Elbow Dislocation: What to Do, Symptoms, Treatment, and Recovery

What to do if you throw your elbow out?

If you suspect you've "thrown your elbow out," which typically refers to a dislocation or severe injury, immediately immobilize the arm, apply ice, and seek urgent professional medical attention as this is a serious condition requiring expert diagnosis and treatment.

Understanding What "Throwing Your Elbow Out" Means

The phrase "throwing your elbow out" is a common colloquialism, not a precise medical term. In the context of an acute injury, it most commonly refers to an elbow dislocation, where the bones of the forearm (radius and ulna) are forced out of alignment with the upper arm bone (humerus) at the elbow joint. However, it can also encompass other severe injuries such as:

• Elbow Dislocation: This is the most frequent interpretation. It can be complete (bones entirely separated) or partial (subluxation). Posterior dislocations, where the forearm bones are displaced backward, are the most common.
• Severe Sprain: Significant tearing or stretching of the ligaments that stabilize the elbow joint.
• Fracture: A break in one or more of the bones forming the elbow joint (e.g., radial head, olecranon, or distal humerus). These often occur concurrently with dislocations.

Common Symptoms of a Serious Elbow Injury: If you've "thrown your elbow out," you will likely experience:

• Intense, sudden pain at the elbow.
• Visible deformity of the elbow joint, which may look misshapen or out of place.
• Significant swelling and bruising around the joint.
• Inability to move the arm or extreme pain with any attempt at movement.
• Numbness or tingling in the forearm or hand, indicating potential nerve involvement.
• Weakness or loss of pulse in the hand, signaling vascular compromise (a medical emergency).

Immediate First Steps: The R.I.C.E. Principle (and Beyond)

Given the severity of a suspected elbow dislocation or fracture, your immediate actions are critical to prevent further damage and manage pain until professional medical help arrives.

CRITICAL WARNING: DO NOT ATTEMPT TO RESET OR MANIPULATE THE JOINT YOURSELF. Attempting to put the elbow back into place without medical training can cause severe damage to nerves, blood vessels, ligaments, and bones.

Follow these steps:

• R - Rest: Stop all activity immediately. Do not try to use the injured arm.
• I - Immobilize:
  • Gently support the injured arm in the most comfortable position you can find.
  • If available, use a sling or improvise one with a shirt or towel to keep the arm still and prevent further movement.
  • Avoid any unnecessary movement of the elbow.
• C - Ice:
  • Apply an ice pack wrapped in a cloth to the injured area.
  • Apply for 15-20 minutes at a time, then remove for 40 minutes, repeating the cycle. This helps reduce swelling and pain.
• E - Elevate:
  • If possible, try to keep the elbow elevated above the level of your heart. This further aids in reducing swelling.
• Pain Management:
  • Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain, but consult with a medical professional as soon as possible.

When to Seek Professional Medical Attention

Any suspected elbow dislocation or severe injury requires immediate medical evaluation. This is not an injury to "wait and see" about.

• Go to the Emergency Room (ER): If you experience any of the following, go to the nearest emergency room immediately:
  • Visible deformity of the elbow.
  • Inability to move the arm.
  • Severe, unrelenting pain.
  • Numbness, tingling, or weakness in the hand or fingers.
  • Coolness or paleness of the hand, or absence of a pulse, indicating potential vascular compromise.
• Urgent Care or Orthopedic Specialist: If the symptoms are less severe (e.g., significant pain and swelling but no obvious deformity or neurovascular symptoms), an urgent care center or immediate consultation with an orthopedic specialist may be appropriate, but still should be sought without delay.

Why Speed Matters: Prompt medical attention is crucial to:

• Ensure proper diagnosis and rule out concurrent fractures.
• Safely reduce (reposition) the joint, minimizing damage to surrounding tissues.
• Prevent complications such as nerve damage, blood vessel injury, severe stiffness, or chronic instability.

