Dislocated Elbow

So halfway through my glorious onsight attempt of the red 4+ on the beach wall at the spot I swung on the sick sideways dyno move and fell onto my right arm pretty severely dislocating my elbow. Can anyone give me some better beta for that move?... just kidding, has anyone had any experience with a dislocated elbow? Specifically:

How long before you felt like you were fully recovered?
Did you fully recover?
Who did you go see and what did they say? (especially in the front range area)
What kind of PT did you have to do?
How much tendon and ligament did you sustain?
Is my climbing carrer over?
Any other advice?

Any advice at all is much appreciated. I am trying to collect as much info as possible before I see a specialist and stories from climbers are very valuable.

-Patrick

Sorry Man. That sucks.

No beta for you on the bouldering, but... Dr. David Schneider at Cornerstone Orthopaedics in Louisville is great for elbows.

I did not fully dislocate my elbow, but subluxed it with a radial head fracture, torn ulnar collateral ligament and ulnar nerve damage. I was out of commission after the original accident for about 7 months. Lived with it for years until it got really unstable feeling, then Dr. Schneider fixed it and it is better than my other elbow.

It is worth a consult to see how much soft tissue damage you did at any rate.

Good luck!

Toe hook on the blue undercling. I've been watching people take crazy face plant falls on that one since it went up. Sorry you got hurt. I hope it heals up quick.

I dislocated my elbow around 8 years ago very severely.. I was in a splint and sling for 3 months then free to do whatever I could after that. It was at least 6 months till I had 90% of my range back and felt comfortable enough to try anything with it. Today I have 95% of my range I use to have and don't even notice it. Key thing is to not rush it and be sure to slowly stretch it out to get your range back. Sorry to hear you got hurt though!

What it is with these Vernons and their elbow problems?!

I dislocated my elbow skateboarding a while ago, before I started climbing. It was full on, bone completely out of socket gnarly. Lots of swelling and pain. I did the PT and started taking glucosamine every day. They told me it would never be the same again, but I think they always say that just in case. I healed completely. No problems anymore, but it took a few years. If I overdid anything, it would let me know. Be patient with it, do the PT, stay hydrated, stay positive, and never underestimate the body's ability to heal itself. I recommend doing some kind of glucosamine/MSM/condroitin supplement and acupuncture. You will climb again if you take it easy now and don't re-injure it. Good luck!

Thanks for all of the replies so far, sounds like I really need to take it easy for a while. Did any of you have much ligament damage? I am worried about permanent damage from torn ligaments but it sounds like if I play my cards right I can get back to normal or at least close to it. Damn the curse of the Vernon elbow.

-Patrick

Patrick, does your dislocated arm fully extend and flex now? I also completely dislocated my right elbow posterior&laterally bouldering, last Friday morning. I checked your ticks and looks like you are climbing hard now again but I'm 4'10 with a -negative APE span so need every centimeter of reach. Wondering if scar tissue works as good as regular ligament. Can't even bring delicious food to my mouth now, look ridiculous trying, but only 8 days in.

Erika, funny, I saw Dr David Schneider just this past Wednesday. Good to know he's good.

I dislocated my elbow bouldering in a gym on June 26, 2014. I fell from the top of an 18' 45˚ overhung bouldering wall and landed on the edge of a pad. That caused me to pitch forward and land on my outstretched right arm, dislocating my right elbow.

Getting transported to the hospital and having it relocated was horrible, but not the point of this post!

My dislocation, while severe, was not nearly as bad as it could have been because I am very flexible and quite loose in my ligaments to begin with.

I was put in a rigid splint for 10 days then I used a sling on and off for 3 weeks. I had a previously scheduled climbing trip in mid July, about 3 weeks after I dislocated my elbow, so when climbing was taken off the table, I chose to solo backpack for a few days instead. It was certainly a challenge at times, but wasn't too bad for me.

The only physical therapy that I did was to constantly extend and contract my elbow, pushing its range of motion. I never used weights, just using my muscles to push and hold at the two extremes. When I first came out of the splint I had less than 45˚ range of motion. By week 6 I could get it very close to horizontal.

I began climbing 7 weeks after the dislocation. I stayed off of overhangs for 2 or 3 weeks before beginning climbing on a 20˚ overhung wall quite consistently. I focussed on climbing statically and not hanging on my right arm fully extended.

