What Are The Causes
A hyperextension injury is triggered and worsened by movements which suddenly overextend the elbow joint, causing damage and pain. Some common factors which influence injury include:
- Trauma significant fall, vehicular accident, etc.
- Forceful or sudden pressure to the arm/elbow
- Poor muscle warmup/conditioning before activity
- Contact sports martial arts, gymnastics, football, tennis, boxing, etc.
The injury usually affects athletes, but can still happen to anyone.
What Are The Symptoms
- Dull to shooting/sudden severe pain felt in the elbow, and around the joint
- Swelling at the injury site
- Reduced or no range of movement
- Bruising/tenderness/blotchy skin
- A unique home exercise program
- Graded Exposure to load program
If the pain and reduced movement is severe, strenuous activity should be avoided. Your physiotherapist may also advise heat or ice application, rest and if necessary, pain medication. Additionally, they might recommend for you to use supportive braces or straps.
Improving Upper Limb Tolerance
The elbow is located between the hand and the shoulder. PhD level anatomy right there, am I right?
What I am trying to say is that the intricate function of the upper extremity starts at the hand and involves the wrist and elbow all the way up to the shoulder
The various muscles that cross the wrist, elbow and shoulder joints work together to distribute load. If the elbow is injured, painful, or otherwise unable to tolerate load, this force distribution is perturbed. This means potential trouble down the line for the hand, wrist or shoulder.
It also means we need to restore this limb load tolerance and distribution as a whole. This concept is explained in marvelous detail by the guys at ikneurology. Their upper extremity limb load tolerance exercises work wonders to both restore load tolerance and show the nervous system that the extremity can handle load.
I typically program these for time, similar to the parameters for the isometric exercises mentioned above.
WATCH THE MAIN VIDEO OF THE ARTICLE TO SEE HOW TO DO THESE EXERCISES
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Surgical Treatment Of Severe Hyperextensions
If the hyperextension is so severe that a bone fracture or other damage has occurred, surgery may be necessary. Afterwards, the patient will be advised to immobilize the elbow for a period of weeks to allow complete healing.
As with conservative treatments, physical therapy will be needed to help the patient return to normal physical activities.
Are There Risk Factors
Just about anyone can hyperextend a joint, but some people are at a higher risk of these types of injuries. Here are some factors that may increase your risk:
- Sports. If you regularly play sports, your joints may be more prone to hyperextension injuries. For example, contact sports and sports that require fast, frequent directional changes like basketball and soccer can put your knees and ankles at risk. Sports like weightlifting, tennis, or gymnastics might increase your risk of elbow and wrist hyperextension. Throwing a ball may make you more prone to a shoulder injury.
- Previous injuries. If youve injured a joint before, youre at greater risk for another injury. A physical therapist can help you learn ways to strengthen an injured joint and lower your risk of hurting it again.
- Muscle weakness. You may also be at risk for hyperextending your knee if you have muscle weakness in your leg. Without strong muscles to support your knee joint, it can become unstable and more vulnerable.
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Elbow Hyperextension And Whats Happening Inside
Your elbow is formed where the humerus of your upper arm and the radius and ulna of your lower arm meet. The bones themselves have a natural stopping place when your arm is fully extended but, unlike your knee, there is not a cap that prevents your elbow from bending outward beyond that point. Instead, your elbow is kept in place by stretchy tendons that can be thought of like one of those large, sturdy rubber bands. Your tendons combined with the effort of your muscles are what hold your arms in place. They are always at their tightest point when your arm is fully extended which is actually why arms are usually slightly bent when left completely loose.
When you extend your arm, the tendon stretches out to its maximum extension, like a rubber band pulled to the last point before it starts to thin and tear. When your elbow is hyperextended, often through accidental force like falling or swinging heavy equipment at a bad angle, your tendon begins to weaken and tear, just like an over-stretched rubber band.
Elbow hyperextension hurts so badly and limits your ability to move because the tendon that supports your elbow and aids movement is damaged and needs time to heal.
Use A Brace Or Splint
If youre waiting to see a medical professional, but want to limit the likelihood of moving your elbow, you can use a brace or splint to support your arm. This will help limit movement and allow for more focus on healing. However, this is usually not done for long after, since inactivity of your arm could lead to loss of strength.
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Managing Pain Is Always A Priority Because An Athlete Will Always Move Based On Pain Either By Compensating Or Over
Isometrics work well in the early stages to both manage elbow pain and prevent disuse atrophy. For one, isometrics dont involve any movement and are usually quite tolerable and manageable for the athlete.
Isometrics also provide an analgesic effect. Exercise-induced hypoalgesia is a well-documented phenomenon.
