Elbow Stiffness

Elbow stiffness is mainly determined by the degree of the joint injury. However, it is also influenced by periosteum loss and immobilization time. These causes may explain why major contractures are observed, despite obtaining adequate reduction and stability, or even in fractures without displacement. Other non-traumatic causes of stiffness are hemophilia, sequelae of infections, rheumatoid arthritis, and osteoarthritis. Among congenital causes, the arthrogryposis and congenital dislocation of the radial head are distinguished.

Symptoms of Elbow Stiffness: The main symptoms are a loss of movement in the elbow. Normally, the elbow can straighten fully (extend) and bend (flex) sufficiently to allow us to perform the movements we need. The elbow is also involved in movements required to rotate the forearm and hand (pronate and supinate). Loss of any of these movements can be a sign of a problem within the elbow (or wrist). Some patients can experience pain and grating with elbow movements, while others may have the sensation of the elbow locking or jamming. These are characteristic of different problems in the elbow and can assist in making the diagnosis.

Causes of Elbow Stiffness: Causes of elbow stiffnesses are numerous and can be classified as traumatic or atraumatic; congenital or acquired.

• Post-injury stiffness: The most common cause in our population is post-injury stiffness of the elbow.
• Other diseases: A stiff elbow joint can also arise due to other diseases like infection and auto-inflammatory conditions (rheumatoid arthritis).
• Congenital problems: Certain congenital problems may also present with elbow stiffness.

Diagnosis of Elbow Stiffness: Patients may experience difficulty reaching or in some instances pain at the end of the range of movements. Examination of the joint shows reduced movements when compared to the opposite side (if normal). An X-ray may be performed to look for loose bodies, bony spurs and to assess the joint surfaces. Special imaging with an MRI or CT scan may be necessary to look at the bearing surface and identify small bone spurs, which can impede movements.

Treatment of Elbow Stiffness: Elbow stiffness can result from various conditions, such as injuries, overuse, arthritis, or post-surgical recovery. Physiotherapy plays a crucial role in addressing elbow stiffness by focusing on improving range of motion, reducing pain, and restoring function. Here are some common physiotherapy treatments for elbow stiffness:

1. Range of Motion Exercises:

• Passive range of motion (PROM) exercises: The physiotherapist gently moves the patient's elbow through its range of motion without the patient using their muscles. This helps prevent further stiffness and maintains joint flexibility.
• Active range of motion (AROM) exercises: The patient performs controlled movements of the elbow on their own to improve flexibility.

2. Strengthening Exercises:

• Progressive resistance exercises: Gradual introduction of resistance to exercises helps build strength in the muscles around the elbow, promoting stability and function.
• Eccentric exercises: These involve controlled lengthening of muscles during contraction and can be beneficial in strengthening the elbow.

3. Joint Mobilization:

• Manual therapy techniques, including joint mobilizations, can help improve joint mobility. The physiotherapist uses hands-on techniques to gently move the joint through its natural range of motion, reducing stiffness.

4. Soft Tissue Mobilization:

• Massage and soft tissue mobilization techniques can help relax and stretch the muscles and tendons around the elbow, reducing tightness and promoting flexibility.

5. Ultrasound and Heat Therapy:

• Ultrasound therapy can promote blood flow and accelerate the healing process.
• Heat therapy (e.g., warm packs) can help relax muscles and reduce stiffness.

6. Cold Therapy:

• Cold packs or ice massage may be applied to reduce inflammation and numb pain in case of acute stiffness.

7. Neuromuscular Techniques:

• Neuromuscular re-education focuses on improving muscle control and coordination, helping the patient regain proper movement patterns.

Exercise of Elbow Stiffness: Elbow pain can be very uncomfortable to live with. Unless there is a specific reason for the pin, it may be due to a tennis elbow. Tennis elbow suggests overuse of the elbow joint that might cause pain and discomfort to the elbows. The best way to avoid tennis elbow is to stretch regularly and not overwork the joint. In this article, we discuss some easy-to-follow exercises that can significantly lower the pain in your elbows.

• Elbow bend
• 90-degree wrist flex
• Wrist turn
• Towel twist
• Wrist extension

Effective management of Elbow Stiffness at Spine Physiotherapy & Rehabilitation Centre (SPTRC) in Shyamoli requires teamwork among medical professionals and patients, which in turn improves the patients' quality of life.

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