Elbow Fractures

This page has been designed to provide you with the right information about elbow fractures and how to manage them from a physiotherapy point of view.

What is an elbow fracture?

Firstly, a fracture is the same as a break. The word fracture is a medical term, whereas a break is more of a common term to describe an injury to a bone that has caused it to break. For the remainder of this information page, we will use the term fracture.

There are many different types of fractures; they all essentially mean the same thing i.e. that one or more of the bones in your elbow have been broken.

The most common type of fracture around the elbow is a radial head fracture and therefore the focus of this information page will be on this.

What is a radial head?

You have two bones in your forearm, one called the radius (thumb side) and the other called the ulna (little finger side). Both the radius and the ulna meet the upper arm bone (humerus) to form your elbow joint.

The part of the radius that meets the upper arm and forms part of the elbow joint is called the radial head. It is important for helping your elbow bend and straighten but is most important for helping your forearm arm twist and turn (for example turning your hand over to look at your watch).

X-ray of an arm from the elbow down to the hand.

Is it easy to fracture your elbow?

It really isn’t easy to break any bone in your body. Your bones are incredibly strong and can take an awful lot of knocks, bumps and injuries and will generally not complain. You are more likely to find that you may upset the soft tissues (ligaments, muscles and tendons) following an injury than your bones.

How would you fracture your elbow?

The most common way to fracture your radial head is by falling. If you trip or slip, you normally react by putting your hands out to protect your face as you fall. As your hand hits the floor, the energy and force created travels up your arm and can be enough to fracture the radial head. Sometimes a radial head can be fractured if you fall onto your side and ‘squash’ it.

Remember, it is very difficult to break a bone, therefore most of the time, an injury to your elbow would result in a soft tissue injury (ligament etc.) rather than a fracture.

What if I think I’ve actually broken my elbow?

If after a recent injury, your elbow is significantly swollen, very painful and won’t move properly, you should seek help via A&E.

If I go to hospital, what will they do?

A diagnosis can often be made by asking some special questions and carrying out a physical examination (if available). However, if the hospital suspects you may have fractured your elbow, they will arrange an X-ray to check your bones.

Hospital building with the work 'Hospital' written on the side

What happens if I've broken my elbow?

If you have been to the hospital and an X-ray has revealed that you have fractured your elbow, you will usually be asked to see a specialist orthopaedic (bone and joint specialist) doctor to discuss your options.

Normally, the two options are non-surgical or surgical management.

This means that your elbow is likely to be placed in a supportive sling for support for several weeks to allow your elbow to heal.

This means that an operation is needed to help your elbow heal. It will normally involve inserting metal screws, wires and/or plates into the bone to hold the fractured pieces together whilst your body heals. It is likely that you will be placed in a supportive sling afterwards for several weeks to help with the healing.

Can elbow fractures be managed without surgery?

Yes. However, the orthopaedic doctor and their team will decide with you what the best option for you might be. Certain types of fractures can be managed more easily without surgery and some types of fractures do better with the help that surgery offers.

What do I do next?

Normally, once you have been discharged from hospital (whether you’ve had surgery or not), you should have been given some advice on what you should be doing. Most often, this will involve how much you can do with your elbow and what things might be useful to avoid whilst your elbow is in the early stages of its recovery.

If you are unsure how much you should/can do, ask the hospital as soon as you are able to.

What are the common symptoms after an elbow fracture?

It is useful for you to know what is normal after fracturing your elbow as it can sometimes be a worrying time. We’ve broken the answer down into things that are found most common.

First and foremost, elbow fractures can be quite sore. As you might expect, the discomfort you get from an elbow fracture can be different from person to person. Sometimes they can be very sore and sometimes they may only hurt a little. It is very normal for your elbow to be sore after a fracture and it is just as normal for that soreness to still be there for some time afterwards (weeks, possibly into months).

After a fracture, it is very likely your elbow will swell. This is your body’s way of starting the healing process. The swelling helps to ‘stiffen’ your elbow temporarily and helps keep all of the ‘healing cells’ where they need to be to help your elbow recover. Interestingly, you might find the swelling lasts for a long time and may even still be there when the pain has settled and you are feeling better. This doesn’t necessarily mean anything is wrong it's very normal for this to happen.

