Dislocated Elbow

Callahan W wrote: 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?

hey man, i ruptured my ucl with a posterior lateral elbow dislocation from a climbing fall in fall 2017

first off, i highly doubt you will be climbing in 6 weeks. i didnt get the OK for a few months. being that i only ruptured my UCL, its really hard for me to imagine my injury will apply to yours. but my orthopedist who i trust very much (and used to go climbing sometimes with his brother, who was a climber) heavily recommended me to NOT get the tommy john surgery, and just to be sure referred me to a specialist surgeon who said the same. to be honest, part of me still considers the surgery, full stability in my elbow has never quite returned. lock off moves on that arm, as well as slow static big moves still give me trouble, as well as i chicken wing much more prominently with that arm. im able to work around it and i feel as though it is still a work in progress, and possibly in the near future it will be 95% back to normal. but my orthopedist also told me there is risk of never climbing again and losing significant range of motion with the surgery.

all that being said, i still have climbed 5.13a sport, 5.12c trad, v7, and El Capitan within a year since my accident, so it might not be as bad as it sounds in reality. some spray here but im proud of my recovery journey :)

this all being said get a second opinion, find an orthopedist you TRUST and who understands you. the first guy i saw was a douche and so that night i went online and searched though all my approved doctors and found a guy who looked promising and he ended up helping me through my journey and i am grateful i found him and he understood my need to return to climbing as soon as possible.

feel free to message me if you need any more info or support.

Hi!!!

Just thought I would share my experience also, because why not. Simple dislocation of the left elbow on July 1st in a bouldering fall. I was in a soft cast for 7 days. Now it's only 9 days since the injury and I'm starting PT tomorrow (so excited!). Extension is wayyyy better than flexion, but both are not super great. Still, I can use my arm a little bit and hold moderately heavy things. I can feel that it's hard to support it by itself (especially when I try to elevate it or bend it without the help of the other arm.) Still quite a bit of pain and there are spots that are very sensitive to touch. That's about it for now!

Hope the recovery is smooth and full so I can come back to normal. Dislocated my right shoulder two years ago and it was doing amazing. Also was climbing about 5 bouldering grades harder than before the shoulder injury. Hope it goes just as good for the elbow!! :)

** It's been 4 months now, I am climbing even better than before and I sent my highest bouldering grade to date since! Just gotta stay positive and motivated :)

Hey Guys!

After I sent a gnarly boulder problem, I down climbed the same problem but couldn't handle a sloper so needed to let myself go from 15 feet. I remember looking down and I think my mind extended my left arm instinctively to ease the fall. (Oh well, I should have used the down-climb handles..) The result is a guy with a dislocated elbow crying out loud in a bouldering gym in Virginia, in a prime time Saturday. It was a life-changing pain, I was so close to passing out many times. After I got stabilized by the emergency medic of the gym, they forced me to take an ambulance.(thankfully because I was trying to get an uber since I am an international student here, and no damn insurance but of course my health is more important..). After they delivered me to hospital they tried and failed closed reduction 2 times, and the doc told me that they need to put me into sleep to loosen my tendons-muscles. Funny thing is I didn't sleep and it turns out I had an "impressive resistance", I don't remember the whole story but when I sobered up they told me reduction was successful. This is my second night following the injury and I wanted to share my experience with my recovery which I realized to be a journey from the doctor google.  

Diagnosis: simple elbow dislocation with a minimal fracture in the radial head.
Currently, I wear a sling and my arm is in a soft cast.

First day: pain level 15/10. Every movement results in a breath taking pain.
Second day: pain level 2/10. I don't feel pain when I don't move my arm. My fingers have full feeling, my front arm and biceps muscles are very tense, I sometimes massage them. Can move my fingers easily and can move the soft cast in every direction. (note that I don't force my arm.).

I will try to update under this post every week. Tomorrow I will see an orthopedic, wish me luck guys. Looking forward to being back in the gym.

