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Elbow Hyperextension

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Middle aged man with elbow injury, possibly due to hyperextension.

An elbow hyperextension is an injury that results when the elbow is bent beyond its normal angle. When this happens, the elbow can suffer damage to its ligaments and bones.  The affected individual can also experience an elbow dislocation.

A hyperextension injury of the elbow joint can in theory occur to anyone. However, in practice, it is most commonly seen in contact sports like football or in combat sports like boxing or judo. However, it is also sometimes seen in other sports such as tennis and gymnastics.

The main treatment options for a mild or moderate elbow hyperextension include rest and cold therapy. For more serious injuries, corrective surgery may be required.


The human elbow contains 3 joints. However, of these three, the one that plays the most important role in elbow flexion and extension is the humeroulnar joint. It has this name due to its location where the upper arm bone (the humerus) meets the forearm bone (the ulnar).

Elbow hyperextension occurs when the humeroulnar joint is bent too far backwards and goes outside of its natural range of motion. The situations in which this most often tends to happen are:

  • Falling while playing a contact sport like football or soccer and trying to catch the body weight on an extended elbow. In this situation, the weight of your body can force the elbow to bend in the “wrong” direction;
  • Landing on a straight elbow while performing a gymnastic manoeuvre. If this happens, the force of the body’s weight bend the elbow in the wrong direction;
  • Elbow hyperextension can also occur during weightlifting. For example, the weightlifter may lose control of the weight he or she is trying to lift. If this happens, the elbow may be bent backwards outside of its normal range.

Symptoms Of Elbow Hyperextension

Individuals who suffer a hyperextended elbow will experience some or all of the following:

  • A “popping” or “snapping” sound at the time the injury occurs. Simultaneously, there will be a sharp pain, possibly at the front of the elbow;
  • After the initial injury, the individual will feel pain whenever trying to bend the elbow or touch it;
  • Swelling & stiffness of the elbow and arm;
  • Weakness in the elbow and upper arm;
  • In some cases, the injured individual may experience muscle spasms when he or she tries to straighten the arm;
  • Skin discoloration (e.g. redness) around the site of the injury;
  • If the injury is a severe one, the individual may also experience a lack of circulation below the elbow. One affected area may be the hand, for example;
  • The elbow may have a misshapen appearance and, for a severe injury, bone fragments may penetrate the skin and be visible.

Individuals who have some or all of these symptoms should make an appointment with a healthcare professional for medical advice.

For severe injuries, there may be bone fragments piercing the skin. If so , the patient should immediately go to the nearest emergency room for urgent medical attention.

Diagnosing An Elbow Hyperextension

To diagnose whether the patient has suffered an elbow hyperextension, the doctor will review his or her medical history. In addition, he or she will perform a thorough physical examination of the injured elbow.

The doctor will try to understand the exact location of the pain and what types of elbow movements make it worse.

The doctor will also likely request an imaging scan (either CT or X-Ray). These will help the doctor see if there are any bone fractures. They can also reveal the extent of soft tissue damage.

Treating A Hyperextended Elbow

Conservative Treatment Of Mild Or Moderate Elbow Hyperextensions

The doctor may determine that the elbow hyperextension is a mild or moderate injury with no bone fractures. If so, he or she may suggest the following:

  • Rest the elbow by using it as little as possible. In particular, avoid elbow flexion or extension movements. Certain types of elbow brace can help to immobilize the elbow. An arm sling can also play a useful role in immobilizing the arm and elbow;
  • Apply ice or a cold compress to the elbow for periods of about 20 minutes at a time. Do this at intervals of 2-3 hours. This will help to reduce pain and swelling. Use a towel or other insulating material to avoid direct contact between the skin and the ice or compress.
  • To further reduce swelling, the doctor may suggest using a non steroidal anti inflammatory drug such as Ibuprofen;
  • Apply compression to the elbow using an elastic bandage or an elbow compression sleeve. This will help to promote blood flow through the elbow, which will aid healing.
  • Elevate the elbow above heart level as much as possible, and particularly when sitting or lying down. The purpose of this is to facilitate drainage of stale blood from the injured elbow and its replacement with fresh, oxygen rich blood.
  • Once the patient is no longer feeling acute pain, he may be advised to commence a physical therapy program. This will help prepare the patient for a return to his or her regular daily routine. The program will include exercises to gently extend the elbow and gradually recover its normal range of motion.
  • The patient may also be advised to avoid consumption of things like alcohol, which can retard the recovery process.

Surgical Treatment of Severe Hyperextensions

If the hyperextension is so severe that a bone fracture or other damage has occurred, surgery may be necessary. Afterwards, the patient will be advised to immobilize the elbow for a period of weeks to allow complete healing.

As with conservative treatments, physical therapy will be needed to help the patient return to normal physical activities.

Elbow Hyperextension Recovery Time

If the elbow hyperextension is a mild one, the patient can expect to feel better after a few days of immobilization.

However, if the injury is severe and requires surgery, recovery will take longer.  The patient should expect to have to keep the elbow immobilized for a month or more.

It is important to be patient and follow the doctor’s guidance as to how long the elbow should be immobilized. A premature return to physical activities could cause problems such as long term elbow instability or even arthritis.

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