A total of 11 or 12 weeks after dislocating my elbow I sent Ginseng Route at Shagg Crag on my second try, my first 5.12c. I'm still not quite sure how I came out of the injury still climbing strong, but I'm not complaining.

About six months later, I had reached the point where I wasn't constantly thinking about how I was loading my right arm. Before I dislocated my elbow, both of my elbows could extend a few degrees past horizontal, probably around 185˚. Nearly 2 years later, my right arm reaches horizontal, but only just. At this point I don't feel like my previously dislocated elbow impacts my climbing at all. All things considered, it was an extremely smooth recovery process.

Callum, thanks for your experience, recovery timeline, and recovery advice! Especially because you are such a high level climber compared to myself, climbing harder after. If the dislocation gets me to climb 5.12c out the gate we should all get our elbow dislocated. I had a lot of room to improve prior to the injury. I didn't hyperextend like you did but hoping to retain flexibility as it helps make up for my height and strength to weight ratio.

Yours went really far back posteriorly! Mine not quite as far back, but more laterally to the side than what I've seen. I noticed you, Patrick, and me all had fully dislocated elbows, but no fracture. They say the impact that causes a full dislocation is also great enough to cause bone fracture. I wonder if it is because indoor bouldering gyms have padding. I was also at the top, about 15 feet (so probably 12 feet to hand), was trying to get stronger with sets and laps and blew the finish hold. Think legs absorbed some impact, otherwise forearm would have launched out even further severing nerves and blood vessels.

I got the rigid splint off on Day 5 for a hinged brace and trying to extend and flex since, only a 45 degree range as you had, although it causes some tingling due to pinching nerves in swollen elbow. Glad to hear you recovered most of your range of motion. Heard early motion is good for retaining ROM. Wrist rotation is not possible at all and painful when attempted. I read so much about stiffness and inability to fully extend, but little literature about inability to rotate wrist. No hand strength, barely squeeze open a loose spring hair clip with focus.

Yep climbing trip off table, backpacking trip on table now.

Right hand has always been the star with left hand as support... now left hand does everything and more with no support hand. Wondering if this helps with climbing later.

Thanks again, feeling quite optimistic now!

Your post reminded me of some details that I didn't mention. I had some nerve issues along the inside of the arm just above the elbow. Even mild pressure would send tingling all the way down to my finger tips. It took quite a while to fade, probably 6 months until I stopped noticing it.

A few days after the dislocation, the most scary part for me was that I couldn't lift my arm at all. My dislocation caused part of either my bicep or bicep tendon to be badly pinched. This meant that I had absolutely no way to hold my arm up for the first week or so. I was worried that I had severely damaged my bicep. If I wasn't wearing my sling, I was forced to hold my forearm up with my left hand.

You mentioned having issues with your wrist. I didn't have any issues with mine at the time. While I was in a sling, I was still able to use my hand and wrist with full capacity. In the years since the accident, my wrist has been clicking a lot as I rotate it. Not painfully, but nearly continuously during rotation. It also can sometimes feel very painful while loading it at odd angles, like when meat hooking a large sloper.

EDIT: I also forgot to mention that when I landed on the edge of a pad and fell forward onto my arm, that arm impacted a 4" thick hard foam floor. I was told that this likely stopped my wrist from breaking from the impact. I was also told that while fractures are common with dislocated elbows, they're less common in this type of dislocation, where it is a sudden, clean impact. Fracture containing dislocations are more common in car accidents.

While some people may wonder why I'm not PM-ing you instead, all I have been doing this week is googling "Elbow dislocation recovery" and think this information may be helpful for someone who undergoes this experience down the road. Especially climber-specific information. Life functions are one thing but climbing is another level of arm and hand usage.

Additional details are very interesting. Did not know that about sudden impact avoiding fracture versus a force applied over a longer time, like a car accident. But it makes sense. Initially prided self on strong bones. Didn't think about wrist breakage and the pad preventing that either. Also makes sense.

As for your initial bicep issues versus my wrist issues, I guess everyone's fall is different and aftermath is somewhat different for each incident. But good to know not usual so if wrist doesn't resolve in 10 days will ask the doctor. Hoping for no later wrist issues, although you're highly functioning despite them. Slopers are a bitch.

