Elbow ligament sprain: what to do and how to treat it

A sprain of the elbow joint is a closed traumatic injury that manifests itself in a rupture of the ligament fibers.

Most people without medical training believe that the name "ligament sprain" refers to the nature of the changes that occur when the ligaments are damaged. However, this is not the case: it reflects the mechanism of the injury.

The reason for the latter is movements in the joint that exceed its physiological capabilities. Depending on the intensity of the injury, the following may occur:

• partial disruption of the integrity of some individual fibers;
• rupture of collagen fibers - complete interruption of the ligament with fraying of the ends;
• rupture of a ligament from its attachment to the bone.

In the latter case, a bone fragment may break off along with the ligament. This type of injury is called an avulsion fracture.

The blood vessels located near the injured ligament are also damaged when stretched. Hemorrhage occurs into the surrounding tissues, and a bruise or hematoma is clearly visible at the site of the pathology.

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Causes of Elbow Sprains

The cause of elbow joint ligament sprain is excessive load that exceeds the elasticity of the tissues of the ligamentous apparatus.

This type of injury is quite common. A distinction is made between isolated sprains, which do not fall into the category of severe injuries, and those combined with a joint dislocation or bone fracture.

The most common cause of isolated trauma is intense physical activity, in which the intensity of muscle contractions significantly exceeds the development and compaction of ligaments, for example, during training for athletes. In people who do not play sports, such injuries can be caused by a sharp movement in a joint or unsuccessful turns when lifting weights. People whose professional activities involve performing the same type of hand movements, such as massage therapists, are also at risk.

This injury can be caused by a fall or an accident. In this case, the injury is usually combined with a dislocation of the joint or a fracture of the bones that form the joint: the coronoid process of the ulna, the medial epicondyle, and the head of the radius.

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Symptoms of Elbow Sprain

Symptoms of a sprained elbow joint appear immediately. And if they are initially mild, then after a few hours swelling occurs in the injury area, pain increases, and joint movement is limited.

There are three degrees of ligament sprain, each of which is characterized by the following symptoms:

• mild pain due to rupture of several fibers, joint mobility is not limited, swelling is absent or mild - first degree sprain;
• severe pain, severe swelling, hemorrhage, sharp pain when moving the joint - second degree sprain;
• severe pain due to a ligament rupture, swelling and extensive hyperemia, and subsequent instability of the joint - third-degree sprain.

Doctors distinguish three types of this type of traumatic injury, each with its own symptoms:

1. Medial epicondylitis, or "golfer's elbow," is characterized by pain on the inside of the elbow joint. Elbow range of motion and muscle strength remain normal. The pain becomes more severe when pronating the forearm or bending the wrist against resistance.
2. Epicondylitis, commonly known as "tennis elbow". There is no pain during rest, but as soon as there is movement in the joint (with extension and supination of the forearm), it immediately returns with its former force. Painful sensations intensify when clenching the hand into a fist and simultaneously bending at the wrist joint. They are usually progressive in nature and appear even with slight muscle tension, for example, holding an object in the hand. There are no external manifestations of epicondylitis.
3. Medial apophysitis, also called "baseball elbow." This type of injury manifests itself in pain on the inside of the elbow and swelling. After rest, the pain decreases or disappears completely. However, when the load is resumed, it returns.

Diagnosis of Elbow Sprain

During the initial examination of a patient with the above symptoms, the doctor acts according to the following algorithm:

1. Checks the pulse, examines the site of injury for the presence of bluish discoloration of the skin (scientific - cyanosis), which indicates insufficient oxygen saturation of the blood, slowing of blood flow.
2. Assesses the functional capabilities of the injured limb.
3. Checks for swelling.
4. Conducts a patient survey to determine the circumstances of the injury.
5. Examines the patient for other injuries.

After the initial examination, the doctor prescribes the following tests:

• X-ray, which allows determining the presence of concomitant injuries – dislocation or fracture;
• magnetic resonance imaging, which makes it possible to determine the number of damaged ligament fibers and the extent of their damage.

In addition, he may refer the patient for a CT scan and ultrasound examination of the damaged elbow joint.

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Treatment of Elbow Sprain

For the treatment of elbow ligament sprains, first aid provided correctly is very important. It includes the following measures: – ensuring immobility and rest of the injured limb;

• application of a cooling compress (20 minutes several times a day);
• arm elevation to reduce swelling;
• taking an analgesic to reduce pain.

Elbow sprains should be treated immediately, within the first 24-48 hours. The affected arm is usually secured with a figure-eight compression bandage and elastic bandage.

The doctor may also prescribe physiotherapeutic measures (electrophoresis of ascorbic acid, diadynamic currents) and injections, such as novocaine blockades with the addition of vitamin B12 and analgin.

The rehabilitation stage of treatment includes three periods: immobilization; restoration of joint movements, and the period of restoration of joint stability. During immobilization, isometric exercises of varying duration are prescribed; their essence lies in muscle tension without movement. After removing the bandage, exercises in light conditions (for example, in water) are recommended to relax the surrounding muscles and facilitate the development of the elbow joint. During the period of restoration of joint stability, exercises are prescribed with a gradual increase in the load on each muscle. In case of instability of the elbow joint, the effect of gymnastic exercises is enhanced by electrical stimulation of the muscles.

At the end of the recovery stage, a repeat examination is carried out.

In case of elbow joint ligament sprain, treatment with folk remedies can act as additional measures. The following recipes are known:

• a raw potato compress to eliminate swelling. To prepare it, you need to finely grate the raw vegetable, then mix the resulting gruel with fresh cabbage in a 2:1 ratio. The compress is applied to the site of injury and secured with a bandage. It needs to be changed several times a day;
• compresses from freshly picked crushed elderberry leaves. Also changed 2-3 times a day;
• Infusion and compresses from wormwood. You will need 30 grams of finely chopped wormwood and 100 ml of olive oil: mix them and put them in a water bath. Boil on low heat for two hours. Then you need to let the mixture brew - put it in a warm place for a day. Lubricate the elbow with the resulting product 3-5 times a day, and apply it as a compress at night.

Such remedies can only be used after a medical examination; they can complement traditional medical methods, but not replace them completely.

Prevention of Elbow Sprains

Elbow ligament sprains can occur in anyone. Moderate physical activity helps strengthen the ligaments, but failure to exercise reasonable caution when performing sports exercises or active recreation always carries the risk of injury. Therefore, sports activities should be done in special shoes and clothing, and with significant loads, it is recommended to wear an elbow brace or elbow pad.

Thus, prevention of ligament sprains consists of preventing constant overstrain of the corresponding muscle groups, rational technique of professional and sports movements, correct working posture, and careful selection of professional or sports equipment.

Elbow Sprain Prognosis

Both conservative and surgical treatment of ligament sprains give good results in most patients. But do not forget that this is a rather insidious disease: the pain can quickly subside, and if the patient immediately returns to his usual rhythm of life, stops limiting physical activity on the joint, then the disease can develop again and with renewed vigor.

If all doctor's orders are followed, timely treatment will be effective and the patient will be able to lead an active lifestyle. The prognosis for recurrence of pain attacks is usually favorable. However, remember: elbow ligament sprain, the treatment of which usually takes a long time, requires the consolidated efforts of the doctor and the patient.

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