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  Exercise & Workout Routines

July 2012
Stiff Elbow Has No Funny Bone To Blame
Dr Ankur Gaur
 
Elbow, the joint between your arm and forearm in the upper limb is designed to serve the hand. It supports the mobility of your hand in space, by shortening and lengthening the upper extremity. Accompanied by its surrounding muscles, the elbow plays an important role in providing control and stability in this part of your body. It aids the hand in its functions – to push, pull, turn, lift, throw, catch, reach and so on.

Injury or disease of the bony, articular/ soft tissue structures of the elbow can be reason for pain and stiffness, compromised mobility, strength and stability, and also muscle atrophy and deformity. One of the common complaints is joint stiffness.

Some Causes Of Elbow Stiffness
  • Prolonged immobilisation due to trauma or surgery
  • Arthritis
  • Tendonitis / Epicondylitis (inflammation and swelling of tennis elbow and golfer’s elbow)
  • Scarring of joint capsule
  • Muscle shortening and adhesions
  • Bone formation in muscles
Treatment Of Elbow Stiffness
The key to preventing stiffness after a broken elbow or elbow surgery, is to start early motions at the joint.

Physiotherapy aims at improving the range of motion in the elbow with end range stretches in both active and passive manner. The focus points are:
  • To relieve pain
  • To increase range of motion at the joint (RoM)
  • To prevent muscle atrophy
  • To gain strength
  • To promote relaxation at the joint
  • To regain functional skills.
Joint Mobilisation Techniques
Passive movements are done with the help of a physiotherapist. It is slow enough to allow the patient to stop the movement on his/her own.

Joint Manipulation Techniques
It involves passive movements using physiological or accessory motions. They may be applied with high velocity short amplitude motions.

Range Of Motion Exercises
These exercises include movements of the joint and muscle through their available range. They are used to maintain joint mobility, soft tissue integrity and muscle elasticity. They can be done actively (movement produced by active contraction of the muscle) or passively (movement produced by external force; for example, force applied by a therapist).

Strength/Resistance Exercises
Resistance exercise is any form of active exercise in which a dynamic or static muscle contraction is resisted by an outside force, applied either manually or mechanically. This enhances muscle strength and power, and decreases stress on the joint.

Stretching Exercises
These are therapeutic manoeuvres designed to increase mobility of soft tissues, and subsequently improve the range of motion by lengthening structures that have adaptively shortened and become hypomobile.

Splinting Of Elbow Joint
It involves the use of an elbow brace, which can be set to apply a constant force to the elbow over a prolonged period of time. It aims at stretching the tissues to improve motion.
Note:If these measures do not help in improving elbow motion and have been tried for long, then surgical measures to release the elbow joint may be considered.
Dr Ankur Gaur is Physiotherapist(Cardio Pulmonary Diseases),Relief Physiotherapy and Pain Management Clinic,Ghaziabad.

    
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