That must have been scary about your torn bicep, probably thought your climbing career was over & time to find a new hobby. Before help arrived, I thought I would lose my arm. While my right arm can move under its own volition, it can be painful and is extremely slow moving. Thus I sometimes find it easer to just use my left hand to position my right hand where I want it to be.

I have to appreciate humans for figuring out how to reduce elbows, as the pain was excruciating before the reduction. Not like movies where people dislocate joints, put it back themselves, and go on fighting.

Hey Hobo Greg, glad to hear you're almost back to normal! I appreciate the good prognosis timeline. Never heard of the hoody pocket medical device but that's a clever idea. Sorry you embarassed yourself in front of everyone. If it makes you feel any better I just laid there, refused to get up even though someone remarked "there's nothing wrong with your legs" (I laugh every time i think of that). I even requested to be carried by stretcher after confirming there was no additional cost. Even though just soft tissue, I'm seeing a doctor because I'm a slow healer & don't want to risk arthritis or other complications.

Glad to hear you're healing up Greg! That was some scary stuff, still can't believe you made that roll left and didn't roll right off the ledge. Glad you're healing up quick. I did something to my right shoulder a couple weeks ago so I gotta let it heal up, but I bet we can still get on some slab at Whitehorse!

As far as the elbow dislocation goes, I had a friend back in high school who decided a dropping a bunch of acid before going out snowboarding was a fantastic idea. Needless to say, didn't work out so well. He hit a small kicker and fell and completely dislocated his left elbow. I don't remember how long the healing process took but I honestly don't remember him being in a sling very long at all. He did fully recover though.

Type 2 monteggia fracture checking in. That is a broken ulna and dislocated radius. I'm about 8 weeks post injury and not climbing yet. I've regained ROM to within 95%. Issues im currently having are popping/locking up/ feeling unstable/ painful while extending my arm. This doesn't happen all the time but only sometimes when i haven't extended my arm in a while or while extending it with an overhead arm position. It seems to be getting better with light weight strengthening.

I don't think this is a career/hobby ender for any of us. Some people lose limbs and continue to climb. I'll check back with an update as I make progress since I haven't found any information on climbing after this type of injury.

Just saw these recent replies while searching for another thread. For what it is worth it has been a while now and I can say that I have recovered completely. The recovery has gone so well that I often forget which elbow I dislocated when describing the injury. I read alot of horror stories on the internet about never gaining back full ROM. The key was one week of rest in a splint followed by fairly aggressive and early PT involving basic passive and active ROM exercises, the earlier you can tolerate it the better. It took about 3-4 months to get full ROM back and get back in shape. I don't even notice it now.

-Patrick

That is awesome Patrick! Thanks for the long-term prognosis. In many of the climbing injuries articles they talk about shoulders, finger pulleys, tendonitis, but not much about elbow dislocations - which I thought would be common among bouldering. Google makes it sound like the full recovery takes 2-3 weeks, which is not true.

I'm 9 weeks out and still not feeling ready to do pushups or other arm exercises, but I've always been a slow healer. Allison must be a super fast healer to feel ready to climb at 5-6 weeks out.

My doctor never referred me to Physical therapy but did recommend stretching. I almost have full range of motion despite forearm at a jaunty angle. Stiffness was a bigger problem than stability because they used to immobilize people for long periods, but for me, stability is slower coming. I can finally, at 9 weeks reach behind my back to fasten hooks without my elbow subluxing (push/pull of forearm and upper arm created a fulcrum at the elbow).

Not sure about bouldering anymore because a 2nd dislocation means surgery. From what I gathered, the UCL and other ligaments are completely ruptured in a full dislocation and do not grow back as a snapped rubber band cannot grow towards each other. What grows back is scar tissue, which is 15% weaker than the original tissue, but good enough to hold the elbow joint in place due to the inherently stable bone shape. With other joint ligaments, such as the ACL, scar tissue does not work, and surgery is required. Everyone knows a shoulder dislocation leads to recurrent dislocations. But a 2nd dislocation in the elbow means the scar tissue will tear, and when it grows back it will be bulkier, weaker, and also stiffer.

I hope Trevor is doing okay... he has a broken ulna on top of the dislocated radius.

