Dislocated Elbow

Hobo Greg wrote:Wow that's a fast recovery. I was in a cast for two weeks and upon removal I couldn't do anything more than just survive. Couldn't even roll my own joints at first. I'm 100% fine after a few months but I think 5 hours between injury and relocation is what made the healing take so long.

Man, 5 hours is a long time. Yeah, I think there's definitely a correlation between how long it stays dislocated, how long it stays immobilized after, and how fast ROM is recovered. I didn't wait on an ambulance; the friend I was climbing with hauled my ass straight to the ER. I was there within 15-20 min of the injury, and they did the reduction probably no more than an hour later, so mine stayed dislocated maybe an hour and a half, tops.

Krista Noland wrote: Man, 5 hours is a long time. Yeah, I think there's definitely a correlation between how long it stays dislocated, how long it stays immobilized after, and how fast ROM is recovered.

I am so glad they realized you don't just immobilize the elbow for weeks like a bone injury (which does not have to ever move), like back in the day. Those people never regained their full ROM. I've also seen articles where people didn't reduce their elbow for 2 days (like in rural areas... how could they stand it?!) and they get much worse problems. I think the standard is to keep it immobilized for 10-14 days. I got my cast off 5 days after the incident only because the doctor had a cancelation. I wouldn't have been able to stand it for much longer because it was itchy.

Really interesting to see all these X-rays and look at the differences in everyone's bones!

From the OP's recent ticks:

> Romulan Freebird 5.12c - Oct 12 - Shoulde dislocation/subluxation on redpoint of first pitch. Trip probably over. :(

...That's some bad luck. Let's hope recovery goes smoothly again.

Ryan Nevius wrote:From the OP's recent ticks: > Romulan Freebird 5.12c - Oct 12 - Shoulde dislocation/subluxation on redpoint of first pitch. Trip probably over. :( ...That's some bad luck. Let's hope recovery goes smoothly again.

That sucks for the OP. Unlike elbow dislocations, shoulder dislocations can become recurrent due to the ball/socket bone shape instead of the hinge shape. Luckily, he wrote it's a "sublux" which means it wasn't a full dislocation. Nevertheless, here's to a speedy recovery!

El Gato wrote:I'll spare the gruesome details of my injury. I reduced the dislocation myself. No one around to help and given my position and circumstances it needed to happen sooner than later. Later on (8 hours) I got an X-ray to confirm there were no fractures of the distal radial head or other. I immobilized it the best I could but what I DIDN'T do is immobilize it for more than 4 days. I started yard work as I could tolerate, passive ROM flexion/extension as tolerated. Ice and stretching. I'm within 5 deg of complete ROM previous to the injury. I have an MRI next week (I'm now 17 months post) to see what damage might be there. 2 things possible: LCL tear existed and still torn (even with 5 deg and been climbing ) or there is quite a bit of scar tissue in the joint capsule requiring some scraping. LCL means surgery and 6 months rest cleaning the scar tissue is laparoscopic and need to move the joint immediately after the procedure.

You are soooooooo brave.
Why are you finally getting the MRI now, does it feel bad? Within 5 degree of complete ROM seems really good compared to some other stories I've read.
Surgery is always an option, at least. ACL injuries always require surgery.
Keep us updated, you deserve a perfectly healed arm.

I fell while bouldering alone at the gym (not doing that ever again) 4 months ago. At first they told me I wouldn't be able to climb for 5-6 months, which was devastating news for any climber. I started PT after 2 days, and spent an hour each night stretching it in a hot bath to regain my ROM for the first 2-3 weeks.

I regained full extension after about 2 months, and was able to start climbing at this time, which made me the happiest top-roper at the gym! Full flexion came at about 2.5 months, at which time I was lead-climbing easy things. I am now pretty much back to where I was before the injury, however I do notice that my injured arm fatigues faster. It is rarely painful though.

