A sprain is an injury to a ligament at a joint. Ligaments are inelastic structures that span the gap from one side of a joint to the other. Joints are made to move but also require sufficient stability to withstand the forces transmitted through them by muscles and outside sources. Ligaments play an important role in limiting motion, holding bones in their proper places and absorbing shock.

Elbow sprains affect the ligaments that support the elbow joint. The elbow joint connects the forearm to the upper arm. The forearm is made up of the radius and ulna bones while the upper arm consists of the humerus. The elbow joint is the articulations between the larger forearm bone, the ulna, and the humerus as well as between the end of the radius and the humerus. These bones form a hinge joint that allows for flexion and extension of the elbow.

The elbow joint is encapsulated by a fibrous joint capsule. Within that joint capsule is the articulation between the ulna and humerus as well as that between the radius and ulna which allows you to turn your palm up and down (supination and pronation). Though they exist within the same joint capsule, most anatomists consider these two separate joints.

There are two primary ligaments in the elbow that support and strengthen the joint capsule:

• Ulnar collateral ligament: runs between the humerus and ulna on the medial side of the elbow
• Radial collateral ligament: runs between the humerus and radius on the lateral side of the elbow

• Sudden twisting or pulling of the elbow
• Fall on an outstretched arm
• Sports injuries such as a fall, tackle or forceful bending motion such as throwing or hitting a ball
• Elbow dislocation

SYMPTOMS OF A SPRAINED ELBOW

Symptoms of an elbow sprain can range from mild to severe. Pain during elbow motion might indicate an elbow sprain. We can categorize a sprain based on its severity:

Grade I (mild): microscopic damage has occurred to the ligament but only mild local tenderness and minimal bruising/swelling is noted without compromising joint stability. Typically takes 2-3 weeks to heal.

Grade II (moderate): partial tear/rupture of the ligament. Obvious swelling and tenderness noted over the injured ligament but joint instability is either minimal or absent. May require up to 6 weeks to heal.

Grade III (severe): complete rupture of the ligament with severe swelling and tenderness. This injury may be difficult to distinguish from a fracture initially. Instability of the joint is noticeable due to the severity of the rupture. Prolonged time to heal is frequent and may require surgery to repair.

With a more severe elbow sprain, it is important to rule out a possible fracture. Signs and symptoms of a broken bone can overlap with those of a severe sprain and include:

• Pain, tenderness and swelling at the elbow
• Redness and bruising
• Difficulty moving the elbow

If you decide to work with a physical therapist to help correct your elbow sprain issues, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

PHYSICAL THERAPY FOR A SPRAINED ELBOW

In the first week or so after an elbow sprain, your physical therapist will guide you on how to protect the recently injured and newly healing ligament. You want to minimize any movement that causes pain or places any stretch or strain across the injured site. A sling may be recommended at first to support the elbow.

Aside from protecting the area of injury, in this very early phase, your physical therapy treatment will focus on reducing inflammation and pain and maintaining strength in unaffected areas above the injury. To achieve these goals your physical therapy treatment may consist of the application of ice or light soft tissue work to mobilize any swelling. Modalities such as electrical stimulation or ultrasound may be applied to increase circulation, decrease inflammation and control pain.

As the healing tissues become stronger, inflammation subsides and pain is reduced, it is time to move on to the next phase of rehab which consists of light muscle activation and endurance work, graded active range of motion and very light stretching. Finally, in the later stages of healing your physical therapy treatment will focus on exercises and activities that prepare the injured ligament to withstand the stress and strain of everyday life and the sports and recreational activities you love to do. This includes moderate-intensity stretching, strengthening exercises of the forearm and arm and sport and work-specific training.

When recovering from a sprained elbow, let the experts take the lead. Our team of physical therapists at Evolve is here and ready to get you on the road to recovery. Call to schedule your initial evaluation today.