Managing elbow dislocations in sports

A dislocated elbow is a condition characterised by damage and tearing of the connective tissue surrounding the elbow joint with subsequent displacement of the bones forming the joint so they are no longer situated next to each other. This is one of the most serious elbow injuries amongst sports persons.

During certain movements of the elbow, stretching forces are applied to the elbow joint. When these forces are excessive and beyond what the elbow can withstand, tearing of the connective tissue may occur. This may allow the bones forming the elbow joint to move out of their normal position if the forces involved are too great and beyond what the connective tissue and supporting muscles can withstand.

This may occur following a direct impact (e.g. during contact sports) or more commonly, due to a fall onto the outstretched hand or arm (especially from a height and onto a hard surface).Athletes with a dislocated elbow usually experience sudden severe pain at the time of injury. The pain is usually so intense that the patient cannot continue activity and may cradle the arm against the body in attempt to protect the elbow. Pain is usually felt in the elbow region, however can occasionally radiate into the arm, forearm, hand or fingers.

Those with this condition will often experience a sensation of the elbow ‘moving out’ at the time of injury. Swelling and a visible deformity of the elbow may be detected when compared to the other side along with bruising which may become more visible over time. Pain will usually increase on firmly touching the affected region of the elbow joint. Loss of elbow movement is usually experienced which may worsen over the coming days as swelling increases. Occasionally, one may experience pins and needles or numbness in the elbow, forearm, hand or fingers. An absence of pulses in the forearm, wrist or hand may be experienced in some cases involving damage to blood vessels and is considered an emergency, requiring the affected athlete to seek medical assistance immediately.

Once a dislocated elbow has been ‘relocated’ (i.e. the bones put back into their normal position), athletes may experience a feeling of weakness and stiffness in the elbow and an ache that may increase to a sharper pain with certain movements. Most of these symptoms generally resolve over time with appropriate rehabilitation. However due to the seriousness of this condition, those with a dislocated elbow may experience long term problems such as elbow stiffness, weakness.

The writer is a physiotherapist with KPL side Mathare United.

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