Hi Guys,
I didn't dislocate my elbow doing anything as interesting as climbing - wish I had!!- so excuse me for posting here... but I have found this thread really helpful.
After full dislocation I am nearly 2 months down the line of PT and still very stiff and not reaching full ROM... Its like Ive reached a plateau and its not moving beyond a point. V. Interesting to read about the time between injury and reduction, even tho I went straight to hospital it was 4-5 hours before they did the procedure. But I had the cast off 3 days later and only used a sling on and off for a week, mainly to remind the kids not to jump on my arm.
I've broken alot of bones in my life (hence why I gave up adventure type sports!!) and never had a problem healing, but definitely swear by physio. this is my first tendon/ ligament related injury.

But I just wondered how much people are doing the exercises in a day, and how long the entire healing process has taken people in general, to acheive full movement; and if anyone has any other tips. Anna you are so right about movement in hot water !

Thanks

Hi! I dislocated my elbow ( 1st time) after a fall at the bouldering gym. I had it reduced about 3hrs later under some meds. I had it in a soft cast for 7 days and then a removable brace for a bit. I started PT 1 1/2 weeks post dislocation. I had a lot of trouble with extension and supination. First I had to get my mobility back which was fully back 2 1/2 weeks post dislocation. In that week of mobility, I mostly practiced simple everyday movements. I then took 1 more week to strengthen by using weights to strengthen the muscles in the area. I went back to climbing on week 4 and had exactly 2 joyful weeks of uninjured climbing. Then I DISLOCATED MY OTHER ELBOW falling at the gym again. This time was not nearly as bad because I got it back in by myself at the gym. I had a pretty good range of motion immediately after, which decreased into the night as the swelling increased. I started simple stretches and exercises 3 days post dislocation. I didn't go to PT that time and went back to full-on climbing 2 1/2 weeks post dislocation. My joints are very loose and are prone to dislocations as I'm hypermobile. I think my quick recovery times were due to the fact that I'm young (teenager), did all of the exercises, and didn't wait too long to start my training again. I'm happy to say that I'm 3 months past dislocation 1 and am back to full strength. The only residual effects I have are that my elbows crack (not painful), the wrist on the side of my first dislocation is always poping and hurts a bit sometimes, and of course the new fear ( which I'm getting past) of falling and dislocating my elbows. Hope this was helpful or comforting to future people who come along this thread!

Oh boy, I suppose i will add to this thread now... Probably will be a long read and maybe some tangents but here we go. I will preface that everyone will have a slightly different injury and recovery time! Everyone heals different. So don't be discouraged what the body can do!

Injury- Fell off a ladder about 12' fall and landed on my elbow. Dislocated elbow with a fractured radial head and torn ligaments. also on my right palm had a severe contusion on my which I presume the hamate bone. 

Surgery- went well, first broken bone (am 24) had 4 pins put in and also a ulnar nerve re routing, so two incisions. 

surgery to 10 day post- nerve block felt really weird. like my arm was a fucking elephant trunk. felt so heavy haha. at about day two there was some good amount of seepage through the dressing and monitored it. Was not stopping so I had to re go in and get new dressing put on. Fucking reeked of wet blood and some minimal joint fluid. Lucky I went in when I did because of infection possibility. 10 day mark is when the dressing was removed for a formed removable cast. 

10 day to 4 weeks- brutally slow process of PT regaining forearm extension and flexion. I was pretty rather aggressive with stretching early on with extension. using light dumbbells and hanging my elbow off a chair to have the weight force my arm to slowly straighten. worked well, until I found a different exercise. laying on my back, with the bad elbow propped up on a towel. opposite leg comes and essentially forcing your arm straight. Defiantly needed to go slow on that exercise haha. Also making sure to pin my shoulder down as it would always compensate and take over somewhat. Also forcing my arm into a doorway was good getting my bicep to stretch was really good. Having everything all contractured up was crazy stiff. Keep in mind my bone bruise on my other palm was in terrible pain to the point where I couldn't even pinch at all. (6 weeks is when the bruise started magically healing and eventually got full strength again but this thread is for the elbow)

Flexion on the other hand was a bitch and well... still is as I write this up 100 days post operation. Up to week 4 my elbow would not get passed 90 degrees! I was getting so worried! like what the hell is happening. So I went to reddit and other forums to see if anyone else had similar issues. Alas multiple people did! So I didn't feel alone. Even cranking out PT 5 times a day and being aggressive with the stretching it still was not loosening up!

