Soft Tissue Injury: Elbow

  • Reference Number: HEY-239/2016
  • Departments: Orthopaedics

Introduction

This leaflet has been produced to give you general information about your injury.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion.  If after reading it, you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

What is a soft tissue injury?

The term soft tissue refers to muscles, ligaments and tendons that surround and support our joints. Injuries to the soft tissue around the elbow can be caused by a fall onto an outstretched hand, overuse or direct impact.

What are the symptoms?

A soft tissue injury to the elbow may result in the following:

  • Pain.
  • Heat, redness or bruising.
  • Stiffness and loss of function.

What if I need pain relief?

To manage your pain, it is advised that you regularly take simple pain relief which can be bought over the counter from your pharmacist. If you have allergies or conditions which prevent the use of pain relieving or anti-inflammatory medication, please seek advice from your General Practitioner (GP) or a pharmacist.

What should I do in the first 72 hours after the injury?

The most important initial treatment is aimed at controlling the pain and swelling by following the principles of RICE:

R – Rest

Complete rest is not advisable but it is important that you prevent putting the elbow under strain in the early stages of healing.

Ensure you continue to move the shoulder, wrist and fingers as normal, as it is common to become stiff in these areas quickly.

You may be given a sling but this should be discarded as soon as the pain is under control, this is usually within 72 hours.

I – Ice

There are many different ways in which ice can be applied. Whichever method you choose, it is important that you wrap the ice in a damp towel in order to prevent ‘burning’ the skin. Ice should be applied for 20 to 30 minutes every two hours.

Please note:

Only use an ice pack on areas that have normal skin sensation i.e. where you can feel hot and cold.
Do not apply over an open wound.
Do not apply an ice pack to an area that has poor circulation.
During ice application check the skin every five minutes and discontinue its use if:

  • the area becomes white, blue or blotchy.
  • the area becomes excessively painful, numb or tingles.

C – Compression

If you have been given a tubigrip to wear it is important this is removed if you develop any signs of poor circulation, pins and needles or numbness. In addition it should be removed when you go to sleep.

E – Elevation

If you have swelling in your elbow, wrist or hand sit on a chair and place your elbow on cushions so that it is level or slightly higher than your shoulder. In this position point your hand towards the ceiling and open and close your hand as this will help to reduce any swelling further.

What not to do

Consuming alcohol, massaging the injured area and applying heat can all be detrimental in the early stages of healing and therefore should be avoided.

Rehabilitation and recovery

If you follow this basic advice, your injury should take around six weeks to heal. However, everyone recovers from injuries at different rates and it is dependent on the severity of the injury and the presence of any other medical problems. It is possible that you may be back to normal in two weeks. However, it is also possible you may suffer symptoms for up to three months.

After 72 hours it is very important you try to start using your elbow normally again when doing everyday tasks like washing and dressing. The exercises below will help you to regain full function, flexibility and strength. You should try to practice these 10 times, 3 to 4 times every day:

1. Bend your elbow up towards you as far as possible.

Rehabilitation and recovery - 1A Feel it stretching and hold this for 10 seconds.

Now straighten it out as far as you are able, but do not force.

Feel the stretch and hold for 10 seconds.

2. Bend your elbow and tuck it into your side.

Rehabilitation and recovery - 2A Turn your palm as far as possible upwards without moving your elbow. Feel the stretch and hold for 10 seconds.

Now turn your hand back over again, feel the stretch and hold for 10 seconds.

You may find that your wrist and shoulder joints feel stiff too. Doing the exercises below will help to improve this:

1. Rest your forearm on a table with your hand over the edge.

Rehabilitation and recovery - 1B Using your wrist only move your hand down towards the floor and then up towards the ceiling.

Hold the stretch 10 seconds in each direction. Repeat 10 times.

2. In standing, sitting or lying hold a stick with both hands at shoulder width apart.

Rehabilitation and recovery - 2B Use the uninjured arm to assist the injured arm to lift out in front of you as high as possible.

Hold at highest point for 10 seconds and repeat 10 times.

You may experience more discomfort when you start the exercises. However, this is normal and does not mean you should stop. If your symptoms remain worse for more than 2 hours after the exercises then you should decrease the number of each exercise that you do and build up again slowly.

Repetitive elbow movements and lifting objects heavier than a tea cup should be avoided to begin with. As your movement improves and pain reduces, little by little you can increase the amount of weight that you are able to lift; this should be done sensibly. Progressing from lifting a tea cup to a heavy shopping bag for example would not be advisable as it is likely to result in overloading of the soft tissue and could consequently lead to a further injury.

When can I return to normal activities?

If you participate in an active hobby then it is advised that you do not return to this until you have full strength, full range of movement and you can use your elbow normally without experiencing pain or swelling.

If you play a sport, practice specific activities like throwing a ball to prepare the elbow. Build these activities up gradually before returning to full training sessions and competition.

When to seek further help

You may be offered a referral to physiotherapy following this type of injury, unless your symptoms are minimal on your initial appointment.

If 10 days following your injury you are still in considerable pain and severely restricted with your movement, despite following the advice above, please contact your physiotherapist.

If you were not referred to physiotherapy or have not started your physiotherapy treatment at this stage, please contact the physiotherapy team on telephone number (01482) 608939. If there is no answer, please leave a message, clearly stating your full name, address and telephone number and we will get back to you as soon as possible.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

Information about you

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We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

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