Bottom line: PT works! The first couple of months after a dislocation are critical to regaining full ROM. If you baby it too much scar tissue will set in, and you may never regain full ROM. This said, every injury is different and you may never regain full ROM even if you are a perfect student, but stretching it in hot water (buoyancy is your friend here) was very helpful for me.

I did not dislocate my elbow, but I'm pretty confident there's a partial tear in some ligament or tendon. Here's a post of the description which happend 6 days ago www.mountainproject.com/forum/topic/113140949/loud-pop-on-inside-of-elbow-medial-epicondyle#ForumMessage-113150926

In short, I heard a loud pop while on a finger crack, didn't feel immediate pain or instability, so finished the climb. After 5 min, the pain set in and now it hurts.

I'm interested in this thread because I'm assuming the soft tissue damage done in a dislocation is probably greater than what happened to me. I'm encouraged that most here have made a full recovery, but can any of you describe exactly which tendons or ligaments were damaged, the extent post-injury, and subsequent recovery?

Im not sure if your experiences will be too relevant to me since I don't know where the pop came from, but hopefully I'll know next week if I get an MRI. I'm super impatient with injuries and have been thru this cycle way too many times.not knowing what to expect makes it way worse.

Lisa, I read what you wrote, and without the shifting of the bone, your tear is likely a minor partial tear.  As such, it should heal with original tissue because there is still most of the ligament intact. I had a complete elbow dislocation, and the ligaments on the inside and outside (but not rotation) were completely ruptured.  This means my ligaments are no longer the original tissue when it "heals", but all scar tissue.  So your experience will be much better, but everyone is different.

It sounds like most people on this thread healed 100% to where they can't distinguish between which elbow was injured.  But I am a notoriously slow healer and I can feel a difference, over a year out.  It feels fatigued for no reason sometimes, and several times a day loudly pops when the bone surfaces get out of alignment and snap back.  It also sometimes feels out of alignment sometimes (sublux) and I have to stop the current motion, and backtrack.  The loud popping can happen randomly, but always with pushing motions, or fast motion- like quickly taking up slack when belaying.  If I try to do pushups or bench press, it feels unstable and pops.  Even when I windex a mirror and wipe hard, or write hard with a pen, it feels unstable and pops.  No more punching, and I'm apprehensive at mantles.  Static pushing (keep arm at same flex/extension) is fine, but dynamic pushing (increasing extension of arm) is unstable. Most people other than me heal fine, but I am an unnaturally poor healer. When I had tubes in my ear the hole in my eardrum never healed. I have scars from childhood bee stings and chickenpox.

On the other hand, pulling motions are just fine.  I can climb and hang on my arm due to the bone supporting much of thr weight in that direction.  Just no "iron cross" suspensions.  The arm does feel weaker, often fatigued, but for daily activities it's no problem.  It's not worth it to risk surgery to be able to do push ups, but I am concerned about arthritis with the loud poppings, which is the sound of the bone surfaces hitting each other.  

My range of motion is a couple degrees off.   I have the same extension as my left arm, but the flexion, I'm missing about 3 degrees compared to my left arm.  It's still within "normal" range as I had more flexion than most people before, and have stretchy ligaments.

I'm thinking you will fully heal with no issues, from what it sounds like.

