Q: I had a car-bike accident eight weeks ago (I was on the bike) and I still have some significant elbow pain and stiffness. I saw an orthopedic surgeon who recommended physiotherapy but what will the therapist do that I can't do myself?
A: Elbow stiffness after a traumatic injury is a common problem. Treatment is decided based on whether the stiffness is coming from inside or outside the joint and which specific structures are involved.
Treatment ranges from conservative (nonoperative) care to surgery. Various treatment options include physiotherapy, bracing, splinting, manipulation under anesthesia, and surgical release of the capsule. For patients who do not respond to any of these approaches, an elbow replacement may be advised.
Before treatment begins, imaging with X-rays and CT scans must be done. Imaging shows any fractures, loose fragments of bone or cartilage, or infection. If nothing shows up, loss of motion could be caused by the patient's apprehension and muscle tension more than a true mechanical problem. It may be necessary to examine the patient under anesthesia to find the true cause of loss of elbow motion.
When physiotherapy is advised, the therapist may apply a number of different approaches. Ultrasound, electrical stimulation, laser therapy, and soft tissue mobilization are some of the techniques used. If appropriate, ther therapist may make a splint for you to help increase and maintain elbow motion. Most of these types of treatment can't be done by yourself.
You will probably be given stretching and strengthening exercises to do on your own at home. If you don't regain full, painfree motion after two to four months of active therapy (including your daily home program), there are some surgical options that might be recommended. Your surgeon and the physiotherapist will both help guide you through this process.
Reference: Charalambos P. Charalambous, BSc, MBCHB, MSc, MD, FRCS (Tr&Ortho), and Bernard F. Morrey, MD. Current Concepts Review: Posttraumatic Elbow Stiffness. In The Journal of Bone and Joint Surgery. August 1, 2012. Vol. 94A. No. 15. Pp. 1428-1437.
COMPHYSIO provides services for physiotherapy in Barrie.
