FAQ Category: Elbow


I was recently diagnosed with rheumatoid arthritis. It seems to have settled in my right elbow. The doctor wants me to start what she calls “aggressive” therapy taking new medications. The meds are called DMARD. I don’t really want to take drugs. Isn’t there a more natural way to deal with this problem?

Rheumatoid arthritis (RA) is a chronic, or long-term, inflammatory form of arthritis. RA is considered an autoimmune disease, in which your immune system attacks the tissues of your own body. In RA, the immune system mostly attacks tissues in the joints, but it can also affect other organs of your […]


I just watched a You Tube video of my brother who dislocated his elbow in a high school wrestling match. Gruesome! He’s so strong, I can’t figure out how this could have happened. If I download it to you, could you look at it and tell me what you think?

Thanks to You Tube we now know that elbow dislocations don’t occur the way previous investigations using cadavers led us to believe. In the past, researchers had no choice but to rely on cadavers (human bodies preserved after death) to study the patterns and mechanisms of elbow dislocation. And those […]


Our daughter is just starting a rehab program at a sports physical therapy clinic for her tennis elbow. She’s actually a volleyball player but they still call it tennis elbow. We are wondering what to expect and how long she’ll be in this program.

Overhead athletes (e.g., tennis players, javelin throwers, baseball pitchers, volleyball players) can lose significant function of the arm after an elbow tendon injury. Physical therapists are often in charge of getting these players back to full force in hitting, pitching, serving, and spiking. But what is the optimal rehabilitation program […]


I just started a rehab program for golfer’s elbow. The physical therapist told me: if it hurts, don’t do it. If it hurts the next day, back off — you overdid it. Does that make sense to you? What about the old saying, “no pain, no gain”?

There are some times when pushing through pain is advised. But there is more and more evidence from studies that this idea is not appropriate for tendon healing. The physical therapist you are working with clearly understands the phases of healing and is tailoring the program to meet your specific […]


I am stumped and so is my surgeon (I think). I have a case of chronic pain from tennis elbow along the outside of my elbow. A tiny tissue biopsy showed there isn’t any inflammation. So why hasn’t anything we’ve done for treatment helped me? I even had an epicondylectomy (if I spelled that right) and still it hurts. Do you have any possible explanation?

Pain along the outside (lateral) elbow from chronic overuse and repetitive activities describes what many patients with chronic epicondylitis experience. Conservative treatment (without surgery) isn’t always successful. The reason chronic tennis elbow doesn’t get better sometimes is because the tiny microtears of the extensor tendons that are involved don’t heal […]


I’m looking for any information I can find to help me avoid surgery for chronic tennis elbow. I’ve spent the last year chasing after every other kind of treatment but nothing has helped. The surgeon has recommended lopping off the tendon and a piece of the bone where the tendon attaches. I’m kind of attached to my tendons and bones and don’t want to go whacking them off. Is there anything else you can suggest?

Without knowing the details of everything you’ve already tried (e.g., acupuncture, diet and supplements, cortisone shots, physical therapy, splinting, pain relievers, myofascial release, and so on), we can report on an alternative treatment that has been proposed for tennis elbow also known as lateral epicondylitis. Pain along the outside (lateral) […]


We are trying to decide on a surgeon for our 14-year-old son who has a torn lateral collateral ligament (LCL) injury of the elbow from playing sports. There are two active orthopedic surgeons in our community. One is young and closer to being out of school. The other is older but with more experience. How do the older docs keep up with new techniques? It would be great if we could find out he has experience and recent know-how.

Continuing education takes many different forms and approaches for the health care professional. On-line courses, hands on conferences, and even review articles in published journals offer a variety of ways to keep up. For example, in a recent article, orthopedic surgeons are brought up-to-date on the diagnosis and treatment of […]


I saw a video at my surgeon’s office on the arthroscopic procedure she plans to do on my elbow. I have a bit of loose cartilage in there that keeps getting caught so she is going to remove it. In the video, the patient was completely covered in surgical linens so that all that was visible was the forearm from the elbow down. This is probably a silly question, but is that really necessary?

You are referring to a technique we call “surgical draping”. The patient is indeed covered from head to toe leaving only the surgical field visible. This approach has been developed over the years to help prevent infection to the patient. It also helps protect the surgical team from any contact […]


My surgeon wants to do an arthroscopic exam on my elbow to find out what’s wrong. I know this is supposed to be a simple procedure. But I seem to be the kind of person where nothing is ever very simple. Can you tell me more about what to expect?

Elbow arthroscopy is a surgical technique used routinely now for the evaluation and treatment of many elbow problems. Since the first arthroscopic elbow treatment became available, the ways and reasons to use this tool have expanded. Now surgeons use it to clean the joint out from any infection, remove any […]


My 69-year-old father thinks he may have dislocated his elbow but popped it back in place. Now whenever he goes to get up from his chair, he cannot push up with his arm on that side without feeling like it’s going to pop out again. What do you make of this kind of problem?

