Most fractures heal on their own within 8 weeks. The healing time is different if the bones are stabilized surgically but rehabilitation is still an important component of recovery in those cases. While the bone is still healing, physical therapy interventions will focus on adjacent areas to limit the effects of disuse. Once healed, your physical therapist may recommend 4-8 weeks of rehabilitation to help restore normal function to the previously broken elbow and surrounding areas. Once PT can target the previously fractured area, you should experience improvements in many symptoms such as pain and stiffness within a few weeks but returns in strength, flexibility and overall mobility and return to your prior level of activity may take longer. Achieving long lasting results may take some time, but dedication to your program will help you achieve these results more quickly.

BASICS ON BROKEN BONES

Broken bones, also known as fractured bones, occur when stress across the bone exceeds the bone’s tensile strength. A bone may fracture due to trauma such as a fall on an outstretched hand, or in the case of a weakened bone, can occur due to relatively normal forces. Fractures can occur in different patterns. They can be stable and nondisplaced and treated with a cast or splint or unstable or displaced and treated with either closed or surgical reduction and fixation followed by a cast or splint. A bone that is broken in several places or unlikely to heal well on its own often requires surgery to stabilize the fracture with some type of hardware.

Bone fractures heal in three phases. The first phase is the inflammatory phase which starts within hours of the break and is normally complete within a number of days. During this phase the body lays down a fragile matrix of new tissues to begin repairing the broken bone. During the next several weeks the reparative phase occurs in which a soft callus is initially formed by bone-producing cells and then transformed into a hard callus over time. The soft callus can easily be disrupted if the bone is not protected but the hard callus is much more durable. In the final stage, the remodeling stage, the callus is slowly removed and the bone is reshaped and smoothed out as it responds to the stress and activity placed on it by normal activity. This phase takes months to years to be completed but in most cases a fracture is considered healed in about 8 weeks.

The elbow joint is made up of three bones. The humerus, or upper arm bone, articulates with the heads of the two bones that make up the forearm, the radius and the ulna. This joint is considered a hinge joint that allows for bending (ie flexion) and straightening (ie extension) of the elbow. Just below this lies the articulation of the radius and ulna which allows you to rotate your palm up and down. The olecranon process, the bony protuberance at the back of the elbow, is part of the ulna. A fracture to the olecranon is referred to as an elbow fracture.

Signs and symptoms of a broken elbow include:

• Pain, tenderness and swelling over the olecranon process
• Redness and bruising near the elbow
• Difficulty moving the elbow, rotating the forearm or putting weight through the arm
• Signs of deformity or misalignment in the bones

If you decide to work with a physical therapist to help with a broken elbow, 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 BROKEN ELBOW

Your PT will avoid manipulating or stressing the broken elbow until the fracture is healed in order to prevent disruption of the healing bone. During this time, your physical therapist may recommend the following interventions:

• If needed, strength training, stretching and range of motion of adjacent areas of the body such as the shoulder may be prescribed to prevent stiffness and atrophy while the elbow is healing
• Education on the healing process of bones
• Recommendations on how to adapt daily tasks to the use of one arm

• Stretching, joint mobilization and range of motion to improve the flexibility and mobility of the wrist and elbow and shoulder
• Soft tissue mobilization to address any adhesions or scar tissue in the area
• Strengthening, motor control and coordination training of the hand, wrist, elbow and shoulder to allow you to grasp, hold, manipulate, lift and carry objects with the arm
• Sport and work specific training to help the injured arm return to higher impact and repetitive activities like throwing a ball, push ups, pull ups, gardening, carpentry and much more