Emergency and Urgent Care - Soft Tissue Elbow Injury

What is a soft tissue injury to the elbow?

A soft tissue means that you have damaged some of the structures that support the elbow, such as ligaments. You have strained your elbow joint, but you have not broken any bones; this is a common injury.

What are the symptoms?

Common symptoms which occur due to this injury include:

• Bruising
• Pain
• Swelling
• Difficulty moving elbow

How is it treated?

P - Painkillers: it is important that you take regular painkillers to reduce the pain and help you keep moving around. Paracetamol and ibuprofen are effective painkillers if they are taken regularly and can be taken at the same time. These medications can be easily purchased over the counter at supermarkets and pharmacies. Please carefully read the instruction leaflet with the medication and only take the recommended dose; there may be reasons why you cannot take these medications, a pharmacist will be able to help you with this.

R - Rest: will help prevent further injury and allow the healing process to begin. For the first 2 days reduce the amount of use of your elbow; gently exercise your elbow to prevent stiffness.

Avoid forceful and strenuous activity, such as lifting and pulling until you can do this without it causing pain.

I - Ice: can help reduce swelling and reduce pain. Make an ice pack by wrapping a small bag of frozen peas or some crushed ice cubes in a damp towel – DO NOT put ice pack directly onto skin. Put the ice pack on the elbow for up to 20 minutes every 2 hours for the first 3 days after the injury. Then use the ice pack 3 times a day until the swelling has gone down. DO NOT eat food that has been thawed and refrozen.

M - Mobilisation: early movement has been shown to help sprained elbows to heal more quickly. Using the exercises in this leaflet will help you to regain movement and build up strength in your injured elbow.

E - Elevation: keeping your injured elbow raised for the first 2 days after your injury; you can use your sling (if provided) for this. This will help to decrease the swelling and pain. Try resting your affected arm on one or two pillows.
 
Compression: We no longer offer compression bandages for sprains, because they appear to have no beneficial effect on how quickly or fully you recover.

What to avoid

H - Heat: hot baths, saunas and heat packs will increase swelling and bleeding.
A - Alcohol/Smoking: reduces healing and increases swelling and bleeding.
R - Rench: lifting and pulling heavy objects too soon can worsen pain and prolong healing.
M - Massage: may increase swelling and bleeding.

Recovery

Healing of the ligaments normally takes about 6 weeks, although everyone recovers from injuries at different rates. Healing time is related to how severe your injury is and any other medical problems you may have.

As healing gets underway, it is important that you begin a series of exercises to help you get back the full use of your wrist by improving its flexibility and strength. This will help to reduce the risk of further sprains.

Returning to physical activity:

• Returning to sport and work will depend on the demands of your job or chosen sport
• Recovery is faster if you stay at work, or go back to work as early as possible
• You may need to gradually return to work, do light duties initially, or have regular breaks
• Once you have regained movement and strength you can slowly start to increase your activity back to your previous level

Driving

It is important that you contact your insurance company to let them know about your injury. You may be able to drive once you are able to perform an emergency stop safely and fully operate your vehicle. DO NOT drive whilst wearing a sling.

Exercises:

• Exercising your hand and arm will help reduce any swelling and help ease the pain from stiff joints
• These exercises will be most effective if completed “little & often”, and can help speed up your recovery
• They can be done every 2 hours
• Start exercising slowly and smoothly, build up the repetitions and range of movement gradually until you have reached full range of movement
• Try to carry out 10 repetitions of each exercise
• Pain can increase initially but will soon settle down within a few days of starting the exercises

Initial exercises:

Do these for the first 2-3 weeks

• Either in sitting or standing position
• Gently bend (flex) your elbow
• Then gently straighten (extend) your elbow
• Do not force the movement
• Repeat up to 10 times
• In the first few days after your injury, you may need to assist your injured arm by using your other hand to perform the movement

• Either in sitting or standing position
• Bend your elbow to 90 degrees and have your palm facing downwards.
• Turn your palm to face upwards and then downwards again
• Repeat up to 10 times

NB. Make sure your keep your shoulder still, the movement should come from the elbow and forearm.

•    Rest your forearm on a table with your hand/wrist hanging over the edge of the table
•    Using your wrist only, move your hand downwards and then lift it upwards
•    Repeat up to 10 times

•    Support your elbow and forearm on a table
•    Clench your fist as tight as you can, feel the stretch in the fingers
•    Now unclench your fist and spread your fingers wide, feel the stretch in your fingers
•    Repeat up to 10 times

Strengthening exercises:

Do these from 3 or 4

• In a sitting or standing position
• Hold onto a small hand-weight, or alternatively a bottle of water or can of beans/soup etc.
• Gently bend and then straighten your elbow
• Repeat up to 10 times

• In a sitting or standing position
• Hold onto a small hand-weight, or alternatively a bottle of water or can of beans/soup etc.
• Bend your elbow to 90 degrees and turn your palm face up
• Rotate your elbow/forearm to face your palm downwards, and then rotate so that palm faces upwards again
• Repeat up to 10 times

• Hold a soft ball or roll some socks into a ball and hold them
• Squeeze the ball as hard as you can and hold for 5 seconds and then relax
• Repeat up to 10 times

Physiotherapy

If you are unsure about what to do and feel you need support with your rehabilitation, then you can always go to see a Physiotherapist.

If you live in the Heywood, Middleton and Rochdale area, you can refer yourself by using the following link:
www.physiodirect.northerncarealliance.nhs.uk

Things to watch out for:

• If your elbow hurts when you exercise but the pain goes away when you rest
• Your elbow is swollen, red and hot to touch; you have a very high temperature or feel hot and shivery
• Your elbow is extremely painful and difficult to move
• Your arm tingles or feels numb
• Your arm/elbow has been injured and you heard a snapping noise, or your arm has changed shape

These can be signs of a heart problem (angina), an infection or a broken arm.

Contact

NHS 111 will advise you what to do. They can direct you to the right place to get help if you need to see someone. Call 111 or visit www.111.nhs.uk

Further links:

External links for further information on elbow pain:

www.csp.org.uk/conditions/managing-your-bone-joint-or-muscle- pain/managing-your-elbow-pain

www.versusarthritis.org/about-arthritis/conditions/elbow-pain/

www.nhs.uk/conditions/elbow-and-arm-pain/

Work

If you do not feel capable of working either due to pain or reduced movement/mobility, you are able to self-certify sickness for the first 7 days.

You must complete a self-certification form found on the government website and give this to your employer. This entitles you to statutory sick pay from your employer for up to 7 days.

To access the self-certification form, follow this link:
https://www.gov.uk/government/publications/statutory-sickpay- employees-statement-of-sickness-sc2

If you feel you need longer than 7 days off work, you must contact your GP for a sick note. The Urgent Treatment Centre does not issue sick notes.

For further advice or information contact Rochdale Urgent Treatment Centre – 01706 517023.