Here's the story of my elbow dislocation.  I fell about 10-12 ft from the finish hold on an indoor boulder problem.  The last move was a balancy match on a slopey, crimp.  I basically went for the crappy hold and slipped off falling at a 45 degree angle on my outstretched right arm,... stupid mistake.  Fast forward now I am 6.5 wks into recovery.  I had a splint on for one week and started PT that wk (forearm flexion/extension, finger extension and grip strengthening exercises).  I did not have any significant pain after the elbow was reduced in the ER.  I only had x-rays before and after reduction and after splint removal, no MRI.  The inside of my elbow where most of the damage is, still feels weak and it is lumpy with indentations.  I saw the doctor yesterday and he said the that ligament is still healing.  The back of my elbow pops when doing pressing exercises, which the MD said is probably due to injury to the tendon from the tricep to the elbow.  He said 6-7 wks for full healing and 2-3 mths to reach pre-injury status.  Just hope everything is healing normally.  I focused on ROM the first 2 wks after the splint was removed and I have been weight training for 3.5 wks now.  The MD and PT said the best way to strengthen joints is by keeping supporting muscles strong.  I also bought a joint supplement with MSM, chondroitin, glucosamine (1750 mg), turmeric (for inflammation) and collagen, plus I starting taking fish oil and a MV to promote healing.  Is anyone else terrified of balancy or dynamic boulder moves now?  I love bouldering, but I am really scared to get back into it.  I've read that ankle injuries are pretty common in bouldering and I'm surprised I hurt my elbow instead.  Anyone else hesitant to get back to bouldering?  Also, how long before you can hang and do pull ups with the affected elbow?

Hey I was wondering if anyone here had to get immediate surgery for their damaged ligament after the elbow dislocation and whats their recovery like now! So great though to see  so much recovery and progress and CLIMBING post-injury!!!

Callum,
That Pain sucks and your experience reminded me of my dislocated ankle. The pain was unbearable and i couldnt even move due to pain..It will take some time to recover but stretching exercises will definitely help you along with treatment. Try to wear sling support as it will reduce your pain..Wishing you a better recovery.

Cheers

This thread is hysterical in how accurately it describes what happened to me as well (indoor bouldering fall from around 14 ft, headfirst fall, transcendently painful dislo, etc.). Bouldering, man. On plastic. Feel like a doofus but super stoked it wasn’t worse.

Also, for future sufferers: just wanted to note that
Lynn Hill’s nasty fall in France caused (among other injuries) an elbow dislocation. She went on to free the Nose, so I’m assuming that if we can’t haul ourselves up ye olde home crag someday, it won’t be because of our elbows. Optimism.

Yeah, I opted for the stretcher too... after trying to put the joint back in place myself. Negative. Was going into shock when the emts got there... not recommended. Seriously the worst pain I’ve ever experienced. I’m not usually quite that much of a wuss but this was intense.

Thanks for everyone's posts thus far, they have been helpful in my own recovery process. I want to echo the benefits of early ROM, assuming you had a simple dislocation (i.e. didnt have multiple fractures or a terrible triad to cause instability). I have read through some articles on pubmed. The basic gist is that elbow dislocations in the past were treated with prolonged immobilization. We're talking 2-3 or even 4 weeks in a cast at 90 degree angle, the studies out there found that early mobility after 1 week of casting/splinting had better short and long term outcomes. One study even looked at splinting only 3 days, short term outcomes vs 1 week splint about the same but both better than prolonged splinting. Also it appears surgical repair of ligaments in the past offered no benefit. I've done a lot of reading on forums from different countries and its interesting to see some people still being placed in prolonged splints of close to 1 month. If you look at the elbow joint it looks to be a fairly stable joint anterior posterior, much more so than a shoulder which has a lot more axis of rotation. As long as you're not applying any lateral or medial stress to the joint, It be very hard to dislocate on your own without another traumatic fall. 

I dislocated my right elbow and sustained a nondisplaced radial head fracture from falling 10-15 ft onto an indoor mat while bouldering. 8/29/18. I live in a major city and was able to have it reduced in one hours time at the local trauma center.

Day 0: I was placed in a splint at 90 degree angle and sling. That same evening, I began working on flexing and extending my fingers, as well as maintaining mobility of my right shoulder. Keep in mind, there will be minor discomfort with this as your flexors and extensors insert right beyond the elbow. I also worked through flexion and extension of the wrist. Supination and pronation caused pain so I held off on that

Day 1: My hand function was much improved this day. I still couldnt lift my forward as I felt pain and tension where the biceps insert onto the forearm. At night, I took off my splint and rested my arm in a flexed position on a pillow. I started working on pronation, supination still caused pain. I was able to slowly without much discomfort extend the arm to about 150 degrees, flexion past night was more difficult.

