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Elbow Hyperextension

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A male athlete suffering from arm and elbow pain and injury at the park.

An elbow hyperextension is an extremely painful injury. It occurs when the elbow joint is bent backwards outside its natural range of motion.

This type of injury tends to occur most frequently among individuals who play contact sports like football, soccer or rugby. However, it can in principle occur whenever you extend your arm to catch your body weight when falling.

The injury is usually accompanied by a popping sound and immediate elbow pain. Mild or moderate hyperextension injuries of the elbow can be treated by resting the elbow joint for a few weeks. However, the most serious injuries of this type must be treated by surgical intervention.

Causes Of An Elbow Hyperextension

The elbow is the point of intersection of three bones:

  • the humerus or upper arm bone;
  • the ulnar (the shorter lower arm bone), and
  • the radius (the longer lower arm bone positioned inside the ulnar).

The elbow contains three joints corresponding to the three points of intersection of these bones.

An elbow hyperextension occurs when the joint at which the humerus and ulnar bones intersect (the humeroulnar joint) is bent backwards.

The most frequent causes of this injury are:

  • Receiving a blow to the elbow that bends it backwards in an unnatural manner. This in turn happens most frequently when you are playing contact sports;
  • Forces exerted on the elbow that cause it to bend backwards, such as when performing gymnastics or lifting weights;
  • Falling onto your outstretched arm, when your body weight may bend your elbow backwards. This too is a common occurrence when playing contact sports.

Risk Factors

The following factors will tend to increase the chances of hyperextending your elbow:

  • Frequent participation in sports, particularly contact ones;
  • Being middle aged or older, as your joints tend to become weaker with advancing age;
  • Having experienced this injury in the past.

What Are The Symptoms Of An Elbow Hyperextension?

The typical symptoms you experience with a hyperextended elbow include:

  • A popping sound or sensation from your elbow at the time the hyperextension occurs;
  • Pain when your elbow is bent or even touched;
  • Swelling and redness around your elbow;
  • Elbow joint stiffness;
  • Reduced elbow strength and range of motion;
  • In severe cases, you may also experience muscle spasms.
  • Also in severe cases, your elbow may take on an unnatural shape;
  • You may also experience reduced blood circulation in the lower arm or hand corresponding to the injured elbow.

Many of these symptoms are similar to those you would experience from a strained or sprained elbow.

A hyperextended elbow is a potentially serious injury. If you are experiencing the symptoms above, you should contact a healthcare professional for medical advice as soon as possible.

Diagnosis

To diagnose your elbow injury and decide whether it is a hyperextension, your doctor may take the following steps:

  • Review your medical history, paying particular attention to previous elbow injuries;
  • Ask you questions about how you sustained the injury (i.e. what were you doing at the time?);
  • Physically examine your elbow to understand the location of your pain and swelling. The doctor may also ask you to hold your arm in different positions and to bend your elbow in different ways.  He or she will also you to report each time on the  pain you are feeling and when it is worse;
  • Your doctor may also request an imaging scan such as an MRI or X-Ray. He will use it  to look for the type and extent of soft tissue and bone damage inside your elbow.

Treating Your Hyperextended Elbow

The doctor may conclude that you have indeed suffered a hyperextended elbow. In this case, the treatment will depend on the severity of the injury.

Conservative Treatment

You may have experienced only mild or moderate soft tissue damage (and no bone fracture or other damage). If so,  the treatment will likely utilize the R.I.C.E. strategy:

  • Resting your elbow by temporarily refraining from demanding activities like lifting if these are part of your daily routine. You should also take a break from sports or other activities (professional or recreational) that utilize your elbow;
  • Wearing an elbow brace or arm sling to further immobilize the joint;
  • Applying Ice or a cold compress to your elbow for periods of about 20 minutes. Do this at intervals of about 3 hours. However, avoid pressing the ice or compress directly to your naked skin. This cold therapy will help to reduce pain and swelling;
  • Applying Compression to your elbow with an elastic bandage or an elbow compression sleeve;
  • Keeping your elbow Elevated above heart level as much as possible (e.g. when sitting or lying down);
  • For additional pain relief, you may be advised to try an over the counter medication such as Tylenol;
  • For reducing swelling as well as pain, your doctor may suggest a non steroidal anti inflammatory medication like Advil;
  • Avoid use of Alcohol or heat therapy during your R.I.C.E. treatment. Massage treatments of your elbow may also be counterproductive and so should also be avoided.

Once healing of your elbow is underway, you will be referred to a physical therapist. This healthcare professional will devise a program of forearm and elbow stretching and strengthening exercises. The goal will be to prepare you for a return to normal physical activities with less risk of reinjury.

Surgery

If your elbow hyperextension involves either complete rupturing of ligaments, muscle or tendons, or bone damage, surgery will be indicated.

The surgeon will need to repair severely damaged (e.g. ruptured) soft tissues as well as any bone damage you may have.

As with conservative treatments, immobilization of your elbow will be an important part of ensuring a full recovery. However, the period of immobilization will need to be longer in this case. It may be several weeks or months compared to just a few weeks for a conservative treatment.

Physical therapy will again be an important stage of the treatment process. However, you will likely require more time for this therapy than with a non surgical treatment strategy.

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