In their meta-analysis, Naugle, Fillingim, and Riley found that isometric exercise reduced pain perception across all pain stimuli .
Many other studies have also shown that submaximal isometric contractions engage a centralized pain inhibitory response.
Isometric holds in various angles of elbow flexion in pronated, supinated and neutral positions work quite well and have the added advantage of loading the musculature of the forearm, a key component for elbow pain rehabilitation.
The optimal dose of exercise that is needed to produce hypoalgesia is not well-documented and since there is no consensus on optimal dosage, I advocate individualization based on the limiting factor:
-If elbow pain limits the intensity of contraction that is possible, opt for low-intensity, long-duration isometrics, for example, 3 sets of 45 seconds.
-If elbow pain limits the duration the contraction can be held, opt for multiple sets of lower-duration isometrics, for example 2 sets of 5 x 10 second holds.
If you want to harness more of the power of isometrics, see this article: The Power of Isometric Exercise in Training and Rehab
Tendon glide exercises
Pain Swelling And Weakness
After the moment of injury, you are likely to experience pain when using or interacting at all with the arm. A dull to sharp pain when you move the elbow is very common and it may be too painful to move the elbow at all without external support. You may also feel pain and tenderness when the injured elbow is touched. Swelling is very common, as is stiffness and weakness. Expect a significant loss of strength in the arm because one of the essential support elements is damages.
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What Is A Hyperextended Elbow
An elbow hyperextension injury is where the elbow joint bends back beyond its normal range of motion.
The elbow connects the upper arm to the forearm and is actually made up of three joints:
- Humeroulnar Joint: Between the upper arm and inner forearm bones
- Humeroradial Joint: Between the upper arm and outer forearm bones
- Proximal Radioulnar Joint: Between the two forearm bones
These joints work together to allow the elbow to flex and extend, i.e. bend and straighten, and the forearm to rotate, so you can turn your hand up and down.
Elbow hyperextension occurs at the humeroulnar joint. The humeroulnar joint, aka olecranon joint, is a synovial hinge joint. The elbow is supported by various ligaments and a joint capsule, a bag like structure that surrounds the joint and contains nourishing fluid.
With a hyperextension elbow injury, the structures at the front of the elbow are overstretched and the structures at the back of the elbow get compressed, which may result in:
- Ligament Sprain: over-stretching and possible tearing of one or more of the elbow ligaments
- Cartilage Tear: tearing in the cartilage that lines the joint
- Loose Body: a small fragment of bone or cartilage may break off
- Capsule Damage: the joint capsule may get overstretched or pinched resulting in synovitis
- Bone Damage: if the hyperextension force is high enough it can result in an elbow dislocation or fracture
The greater the hyperextension force through the elbow, the more damage there is likely to be.
Diagnosing An Elbow Hyperextension
To diagnose whether the patient has suffered an elbow hyperextension, the doctor will review his or her medical history. In addition, he or she will perform a thorough physical examination of the injured elbow.
The doctor will try to understand the exact location of the pain and what types of elbow movements make it worse.
The doctor will also likely request an imaging scan . These will help the doctor see if there are any bone fractures. They can also reveal the extent of soft tissue damage.
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How To Treat A Hyperextended Elbow
Treatment of hyperextended elbow is usually conservative. Rest to the affected elbow and ice fomentation is first line of treatment.
- Give rest to your elbow by giving it support with a brace or a strap. Usually you have to give rest your elbow for many days. It encourages healing process of the damaged structures of elbow.
- Ice fomentation for first few days will help to reduce swelling. Crush few ice cubes in a towel and place it over the elbow. Keep it for few minutes and repeat it few times in a day.
- Use a compression bandage to maintain stability and strength of elbow. However, avoid wrapping it too tight as it may affect blood circulation.
- Painkiller and anti-inflammatory medicines will help to alleviate pain and swelling.
After one or two weeks of rest your doctor will recommend you for physical therapy. It is necessary for two reasons, to restore full movement and strengthen the elbow joint. However, even during the period of physiotherapy, you should wear elbow support.
There are several exercises which may be recommended by your physiotherapist that can be done at home. Wrist flexion, wrist extension, biceps and triceps contractions are some of them which will help to gradually increase strength of elbow joint and increase the movement.
When To See A Doctor
When the actual hyperextension injury occurs you might hear a popping sound that is followed by instant pain. Take steps to immobilize your elbow and apply the RICE method. However, that may not be enough. You should see a doctor if you also have any of the following symptoms:
- Elbow deformity
- Loss of strength in your hand or arm
- Numbness or tingling
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Therapeutic Exercises For Any Hyperextended Elbow
Video taken from the channel: Logan Spiers
Watch how to treat an armbar/hyperextension injury of the elbow..Dr. Jagoda is a Sports Chiropractor located in San Diego, CA.www.sandiegospineandsport.com.