The Medical Evaluation Process

Upon arrival at a medical facility, the healthcare team will:

• Take a Detailed History: Ask about how the injury occurred, your symptoms, and any relevant medical history.
• Perform a Physical Examination: Assess the elbow for deformity, swelling, tenderness, range of motion (if possible), and perform a thorough neurovascular assessment (checking nerve function and blood flow to the hand and fingers).
• Order Imaging Studies:
  • X-rays: These are essential to confirm a dislocation, determine its direction, and rule out any associated fractures.
  • MRI or CT Scans: May be ordered later if soft tissue damage (ligaments, tendons) or complex fractures are suspected, or if the diagnosis remains unclear.

Treatment Options

Treatment will depend on the specific injury diagnosed:

• Reduction: For a simple elbow dislocation, a doctor will perform a "reduction," which is a manual maneuver to gently guide the bones back into their correct anatomical position. This is typically done under sedation and/or pain medication to ensure patient comfort and muscle relaxation.
• Immobilization: After reduction, the elbow will be immobilized in a splint or cast for a specific period (usually 1-3 weeks) to allow initial healing of the joint capsule and ligaments. The duration depends on the severity of the injury and any associated soft tissue damage.
• Surgery: Surgery may be necessary if:
  • The dislocation cannot be reduced manually (irreducible dislocation).
  • There are significant fractures that need to be stabilized.
  • There is severe ligamentous damage causing instability.
  • There is nerve or blood vessel damage requiring repair.
  • The elbow frequently re-dislocates.

Rehabilitation and Recovery

Rehabilitation is a critical phase following an elbow injury and is often supervised by a physical therapist. The goal is to restore full range of motion, strength, and function while preventing stiffness and re-injury.

• Phased Approach:
  • Initial Phase (Immobilization): Focus on pain and swelling management. Gentle, passive range-of-motion exercises for the hand, wrist, and shoulder may be permitted.
  • Early Mobilization Phase: Once the splint is removed, a physical therapist will guide you through controlled, progressive range-of-motion exercises to prevent stiffness.
  • Strengthening Phase: As motion improves, exercises to strengthen the muscles around the elbow (biceps, triceps, forearm muscles) will be introduced. This includes isometric, then isotonic exercises.
  • Functional and Sport-Specific Phase: Once sufficient strength and mobility are achieved, exercises will progress to mimic daily activities and sport-specific movements, including proprioceptive training.
• Expected Timeline: Recovery can vary significantly depending on the severity of the injury, from a few weeks for a simple dislocation to several months for more complex injuries involving fractures or surgery. Full recovery of strength and range of motion can take up to a year.
• Potential Complications: Stiffness (most common), instability, re-dislocation, chronic pain, nerve damage, and heterotopic ossification (abnormal bone formation) are possible. Adherence to your rehabilitation program is key to minimizing these risks.

Prevention Strategies

While not all elbow injuries are preventable, especially those from high-impact trauma, several strategies can reduce your risk:

• Maintain Joint Strength and Stability: Regular strength training for the muscles crossing the elbow joint (biceps, triceps, forearm flexors and extensors) helps support the joint.
• Ensure Adequate Flexibility and Mobility: Maintain a full, pain-free range of motion in your elbow and surrounding joints.
• Use Proper Technique: In sports, weightlifting, and occupational tasks, ensure you are using correct form to avoid putting undue stress on the elbow joint.
• Wear Protective Gear: In contact sports or activities with a high risk of falls, consider elbow pads or braces.
• Listen to Your Body: Avoid pushing through pain or ignoring warning signs of overuse or instability.

Conclusion

A "thrown out elbow" is a serious injury that demands immediate and professional medical attention. While initial first aid focuses on immobilization and pain management, the definitive diagnosis and treatment must come from healthcare providers. A structured rehabilitation program is essential for a successful recovery, restoring function, and preventing long-term complications. Prioritizing prevention through strength, flexibility, and proper technique can significantly reduce your risk of experiencing such an injury.