I had surgery to smooth the edges of my elbow. They removed some bone spurs and cut some of the joint capsule to give me more motion. The pain is gone but I’m still stiff as a board. What causes that?

The elbow is a hinge-type joint allowing open and close motion. But it really has three separate articulations (joints) to make forearm rotation possible (palm up, palm down). The capsule and surrounding ligaments help hold and support the elbow giving you stability. The muscles give strength. Together, the soft tissues and bone structure of the elbow complex provide mobility.

Anything that disrupts the musculoskeletal components of the elbow can result in scarring, fibrotic tissue, and loss of motion. After injury or surgery, bone cells can form in the muscles causing a problem called heterotopic ossification. Elbow stiffness is a side effect of ossification.

Scientists aren’t really sure all the steps in the formation of elbow stiffness. The inflammation and swelling that accompanies any injury (or arthritis) contributes to this problem. But it’s likely there’s more to it than that.

A key focus of treatment for any elbow problem is to prevent stiffness. Once it develops, rehab can be a long, slow process. If you have not gone back to your surgeon, a follow-up visit is advised. You may need to see a hand therapist for some special one-on-one help. Regaining elbow motion is essential for upper extremity function.