Video taken from the channel: San Diego Spine and Sports Wellness
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Conservative Treatment Of Mild Or Moderate Elbow Hyperextensions
The doctor may determine that the elbow hyperextension is a mild or moderate injury with no bone fractures. If so, he or she may suggest the following:
- Rest the elbow by using it as little as possible. In particular, avoid elbow flexion or extension movements. Certain types of elbow brace can help to immobilize the elbow. An arm sling can also play a useful role in immobilizing the arm and elbow
- Apply ice or a cold compress to the elbow for periods of about 20 minutes at a time. Do this at intervals of 2-3 hours. This will help to reduce pain and swelling. Use a towel or other insulating material to avoid direct contact between the skin and the ice or compress.
- To further reduce swelling, the doctor may suggest using a non steroidal anti inflammatory drug such as Ibuprofen
- Apply compression to the elbow using an elastic bandage or an elbow compression sleeve. This will help to promote blood flow through the elbow, which will aid healing.
- Elevate the elbow above heart level as much as possible, and particularly when sitting or lying down. The purpose of this is to facilitate drainage of stale blood from the injured elbow and its replacement with fresh, oxygen rich blood.
- Once the patient is no longer feeling acute pain, he may be advised to commence a physical therapy program. This will help prepare the patient for a return to his or her regular daily routine. The program will include exercises to gently extend the elbow and gradually recover its normal range of motion.
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Recovery From Elbow Hyperextension
As your elbow starts to recovery, your doctor will probably recommend beginning to ease it back into normal activities. There are a number of physical therapy exercises available that can help you to rebuild strength and flexibility in your injured arm and it will become less and less necessary to wear a bandage or brace. Depending on the severity of your tendon damage, recovery may take anywhere from a few days to a few weeks to heal but it wont take you out of commission forever.
What You Need To Know
- The most common UCL injury is a UCL tear that is usually gradual but may also happen in a single traumatic event.
- Pain on the inner side of the elbow is the most common symptom of a UCL injury. A UCL tear may sometimes feel like a pop after throwing followed by intense pain.
- UCL injuries are diagnosed by physical examination and a valgus stress test to assess instability of the elbow. An MRI scan or may also be taken.
- Treatment for UCL injuries ranges from rest and physical therapy to surgery, depending on the extent of the UCL tear and your health goals.
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Elbow Braces And Supports
Over-extension, or hyperextension as it is known in the medical world, is when a joint or band of connective tissue is pulled too far without the weeks and months of flexibility training it would take to achieve this reach. Many athletes understand hyperextension in reference to their hamstring, that cord along the back of your leg that pulls tight when you do lunges and press your heel down. However, the same kind of damage can be done to your elbow as well. When this happens, it is known as elbow hyperextension and no one enjoys the results.
When Does Elbow Hyperextension Occur
The exact cause of elbow hyperextension is not known, but there are several factors that contribute to its occurrence. One such factor is improper training techniques. Another contributing factor is overuse injuries like rotator cuff tears and herniated disks. Finally, excessive stress on the ligaments around the elbow can lead to hyperextension as well.
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What To Do If You Hyperextend An Elbow
Certain arm injuries are more likely to happen when we overwork ourselves. Whether it happens in the gym, while playing sports, or simply during an activity in our daily grind, we dont always pay the most attention to our body and how much we may be pushing it. The most frequent kinds of arm injuries that happen are sprains or pulled muscles, and one way that this can happen is by hyperextension. Should you hyperextend an elbow, youve likely pushed or bent the elbow joint beyond its normal range of motion. If you have this happen, you will likely feel an immediate shooting pain and maybe hear or feel a popping. Once its hyperextended, the joint will likely become swollen and youll experience a lack of elbow joint mobility over several weeks. Medical assistance should be sought out if you experience a severe or painful hyperextended elbow, but here are some things you can do immediately and what you might consider to help your elbow recover.
Ucl Tears From Overuse
The UCL can be injured in several ways. Most commonly, there is a gradual onset of elbow pain due to repetitive stresses on the ligament. This is especially common in athletes who play sports that require overhead arm use or throwing.
UCL Injuries in Children
Children, particularly baseball pitchers under age 15, may develop UCL tears from repeated stress. It is important to remember that pain when throwing is not normal for young children. It should be addressed immediately to prevent further injury.
A UCL tear shouldnt be confused with Little League elbow another overuse injury common in young baseball players. This is an injury to the growth plates on the ends of the bones forming the elbow joint.
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