Make sure you do some reabilitation excercise, like weight and stretching, it will help recover faster but may painfull.

Wow, you guys have no idea how thankful I am to have found this thread. Climbing is my life and I'm on day 6 after complete elbow dislocation, also the result of an indoor bouldering fail. So much for my first Potrero trip we had planned for Climbsgiving in a couple of weeks... Heartbreaking.

While I am incredibly relieved to hear that essentially everyone has regained full or nearly full ROM & returned to climbing without major setbacks, I'm suddenly very concerned that I'm on a freakishly atypical timeline, and wondering if I'm doing more harm than good by not allowing for a more typical rest & immobilization period.

Fell Monday night, had cast removed Wednesday (would've been Tuesday if I had been able to make an earlier appointment), and began doing PT on my own the day the cast came off. Orthopedic surgeon that removed cast told me to use a splint/brace/sling only when I felt like I needed it, and for the most part I haven't. Today is now Sunday so I'm currently on day 6 post-injury and am probably 20 degrees shy of full extension, regaining about 5 degrees per day, maybe a little less. Swelling is dropping pretty fast as well. As measured directly over the bend with arm outstretched, the circumference of my unaffected arm is ~8.5in; for the injured arm, I'm now at ~9.75in (day 6), down from 10.2in Thursday (day 3), and 11.5in Wednesday (day 2, after cast removal). Faint yellow bruising started to appear over the weekend, but it's barely visible in most llighting; not sure if that will continue darkening or if this is it.

No problem lifting light objects. Went running yesterday with the sling, and again today without it. Besides that, I pretty much only wear the sling while driving. It stiffens up pretty quickly, even after brief periods without movement, but loosens back up pretty quickly with light stretching. I have some numbness and tingling in my fingers periodically, but that has so far subsided quickly too with minimal effort (stretching, elevating). One aspect that really bothers me is what feels like nerve damage, a sharp pinching sensation, in the area where the bicep approaches the elbow. It doesn't happen often and it's not unbearable, but most worrisome because It could be indicative of long-term/permanent nerve damage, and there's no fixing that.

Anyway, just thought I may as well throw my experience up here as well, mostly because it was extremely helpful and informative to me to read specific accounts from fellow climbers, so perhaps mine might be useful to someone else. Also, I'm very curious to hear if anyone out there has had a recovery timeline more akin to mine, and if so, what that might mean for how soon I can get back to climbing. If I inadvertently race ahead through this rehab process and feel ready to climb again much, much sooner than is typical, might I be exponentially increasing my odds of subsequent injury? Is this warp speed timeline that I seem to be on just a weird fluke, or worse, maybe just an illusion of actual healing that could trick me into getting back on the wall much too soon? Has anyone out there experienced anything similar?

Either way, thanks again so much to everyone that has contributed to this thread. I ended up here as a result of a frantic Google frenzy, borderline panicked that if I'm still unable to straighten my arm after an entire week, maybe it's broken for good and I'll never be able to climb again. Ha... Thank you all so much for putting my mind at ease.

Climb on!

Hi Krista, that's really cool you have a video of your dislocation. I'd have to agree, you are a freakishly fast healer, but everyone's body is different, and everybody's fall/ligament damage is different. I'm on the other end of the spectrum where I am a sluggish healer - the scars from when they inserted the IV are still visible, the tubes I had put in my ear as a child healed so slowly, the hole never sealed up.

I also had some tingling in my arm, I believe it is due to the swelling compressing the nerves. As long as you can move your fingers, I believe there shouldn't be any nerve damage. But you might want to make sure no nerves are entrapped with the reduction.

Day 7 I couldn't squeeze open hair claws, so it's amazing you are lifting light objects. I was at 30/35 degrees to full extension and 100/110 degrees flex.

As for climbing, Alison was traversing at week 5 and felt like she could climb, but at week 5 I still did not feel ready. I don't think there is an illusion of healing or readiness, I think you can feel when you are ready, because no one wants to injure themselves.

Everybody heals at different speeds... but as sluggish as I am, I'm climbing again now 6 months later, and I'm at full extension and possibly full flex. I can still feel there is something different, and some climbing moves I hear a click, but mostly it's fine and the biggest issue is regaining strength and endurance from not climbing. Based on your timeline, you'll probably be back in a month or two.