About Stiff Elbow
Stiffness in elbow is very common and it can affect day to day activity drastically. It can affect normal movements such as bending and straightening the arms and also wrist movements(1, 2). If left untreated, the condition of elbow stiffness can worsen and can lead to serious complications. It is advised to consult an experienced physician or a physical therapist once the symptoms of stiff elbow is experienced. Elbow stiffness can be a result of a trauma or injury to the elbow or it can be a manifestation of an underlying medical condition.
Causes of Stiff Elbow
Stiff elbow can be due to multiple reasons. The most common reason is trauma or injury to the elbow joints which can lead to tightness in muscles and formation of scar tissue while healing. Excess of scar tissue can cause the surrounding tissues to tighten and stiffen causing elbow stiffness. In some cases, there may be growth of a bony structure into the muscles. This abnormal bone formation is called as heterotopic bone formation(3).
Management of stiff elbow depends on the underlying cause of it. Exercise can worsen the condition in some cases and thus should be done only after consulting an expert. Other treatment plan includes anti-inflammatory medication. In some cases, using radiation may be considered.
3 Useful Exercises for Stiff Elbow
Exercises are usually recommended to improve the range of motion in elbows. A slight pulling sensation can be felt, however, if the exercise feels too uncomfortable and painful, it is advised to stop the exercise immediately. It is also advised to consult a doctor if there is no improvement in range of motion of the elbow joint with exercise.
The most common exercise recommended with stiff elbow are listed below:
1. Active Assisted ROM Elbow Exercises for Stiff Elbow
In this exercise the opposite hand is used to activate the affected hand. This exercise for stiff elbow helps in improving the range of motion. It is advised to do 8 to 10 sets of repeats at least 4 times a day(4).
Step 1 – Active Assisted Flexion
- Sit straight with elbows by the side
- Keep you palms up and bend your elbow as far as you can
- Take your opposite hand and place it at the back of your forearm
- With a gentle push with hands bend your elbow further
Step 2 – Active Assisted Extension
- With arms rested on the table sit straight. A towel maybe placed under the elbow for extra comfort.
- Stretch and straighten elbow as far as possible
- Use opposite hand to gently push the arm forward and downwards towards table. This will help in increasing the stretch.
Step 3 – Active Assisted Supination
- Bend your elbow to about 90 degrees.
- While keeping arms close to the side rotate forearm into a palm up position.
- With your opposite hand grasp the forearm just below the wrist
- Apply gentle pressure with palm up position
Step 4 – Active Assisted Pronation
- Bend your elbow to about 90 degrees.
- Rotate the wrist into a palm down position with arms against the sides.
- Hold your forearms just below the wrist with the opposite hand
- Rotate forearm into palm down position.
It is advised to hold each stretch for about 20 to 30 seconds.
2. Active Elbow Range of Motion Exercise for Stiff Elbow
This exercise helps in strengthening the muscles around the elbow. It is advised to perform 10 sets of repeats holding each position for about 5 seconds at least 3 times a day(5).
Step 1 – Flexion of elbow
- Begin the exercise by sitting up straight with arms by the side.
- Bend your elbow to farthest possible position with thump facing towards the ceiling.
- Return back to neutral position.
- Repeat the step with palm facing down and then palm facing up.
Step 2 – Extension of elbow
- Stand straight up with arms by the side
- Stretch elbow as far as possible
- Return back to neutral and repeat 10 times
Step 3 – Supination or Pronation of Forearms
- Sit up straight with elbows by the side bent to about 90 degrees. Make sure that the thumb is pointed upward.
- It is important to keep elbows tight by the side throughout the exercise.
- Rotate forearm into palm up position.
- Repeat the same in palm down position.
3. Advanced Elbow Exercises for Stiff Elbow
This is a rather aggressive stretching exercise technique. It is advised to perform this exercise if only advised by a doctor.
Step 1 – Table Flexion
- Start by standing straight up facing a table
- While keeping arms close to the body rest the forearms on the surface of the table
- Stretch your arms into a bent position by leaning your upper body over the elbow
- Hold the position for at least 10 seconds before returning to neutral position. Repeat 3 times.
Step 2 – Wall Flexion
- Start by facing a wall and place forearms flat against the wall
- Increase the bend in elbow by slowly sliding the elbow down the wall
- Hold for 10 seconds just when you start to feel stretch in arms and then stop.
- Repeat 3 times.
Step 3 – Supine Elbow Extension
- Lie flat on your back with arms on the side
- A folded towel may be placed under the upper arm
- Hold a small object of 5 pound or less in the palm
- Relax elbow so that that the weight allows the elbow to stretch straight
Hold for 30 seconds initially and increase as the body gets used to the exercise.
Conclusion
Stiffness in elbow is very common and it can occur due to injury or trauma to the elbow joints. It can affect the normal range of motion and can affect functional movements of daily living. There are few specific exercises designed to combat elbow stiffness. However, it is important to consult a doctor or physiotherapist before starting these exercises, as there is a risk of worsening the condition rather than improving stiff elbow.
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