Sometimes, a joint gets pushed too far. Your bones, muscles, tendons, and ligaments can only take so much pressure, activity, or extension before something goes wrong. When it comes to soft-tissue damage, normally the first thing to give is the connective tissue, the tendons and ligaments that hold your body taut like puppet strings. These connective strands are what truly defines how far a joint can bend deep or stretch outward until the bones themselves can’t hold. This is why you can improve your flexibility by slowly stretching and strengthening your connective tissue and the muscles nearby. However, there’s a difference between flexibility exercises and accidentally over-extending yourself.
Over-extension, or hyperextension as it is known in the medical world, is when a joint or band of connective tissue is pulled too far without the weeks and months of flexibility training it would take to achieve this reach. Many athletes understand hyperextension in reference to their hamstring, that cord along the back of your leg that pulls tight when you do lunges and press your heel down. However, the same kind of damage can be done to your elbow as well. When this happens, it is known as elbow hyperextension and no one enjoys the results.
Elbow Hyperextension and What’s Happening Inside
Your elbow is formed where the humerus of your upper arm and the radius and ulna of your lower arm meet. The bones themselves have a natural stopping place when your arm is fully extended but, unlike your knee, there is not a ‘cap’ that prevents your elbow from bending outward beyond that point. Instead, your elbow is kept in place by stretchy tendons that can be thought of like one of those large, sturdy rubber bands. Your tendons combined with the effort of your muscles are what hold your arms in place. They are always at their tightest point when your arm is fully extended which is actually why arms are usually slightly bent when left completely loose.
When you extend your arm, the tendon stretches out to its maximum extension, like a rubber band pulled to the last point before it starts to thin and tear. When your elbow is hyperextended, often through accidental force like falling or swinging heavy equipment at a bad angle, your tendon begins to weaken and tear, just like an over-stretched rubber band.
Elbow hyperextension hurts so badly and limits your ability to move because the tendon that supports your elbow and aids movement is damaged and needs time to heal.
What Causes Hyperextension
Elbow hyperextension can happen for a broad number of reasons. In fact, for people involved in active sports or martial arts, hyperextension is surprisingly easy to do to yourself by accident. All it takes is one moment where your wrist is pushed too far back across the axis of your elbow to the point where your tendon stretches and takes damage. This can happen as a result of colliding with something or someone else, swinging something heavy, or simply supporting yourself with your arm at a bad angle.
Gymnasts are among the most likely athletes to experience elbow hyperextension because it can happen during one of dozens of times you will support yourself with your arms. Just one tumble or bad landing can pull your elbow out of place. People who use hand-held sports equipment like tennis rackets, baseball bats, and weight lifting also risk hyperextension because the object in your hand can pull your elbow out of position by accident. Swinging a tennis racket at a bad angle, for instance, can do it, as can letting your weights get away from you while still holding them in your hands.
Finally, martial artists also deal with elbow hyperextension regularly because there are so many circumstances that can lead to the elbow being pushed too far. Often on the body of a fellow martial-artists. There are many defensive exchanges, for instance, that specifically put the elbow at risk of hyperextension in the form of holds, throws, and certain blocks. While this is a great defense for real combat, getting overenthusiastic with a sparring partner or even training on your own can lead to accidentally forcing an elbow too far back in the heat of practice.
Of course, elbow hyperextension can happen for other reasons as well. Anything that pushes your elbow further back than it is meant to go will cause this condition. Apart from occupational and recreational hazards, simple falls are among the most likely causes.
Symptoms of Elbow Hyperextension
It is very important to know the difference between the damage done by elbow hyperextension and simple joint fatigue. Fortunately, the symptoms are distinctive and often far too intense to ignore or try to “walk off” expecting to be well in a few days. Symptoms start at the moment of injury. Many people will notice a popping sound or feeling inside your arm when your elbow is hyperextended accompanied by immediate sharp pain. That is the feeling of your tendon tearing as it is stretched too far beyond your normal range of motion.
Discoloration and Dislocation
After the injury, your skin may become red and blotchy accompanied by swelling around the area. It is even possible that your elbow will have been dislocated at the same time as hyperextension and you will need to get it back into place immediately before recovery can begin.
Pain, Swelling, and Weakness
After the moment of injury, you are likely to experience pain when using or interacting at all with the arm. A dull to sharp pain when you move the elbow is very common and it may be too painful to move the elbow at all without external support. You may also feel pain and tenderness when the injured elbow is touched. Swelling is very common, as is stiffness and weakness. Expect a significant loss of strength in the arm because one of the essential support elements is damages.
Some people also experience muscle spasms in your bicep as you try to straighten the arm. This is because your muscle is unable to interact correctly with the damaged tendon and cannot properly control the extension movement.
How to Treat Your Tender Elbow at Home
Elbow overextension is a serious medical condition and you should always start any treatment by visiting a doctor. They will examine the arm, relocate it if necessary, and determine if the damage is extreme enough to need special treatment. They will also likely prescribe or recommend something for the pain while your elbow heals as overextension can be an incredibly painful injury even during the healing process.
Once you get home, there are three key factors to handling your own recovery. The first is rest, followed by ice and supportive compression. Your elbow has been seriously damaged and will need time to heal. Don’t expect to be doing a lot with that arm in the next few weeks, though once properly supported you should be able to regain most of your normal use with the connected hand. The more you rest your elbow during the early stages of recovery, the more quickly it will heal because the elbow will not have stress on it as the tendon mends.
Swelling is also a major consideration for recovering from an overextended elbow and the swelling itself can add unnecessary pain, tenderness, and immobility to the arm. Begin ice treatments almost immediately and be careful about how to expose your elbow to ice. Your two best options are nestling your elbow in a cloth-wrapped bag of ice or to wrap your elbow in a cloth and set it into a bowl of ice. Both allow you to fully wrap your elbow in ice without having to manipulate it. Be sure to ice for no longer than 30 minutes at a time about every two hours.
Compression and Support
The weakness in your arm is a clear sign that your elbow is not going to be up to the task of arm control for a while. In order to avoid constant unnecessary pain and muscle spasms, you will want to wrap up the elbow tightly to provide additional support and a certain amount of immobilization. Tight wrapping with an elastic bandage will provide the same kind of rubber-band-like support that your tendon used to, keeping your arm in good condition while the tendon heals. You may also gain a great deal of benefit from an elbow brace that will hold your arm in place, keep it comfortably compressed, and protect it from your daily activities.
Recovery From Elbow Hyperextension
As your elbow starts to recovery, your doctor will probably recommend beginning to ease it back into normal activities. There are a number of physical therapy exercises available that can help you to rebuild strength and flexibility in your injured arm and it will become less and less necessary to wear a bandage or brace. Depending on the severity of your tendon damage, recovery may take anywhere from a few days to a few weeks to heal but it won’t take you out of commission forever.