broken any bones before and I dont really work out. Im very embarrassed about this because it looks funny! What can I do to fix this?

  4. Pete sinoyiannis says:

    REGUARDING MY LEFT ELBOW,CANNOT MAKE ELBOW STRAIGHT ALSO AT TIMES SEVERE PAIN BY THE JOINT AREA SHOULD I BE CONCERNED

  5. Have you worked with distal bicep repairs before? Are there any basics do/don’t you use to treat these injuries? I just finished my second bicep repair surgery of the year.

    • Your surgeon should have a protocol for dealing with a distal biceps repair. For the most part the patient is not allowed to load the biceps tendon for a good 8 weeks following the surgery. The earlier phases deal more with the therapist ranging the elbow without your help.

      I would ask the surgeon for a written timeline of what to do and when to do it.

  6. nathan morris says:

    Hello, i suffered a fracture to my left humerus mid point. It was opened up in surgery and pinned and plated. I was the put in a splint with my arm across my chest i’d say for at least 2 to 3 weeks.
    I then had physio to try and get my range of movement back but have been left with now 15 to 20 degress fixed flexion on extension through my left elbow. Previous to this it would only go to 30 to 35 degrees with quite intense physio and it wasn’t seeming to improve.
    The physio who i had recomended that i go back to see my surgeon and discuss the matter as she fealt there was a block of some sort elbow related. Sure as an xray reveiled bone growth in the elbow joint and this could be the reason for not getting full extension. I was put under for surgery on my elbow which was opened up a quick port polish removed the growth of bone and while i was under they tried to manipulate it but only got to 15 degrees from the original 35 degress of fixed flexion i had.
    They told me that at 15 degrees they fealt the bicep muscle was so tight that any further and they reakon it would of snapped.

    In you’re opinion do you think i could ever improve on the 15 degrees?

    • Nathan if the biceps is restricting the terminal elbow extension, have the physio or a massage therapist (approved from the doctor of course) work on the biceps to make sure that any scar tissue is stretched and released. You may get some improvement.

      I would also consider getting a “static progressive” device, such as a JAS brace (check them out online). You would need a prescription from the doctor to get one fitted for you.

  7. I fell off my bike and landed on my wrist, and now I experience pain when I try to grip. Also, my elbow cannot straighten or bend fully (with a little bit of swelling on the joint), and it aches when I try to stretch it. The X-rays did not reveal any fracture. How soon can I resume and to what extent can I participate in activities such as swimming and yoga? (Can I use pain as my barometer?)

    Thank you!

    • It sounds like it will be a month or two before you are back to doing higher level activities. I would not try any downward dog type poses until you have your elbow range back. Swimming will probably be easier to do, perhaps a bit sooner than a few months?

      As always pain should be your guide, if it is sharp don’t do it.

  8. Sherri McKenzie says:

    I dislocated my elbow about 5 weeks ago and at the time of the accident, it popped back into place when i moved my arm. I had great pain and swelling for two weeks. But now it hardly hurts, but i can not extend my arm fully, it if try it begins to hurt. It’s close, but I am worried about it not improving. My question is how long might it take for an elbow to fully straighten after dislocation. And if it hasn’t straighten after five weeks, could this be permanent loss of extension.

    • Sherri you may want to give it more time to heal. I think that five weeks does not equate with a permanent loss of extension. Talk to your doc about perhaps getting a “static progressive” brace to help it along. A slow, gentle stretch tends to work better than aggressive stretching. It could take 3-6 months for the elbow to entirely heal.

  9. 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.

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