Whilst your elbow is sore and swollen, you can expect to find that moving your elbow will be difficult. Radial head fractures are most likely to limit your ability to straighten your elbow. Again, this is normal and will help the early stages of your healing. Once you are ready, it is important to get your elbow moving as soon as you feel that you can, as this will make sure your recovery is started nice and early.

Sometimes after a radial head fracture you can develop a clicking noise or feeling of something being stuck within the elbow.

How long will it take for my elbow to heal?

Fractures typically heal within about 6-8 weeks. There are things that might influence this such as any pre-existing health conditions e.g. diabetes or if you smoke, but in general once you pass the 6-8 week timescale, you can consider your elbow to be healed.

Unfortunately, just because the fracture itself might have healed, it does not mean that any pain will stop or the movement will come back by itself. This is where rehabilitation and physiotherapy can help.

Can I break it again by using it?

This is quite a normal concern for someone who has broken a bone. It is worth reminding yourself that your bones were strong before the fracture and they will still be strong now after the fracture.

By exercising your elbow and returning to normal daily activities (some of which might need some adjusting for your elbow), this aids the healing process even more and will help you get a better result overall.

Is there anything I shouldn’t be doing?

You are likely to have been advised to use the sling for a short period (a few days to perhaps 2 weeks), but it is important to still try and use your arm.

You can try and return to normal activities like brushing your hair or getting dressed using the elbow, and may choose to use the sling to rest it as needed, but it is strongly encouraged that you try to reduce how much you use the sling as soon as you feel you are able to, as it will help your overall recovery.

You may find lifting things like a full kettle difficult for the first 6 weeks and heavier things for probably a few weeks beyond that. Lifting is safe but whilst in the early stages of recovery, try using the other hand/asking for help or modifying how you lift (i.e. don’t fill the kettle too full).

Can I expect my elbow to go back to exactly how it was before I broke it?

This is a really good question. Once you have broken a bone, especially if it is close to a joint, you have effectively changed its anatomy. With this in mind, you may find that after a fracture, your elbow may not be able to go back to everything you did before or do things in the way you did before. It is not uncommon for radial head fractures to cause a limit in the amount of movement you have in the elbow, especially when trying to straighten it. The good news is that if you work hard, are patient and kind to yourself and give it the right amount of time, you will make the best recovery that you can.

Ok, what can I start doing to help my elbow get better?

Any type of pain, no matter where it is, is unpleasant and can sometimes become a bit concerning. We have designed this page specifically to give you the right information about elbow fractures and hopefully some reassurance that even if it’s really rather sore, your elbow is an amazingly strong and robust piece of kit, and even if it's sore and hard work, you are doing the right things to help yourself get better.

Interestingly, after any type of injury, including elbow fractures, it is important to recognise that sometimes there can be an emotional part to the injury and your recovery. After an elbow fracture, you might not feel confident to use your arm or may feel that it will let you down or that you might injure it again. Accepting that this may need working on as part of your rehabilitation can help you get a better overall outcome. It is hoped that the information on this page will help you with your confidence, but you can always discuss any worries you may have with your physiotherapist.

Your elbow is designed to be used, therefore, it is important to try and get it going again as soon as you can. It is likely to be sore when you first start, but you will not make it worse by using it. In fact, it will help your elbow start to get better more effectively. You may need to adjust how you do things or how long you do them for to help you succeed in getting your elbow going comfortably in the first stages.

One of the best things for most aches and pains is normal, confident movement. Your elbow may be sore, stiff and swollen and it might feel like the last thing you want to do is to move it, but movement is the best medicine for your elbow. Us physios like to say "motion is lotion!". When you are ready, try moving your elbow as far as you are comfortable, as regularly as you can. You will not injure your elbow or upset the healing process by moving it.

We have a selection of exercises to help you get moving at the bottom of this page.

Once you have started to get your elbow moving again, you might want to add some other exercises into your rehabilitation to help you make the best recovery.

Working on the strength of your elbow/arm is normally really useful in helping you get a good outcome after an elbow fracture. We have a selection of exercises at the bottom of this page to help provide you with some ideas.

Is there anything else I can do?

As mentioned previously, elbow fractures/sprains can be sore. Some people will choose to manage this pain with pain relief, whilst some may choose to avoid medication. If you need pain relief and either don’t have any or what you have isn’t working, please speak with your GP or pharmacist. Applying something cold to your elbow may also be useful in helping with some of the pain (do remember to wrap your frozen peas in a towel before applying them to your skin to avoid cold burns).

