Question:

Dear TAI Experts:

I need some insight into a nagging injury that occurred back in Nov. 2008. I flipped over the handlebars of my bicycle and cracked both my right wrist and elbow. The hospital put me in a cast that immobilized my wrist but it stopped short of my elbow. The doctor said my elbow needed to be able to move in order to heal properly. Throughout wearing the cast and after it was removed, I could never fully extend my arm. I expected some initial soreness and stiffness but after weeks, the stiffness never went away. The doctor never prescribed any physical therapy or anything.

Fast forward two years and I still can’t straighten my arm completely. At best, my forearm makes a 40 degree angle from horizontal. It’s like my elbow just hits a stop and will not extend any further. Whenever I apply weight and force my arm flat, it causes pain and discomfort. Even when my wife pushes down on my arm with all her might, it will not completely straighten and it never seems to make a difference. My arm just springs right back to the same position at 40 degrees. Is there anything I can do to regain my range of motion? I realize this is probably too little too late…

Answer:

Without doing an examination I am unable to comment on the specifics of your condition. In general, there are various reasons why elbow motion can remain limited following a fracture. These reasons include but are not limited to altered bony alignment as a result of the break, muscle tightness, scar tissue buildup, and joint stiffness. It’s usually easier to gain motion immediately following an injury, but progress can often be made even years following, depending on the reason(s) behind the limited motion. A physical therapist should be able to determine which of the aforementioned possibilities is limiting your motion and provide hands on treatment as indicated, instruction as to how to best address the restriction independently, and guidance as to what to expect for the future.

Josiah Faville PT, DPT