4 weeks to 10 weeks- 5 week follow up I was cleared to start pronation movement as I had tore ligaments.  6 week follow up with the surgeon and my bone is growing back rather slow... (I am up north and was not getting any sun for like 4 weeks and mind you this is in winter when it was still pretty cold to go bask in the sun haha) So i ask what I can do to help speed up growth. Multivitamins! 10 week follow up with the surgeon and the bone is growing back well! "almost too well" as I know have Heterotopic Ossification going on (bone growth where it shouldn't be). So the surgeon says we will check back up at week 16 and see if it impedes my range of motion or impinges anything etc. All while this time has elapsed my extension of the elbow is more or less straight(probably 5 degrees off straight) and my flexion is around 136 degrees if I recall. So still a lot of work to do with my flexion!

10 weeks to 14 weeks(present)- extension is 2 degrees off straight and that's really about as far as I think it'll go? Maybe it will still loosen up as time goes on as I write this. My flexion I have been laying on my arm in a prone position a lot on the ground when I get the chance and really get that stretch as well as some other forceful stretching. Feels sore lot of the time but hey if you aint working it you aint healing it! With properly stretched I can reach and touch my shoulder again. But not when it is cold. Working range of motion is probably like 132? Being that my normal other arm is like 145. At week 12 I finally went to the gym to start loading my arm and stressing the bone. Pronation and Supination are still really stiff and need deep stretching. Maybe the heterotopic ossification is causing a block in my range of motion as proposed by my PT. I get a lot of clicking in certain motions but just try to get in uncomfortable positions to re adapt my body.

Domino affect- as my arm was immobilized for so long and my front delt took over for a lot of the exercises, my rear delt and rotator cuff took a hit. So I have been also training alot of band work and facepulls etc to work the posterior chain. 

I will maybe add to this as i progress further but this was a write up out of the whim and tried to remember everything that happened and what my frustrations were. but currently at day 100 and normal day to to day functions are doable and arent that hard... just climbing on the other hand is tricky... ha

Boy am I glad to see this thread! I dislocated my elbow yesterday while bouldering. I was about 12 feet up on an overhung route I had been projecting. 

My grip slipped yet again but this attempt I had commited a little harder than usual, so I was totally unprepared for the fall. In preventing myself from falling on my back or my head... I guess my left arm got in the way. I thought it was broken for sure, I was certain it would be a long time before I climbed again. It was a real relief when the x-rays came in. 

They got it reduced within minutes and your replies have left me optimistic for a speedy recovery.

At least it's my left arm, not my right, so I can continue my other favorite hobby, art.

Roger C wrote: 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.

This has certainly inspired me to start ROM training early. You could flex your biceps on day four? Wow, for me it was much easier to extend my arm down then contract my bicep. It appears to be dead weight, currently it feels like a mushy, useless pulp. I am able to extend fairly well. Currently I am typing with both hands, but my left thumb and pointer are quite numb and have the ROM but are stiff. Middle is half numb and ring and pinky are normal. I suspect nerve damage. My supination and pronation are both equally bad.

Okay, so it's been over a week now. (Today is Day 9) I can lift my arm, use my fingers, the sling has been completely off for two days. 

I actually keep accidentally using my left arm now because it feels just as fine as my right arm but much much weaker. I allow this as long as it's a task it is up for.

Pronation easy. Supination easy.

Extension and flexion have proven to be an issue. If I let my arm hang at my side it feels uncomfortable and looks very wrong. I can't make it go past 172 degrees. Holding it in front of me in a flexed position or shoving it in my pocket is more comfortable and looks more socially acceptable.

I can't flex it past 92 degrees either.

My forearm and hand are still swollen and bruised and concerningly, though my hand has worked since the beginning, numbness persists. My middle, index, and thumb and all the palm below them have reduced sensation and tingliness. I'm worried I have a medial nerve entrapment. Does anyone have experience with that and did it go away? Or do I need to get surgery. :( 

I'm not so worried about the hand numbness (maybe it would help with painful crack climbing moves) but if it prevents me from ever being able to extend or flex my arm all the way, that's a concern.

Maybe I'm being overdramatic. Even with that big old bend, I can still touch my toes. Arm length and hamstring flexibility definitely contribute to that. It looks silly because while my left fingers barely touch, my right palm is flat on the ground.