Getting your elbow moving is key to getting a good result after an elbow fracture and helping to reduce any swelling. It is worth remembering that swelling will often ‘hang around’ for some time (possibly into weeks or months), but this doesn’t necessarily mean anything is wrong. If your elbow is hot, red and swollen you should seek help from your GP or hospital consultant.

Fracturing your elbow can be traumatic and for some people, quite upsetting. You may feel that your confidence has been reduced and you might even find yourself scared to use your elbow. These are entirely normal reactions to an injury.

Any progress you will make will likely take time and the ‘road to recovery’ is often bumpy (meaning it will take effort, energy and perseverance). Adjusting things that you find sore, asking for help if you can, being realistic about the difficulties you are having and what you expect from yourself can all be helpful in making your rehabilitation easier.

As mentioned previously, getting your elbow moving as soon as you can is really important to getting a good outcome after your fracture. It is likely to be sore and difficult to move your elbow to begin with, but you will not injure your elbow again by moving it. Anything is better than nothing when it comes to movement.

Is there anything I should look out for?

After a fracture it is important to look out for the following symptoms:

Redness, swelling and heat around the elbow, especially with a fever or feeling generally unwell
Significant pain that is not helped with pain relief or exercises
Considerable swelling of the whole arm (especially if pressing it leaves a finger mark)
Difficulty breathing
Any of the above especially if you have had a history of Deep Vein Thrombosis (DVT)

If you have any concerns about any of the symptoms listed above, you should speak with your GP, 111 or seek help from A&E.

man in a checked shirt and backpack with binoculars looking out over a countryside scene.

What exercises should I be doing to start with?

In the earliest stages of your recovery i.e. within the first two weeks, it is recommended that you simply try to gently move the elbow as well as you can, and as far as is comfortable. We have provided a selection of suitable exercises below.

Frequently asked questions

Q: My elbow feels tight and a bit strange. Is that normal?

A: It is not unusual to find that your elbow feels strange after an injury. It is normal to feel tight or stiff after a fracture, but these things often ease with time and some gentle exercises.

Q: My elbow is still swollen after all this time. Is this normal?

A: Swelling can sometimes be the last thing to ease after injuries. It can sometimes hang around for weeks into months after the injury, however if you are feeling better, moving better and doing more, it is not something you should be worried about.

Q: Why are my fingers stiff and swollen?

A: It is not uncommon to find that your fingers might swell or feel stiff after an elbow injury. For the most part, this is either down to gravity pulling the swelling down from your elbow into your hand, or the fact that you might be using the arm less, which might contribute to your fingers feeling stiff.

Q: Why does my shoulder hurt since I broke my elbow?

A: Again, this is something that can be fairly common after an elbow fracture. If you managed to injure your elbow after a fall or an accident, it can sometimes be that your shoulder may have been upset at the same time. Sometimes, as the pain settles with the elbow you can find that the issues with the shoulder start to come to the surface.

You can find some excellent guidance and exercises for common shoulder problems here: Shoulder Self-help

Q: When can I drive again?

A: It is likely that you will not be able to return to driving for at least 6 weeks after your injury. It is each individual’s responsibility to ensure they are fit to drive. As well as making sure you are in full control of the vehicle at all times, you should ensure you can confidently and without any hesitation, perform an emergency stop before even considering driving on public roads.

It is always recommended to contact your insurance company one month before you return to driving to ensure your insurance is valid. This advice is the same if you drive an automatic car.

Q: When can I get back to sport?

A: This will be dictated by your elbow and your sport. Most people will find their elbow feels better after a few weeks/months. By working on the movement, strength and balance exercises, as well as being patient, you may find that going back to most sports in about 3 months will be successful (this can be very variable).

Exercise tip:

Movement exercises: You should try to complete these little and often throughout the day. Try to move your elbow as far as is comfortable.

Strength exercises: You should aim to complete the exercises (as many or as few as you want to) about 3 to 4 times a week.
Each exercise should be completed between 8-12 times (or repetitions) for 3 to 4 sets. Make sure you have about 1 minute's rest in between each set.
For the strengthening exercises, remember that in order to change your muscles, you need to challenge them. In other words, you should really feel the effort with each set of exercises and should really not be able to do more than 12 each time around.