Day 2: I had my splint off for the entire day, only used when I went for a short walk or at night when sleeping. Otherwise, I used warm soaks on my arm and proceeded to extend my arm to about 170. flexion maybe to 80 or so.

Day 3: Much of the same, sitting on the couch, splint off, elevation, warm soaks, continued passive extension and flexion.

Day 4: I started walking around mostly in a flexed position allowing my bicep to engage and hold the forearm, I also started to reach for things when doing my daily activities to at least simulate the motion, my left arm still did all the lifting and work.

Day 5: Much of the same as day 4, just improved range, less swelling and less discomfort. I noticed by this day that my grip strength was probably 80% of my baseline. My hand mobility was otherwise at baseline. 

Day 6: Started using my hangboard just to load my fingers and allow my elbow to stretch to near straight, I obviously stayed on my feet, and leaned back a bit just to provide enough weight to genlty load the fingers. At this point, I was about 5 degrees from full 180. I also started pushing my arm into the door frame while flexed to get it to around 45 degrees of flexion.

Day 7: Saw the orthopedist, admitted to him I had the splint off at day 2 and was performing early ROM. He seemed to like the progress. He gave me no restrictions moving forward aside from the obvious climbing and pushups. At this point I could walk with my arm in a natural nearly straight position. He didnt even think I needed a transitional brace or PT.

Day 8, Today, much of the same as days 6-7 with less stiffness, Started experimenting with 2.5- 5 lb weights without pain.

Keep in mind, every injury is different, some people may progress slower or faster. The point of this post is to suggest that early ROM may be beneficial if you dont have a complex dislocation (mine is technically complex given the radial head fracture). Every day that your arm is in a splint, multiply several days of rehab to recover that ROM and strength. Play it by ear, dont overdo it, Pain is a great clue to stop, I didnt take anything other than a few motrin just to reduce the swelling (but also note motrin/ Ibuprofen/ NSAID may reduce bone/ ligament healing). Consult with your doctors as well. Good luck to everyone.

I started this thread back in 2012, for anyone who is interested I have recovered fully and have had 0 loss of ROM, 0 pain and 0 effect on my climbing.  I think early ROM exercises are key.  

Echoing the early ROM sentiment. I'm five months out, and I'm about (actually slightly beyond) where I was before, strength-wise.

I had a full dislocation with minor bone trauma in April. The orthopedist said it would be about a year before I could do anything as well as I was doing it before. I listened to her recommendations because I liked her a great deal, and then I proceeded to do what I felt I needed to, which was quite different than the weeks of immobilization prescribed. I also began to move and/or isolate my fingers, wrist, forearm, and upper arm the same evening of the injury, even while the elbow was immobilized, and basically proceeded with baby steps from there.

I paid attention to what the elbow wanted and did what I felt it needed to do re immobilization and movement (for me, this meant keeping soft cast on for about a day before removing it and very very gently starting to work small ROM, then putting cast back on... this was radically painful... then more doses of motion, then soaking, then after a couple weeks started going castless at times, then more... etc.). I could actually feel what was the right thing to do at what time, and that intuition was right on. Started lifting light weights early on, maybe a week or two in, every few days. Took it much easier than usual. Read a lot of books, took care of a lot of business. i usually heal super fast, but there was no way I was doing anything serious with my arm for at least a month. Pushing it by rehabbing it, doing daily stuff, and regaining ROM hurt like hell, BUT was definitely the right thing to do. Went to PT. Really helped (mostly the massage and putty exercises, the putty is great), though they kicked me out when I told them the elbow felt stiff while doing handstands, ha.