You may be describing what is referred to as a positive chair sign. Essentially he is performing a sitting pushup. With the elbows bent to 90 degrees and the arms out to the side, extending the elbow fully while pushing up on the arm of the chair causes a feeling […]


I’m 61-years old, so I’m no spring chicken but I’m also no wimp and stay active each and every day. Unfortunately, last fall, I fell and broke my elbow. The radial head was broken into tiny bits and pieces. I had surgery to put it all back together and I’m still in rehab but wondering if I’ll ever get my motion back. What is a realistic expectation for something like this?

According to a recent update on radial head fractures published in The Journal of Hand Surgery, this type of fracture is the most common elbow fracture. Undisplaced (bones are not separated) fractures have the best results. More serious, involved fractures may take longer to heal with less “perfect” outcomes. For […]


I’m new at this Internet thing, so I hope this reaches you because I need some help. I broke my elbow (radial head fracture) into a couple pieces that could be pinned back together. It’s been six months now and I’m still stiff as a board — can’t bend or straighten all the way either. I did (and still do) my exercise program. What’s holding up the works?

If you took a poll of all adults who have had a radial head fracture, stiffness would probably be the number one lingering postoperative problem. There are a number of different possible reasons for this complication starting with the hardware used to hold it together. If the pins or screws […]


Our family has come up against what we’ve been told is a “rare” problem: a coronal shear fracture of the elbow. The surgeon is going to put some compression screws to hold it all together until healing takes place. We’ve been warned that there could be some complications and problems down the road but that this is rare. What kind of problems are we talking about here?

Coronal shear fractures of the elbow describes a break in the lower end of the humerus (upper arm bone). The elbow has some unusual and very individual anatomy that can make a difference after injuries. Fractures and dislocations can alter the normal bumps and grooves that give the elbow joint […]


I have kind of a delicate question that I haven’t quite gotten the nerve up to ask my surgeon. I’m scheduled for an elbow replacement. I’ve done all kinds of other stuff and nothing has helped — medications, physical therapy, arthroscopic surgery, etc. I’ve been told there are some restrictions with this implant: no lifting heavy items, no push-ups or heavy loads through the joint, no bowling. What about sexual activities? I notice it does usually require me to put my weight through my arms. Is that going to be a problem?

Elbow arthroplasty or implants used to replace the elbow joint have distinct advantages and disadvantages. As you have been told, before receiving an elbow implant to replace the diseased, degenerated joint, the patient must agree to limit lifting to less than 10 pounds for a single item and less than […]


I dislocated my left elbow during a wrestling tournament in high school. The orthopedic surgeon put it back in place for me so I didn’t have to have surgery. But then I mangled the same elbow in a motocross accident about five years ago. So now at age 35, I have arthritis worse than my grandma. I asked my doctor about an elbow replacement. She said I am ‘too young’ for that. She gave me a prescription for some antiinflammatories. Is that all I can do?

Joint replacements are available now for the elbow. But it’s a tricky joint made up of three separate bones and two distinct joints. And it is responsible for repetitive motion of the hand and arm as well as rotation of the forearm, and weight-bearing activities through the hand and wrist. […]


I am a surgical scrub nurse so I have a little extra knowledge of orthopedic problems. I want to ask about surgery for my niece. She has a type two fracture of the elbow (capitellum and trochlea are still together but broken off from the rest of the bone. Her mother (my sister) is a physical therapist and wants her to have surgery. I always recommend people avoid surgery. What’s best in a case like this?

From your description, it sounds like she may have what’s known as a coronal shear fracture of the distal humerus. As you probably know, the distal humerus refers to the bottom end of the upper arm bone, which forms the top half of the elbow joint. This lower end of […]


Do you think it’s reasonable that my tennis elbow is going to take a full year to heal? That’s what both the surgeon and the physical therapist said. That seems like a very long time to me. I usually heal fairly quickly from most other injuries. Why does this take so long?

Acute tennis elbow, known as lateral epicondylitis often occurs as a result of repetitive overuse of the elbow extensor tendons. In the beginning of the injury, the body responds to the microtrauma with an inflammatory process. If all goes well, the body regenerates the area and the person recovers. But […]


I’m self-insured so trying to spend my money wisely with what seems like a bad case of tennis elbow. Do you recommend X-rays? MRIs? CT scans? What’s the best route to take when dealing with this particular problem?

Despite over 100 years of study and treatment, lateral epicondylitis, otherwise known as “tennis elbow” can be a difficult problem to treat. Recent research has shown us that partial tears of the extensor carpi radialis brevis (ECRB) tendon just don’t heal right. But the reason for this remains unknown. After […]