I learned I could feel what was "good" pain and what was too much. Did not overdo (except a few times :0 ). Did ice & hot water baths after those workouts. Did lots of yoga -- weight bearing hurt worst of all but really helped build strength, plus different poses helped both extension & flexion (yow). Eased back into my lifting routine and that was very helpful. Orthopedist indicated that she did not wish to know exactly what I was doing but was very impressed with my progress and said to continue doing whatever I was doing.

A great diet with plenty of protein, iron, and all the other goods was also a huge advantage.

From reading this thread, I get the feeling that there are definitely different degrees and types of this injury, even apart from the bone trauma issue. I think my dislocation was probably one of the nastier variety (although thankfully not bone-wise), but lots of recovery attention and early efforts at increasing ROM, however small and/or painful, seem to have paid off. I suspect this is due mostly to neurological effect, so even a little bit seemed to go a long way. The benefit of exploring early ROM seems to be especially applicable to this injury, since the bone structure of the joint is in fact quite stable when correctly aligned, as other posters have noted.

Cheers ~
Elizabeth

I brought upon myself a total radial head fracture of my right arm (I'm right handed) mountain biking in Moab in 2016. My elbow was very dislocated for about 8 hours limping my way to the ER and was reduced under anesthesia. Two surgical procedures with very well qualified care providers at TOSH orthopaedic in Salt Lake City, I have very limited ROM (supination, pronation, extension) and feeling in my right arm. And a lot of pain. I went through all of the recommended post-surgical rehab in a motivated way. Not an injury I'd wish on anyone and life changing for an active person. On the upside, there is life after climbing and best wishes in your recovery. 

Hi guys I dislocated my elbow the end of july I was in cast for three weeks.  It's been 8 weeks sinc I've been out of my cast.  I can bend my elbow about 130 degrees toward my chin but my arm will not fully extend.     I'm worried if it ever will again. My PT said it may not ever fully extend and the longer it takes it wont. My arm still isnt straight n has a curve to it. I can function n move it but it crooked per say.  My doctor said some ppl it takes up to year. To fully extend 

Amber Godfrey wrote: Hi guys I dislocated my elbow the end of july I was in cast for three weeks.  It's been 8 weeks sinc I've been out of my cast.  I can bend my elbow about 130 degrees toward my chin but my arm will not fully extend.     I'm worried if it ever will again. My PT said it may not ever fully extend and the longer it takes it wont. My arm still isnt straight n has a curve to it. I can function n move it but it crooked per say.  My doctor said some ppl it takes up to year. To fully extend 

Hey Amber - I had a similar situation after my injury. My PT said it was normal, and yes, they also warned me that it would never be the same, etc., but I kept working and stretching and I gained almost all extension back. It was effort and it hurt at the time, but it felt like the right thing to do and it worked for me. I'm a little over 6 months out and missing about only five degrees of extension, which I think will return, because it worked the same way for the entire range. Yoga was super helpful, weights too. And hanging. Good luck!!

Elizabeth

No I didnt break a bone 

This thread has been super encouraging over the last day or so. Monday (this is day 3) I fell bouldering indoors and dislocated my right elbow. After a looooong time in the ER and an MRI, I was referred to an orthopedic surgeon. He is a sports medicine specialist with an extra focus in elbow injuries - yay - but he seems to be taking my injury way more seriously than it feels. He recommends full reconstructive surgery ASAP and I just don't understand why that is necessary, particularly after reading so many of your stories here.

No broken bones, rupture of the UCL, LUCL, radial collateral and common flexor, some muscle tearing, and common extensor tendon high-grade partial tear with epicondyles stripped - sounds like a lot, but I am in NO PAIN. I have full range of motion in my hand and wrist and can open jars, lift things, write, etc. I'm definitely seeking a second opinion, but dang I would really like to not have to have surgery and just go back about my business in 6 weeks like so many of you guys have done.

Advice? Insights? Can you recover from these things without having to get cut open?