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Elbow Arthrolysis
Elbow arthrolysis is a surgical procedure to treat conditions that are causing stiffness and significantly reduced range of motion in the elbow joint. Physiotherapy with Physio.co.uk is crucial before and after elbow arthrolysis to maximise range of movement and function within the elbow joint.
Elbow stiffness is a common problem that is associated with numerous conditions including osteoarthritis, fractures and other injuries to the elbow joint as well as developing as a result of previous surgeries and treatment. Elbow arthrolysis surgery is required to increase range of movement and function within the elbow joint and is recommended for patients who cannot bend (flex) their elbow up to 130˚ or straighten (extend) more than 30˚ and for those who cannot rotate their elbow joints more than 45˚ in both directions (pronation/supination).
Elbow arthrolysis involves the release of all soft tissues that interfere with full range of motion in the elbow joint. During elbow arthrolysis a number of small incisions are made at the side and at the back of the elbow joint. The front of the elbow is inspected and the scar tissue within the elbow is debrided. The restricted joint capsule and contracted tissues are the released to allow more movement. The outer (lateral) side of the joint is released first and any adhesions are divided. The restricted joint capsule and contracted tissues are then released from the inner (medial) side of the joint. The medial ligament on the inner side of the elbow is then released to further improve range of movement within the joint. Following this, any bony abnormalities are then treated. Small butterfly stitches are then used to close the wounds.
Physiotherapy is highly essential before and after elbow arthrolysis to ensure that the surgery is a success, to prevent the likelihood of problems in the future and to help guarantee the full or near to full return of full range of movement and function with the elbow joint and consequently the entire upper limb.
Above: Soft tissue massage of the the connective tissues around the elbowPhysiotherapy prior to elbow arthrolysis
Physiotherapy prior to your elbow arthrolysis surgery is highly recommended to better prepare your elbow for surgery and to help ensure a fast and uncomplicated recovery afterwards. Physiotherapy with Physio.co.uk before the surgery will aim to maintain as much range of movement as possible whilst also aiming to strengthen all the muscles around the elbow joint including the biceps and triceps to name but a few. The stronger your elbow is prior to your operation, the more successful the elbow arthrolysis surgery will be.
Symptoms after elbow arthrolysis
Once you have undergone elbow arthrolysis surgery you will experience some pain and swelling of which you will be given modalities to control for. You will suffer from numbness, weakness and a short term reduction in function within the elbow joint during the initial period after the operation. You will be provided with a sling immediately after the surgery to give your elbow essential support and protection in the early stages of recovery. A bulky dressing will have been placed on your elbow after the surgery but can be removed after 48 hours. You should be able to return home as soon as you feel comfortable providing that there were no complications during your hospital stay. Physiotherapy should start as soon as possible after your elbow arthrolysis surgery and recovery should take up to 3 months depending on the success of your rehabilitation programme. Driving is not permitted until you have full and painless range of movement within your elbow joint.
Above: Transverse friction massage of the connective tendons around the elbow.Physiotherapy after elbow arthrolysis
Physiotherapy after your elbow arthrolysis is imperative to maximise the success of the surgery. Physio.co.uk offers a comprehensive physiotherapy programme that will help prevent further problems with your elbow in the future and help you achieve the return of full or near to full function in your elbow joint. To safely and most efficiently return to normal or high level functional activity you will require adequate strength, flexibility and endurance in your elbow. After elbow arthrolysis your rehabilitation may take up to 3 months before achievinga successful and full recovery. It is important not to return to high level activities too soon following your elbow arthrolysis surgery as this will increase the risk of repeat problems and possible injury.
Above: Strengthening exercises for the muscles and connective tissue around the elbowWeek 1
You will be advised to wear the sling provided for up to 48 hours after your elbow arthrolysis and you may wish to carry on wearing short term while you are out and about for necessary support and protection. The initial goals of your physiotherapy programme with Physio.co.uk begin by focusing on controlling any pain and swelling you may be experiencing and to gradually improve range of movement as soon as possible after your surgery. Initiating early movement within your elbow joint is highly essential in the first stages of your recovery and is an important determinant of your rehabilitation and elbow function in the future. Your physiotherapy will include:
- Cryotherapy (ice)
- Pain modalities
- Shoulder, wrist and hand active range of movement exercises
- Elbow passive range of movement exercises
- Mobility exercises for upper limb i.e. shoulder shrugs
- Stretching exercises for upper limb muscles
1-4 weeks
During the first month of your rehabilitation with Physio.co.uk, your physiotherapy programme will continue to focus on controlling any pain and swelling you may still be experiencing as well as focusing on increasing passive (assisted) and active (on your own) range of movement as much as possible in your elbow joint. Goals at this stage will begin to gear towards strengthening the muscles around your elbow joint to aid your recovery further. Your physiotherapy will include:
- Cryotherapy
- Use of sling when out and about for protection (not necessary all the time)
- Passive range of movement exercises for elbow and wrist (bending, straightening, twisting)
- Progression to active range of movement exercises
- Isometric (hold) strengthening exercises for muscles around elbow joint (pronator teres, supinator, brachioradialis, biceps, triceps)
- Hand squeezing exercises (putty/sponge)
- Upper limb mobility exercises (shoulder shrugs etc)
- Stretching exercises to increase flexibility
- Strengthening exercises for muscles in wrist, hand and shoulder
- Activities for opposite arm
4-8 weeks
After a month of successful rehabilitation with Physio.co.uk your physiotherapy programme will aim to progress activities in order to continue improvements in strength, range of movement and flexibility seen in previous weeks. Goals will also begin to focus on improving your cardiovascular fitness and muscle endurance for maximum function in your affected and non-affected upper limb. Your physiotherapy will include:
- Continuation of modalities to control pain and swelling (if applicable)
- Active range of movement exercises (bending, straightening and twisting elbow joint)
- Active strengthening exercises for muscles in and around elbow
- Strengthening, stretching and range of movement exercises for wrist and hand
- Strengthening, stretching and range of movement exercises for shoulder
- Activities for opposite arm
- Arm cycle
- Hydrotherapy
8-12 weeks
In the third month of your rehabilitation post elbow arthrolysis, your physiotherapy programme with Physio.co.uk will aim to continue the improvement seen in the exercises from previous weeks. Your physiotherapy will include:
- Continuation of strengthening, stretching and range of movement exercises for muscles in elbow
- Continuation of strengthening, stretching and range of movement exercises for wrist, hand and shoulder of affected arm and also equivalent exercises for opposite arm
- Arm cycle (resistance as tolerated)
- Hydrotherapy
Full recovery after elbow arthrolysis may take up to 3 months. The success and rate of your recovery highly depends on your commitment and adherence to your comprehensive physiotherapy programme with Physio.co.uk as well as the condition of your elbow prior to your elbow arthrolysis surgery.
Above: Soft tissue massage of the the connective tissues around the elbowSummary
Elbow arthrolysis is a surgical procedure to treat conditions that are causing significant stiffness and reduced range of motion in the elbow joint. The procedure of elbow arthrolysis involves the release of all soft tissues that interfere with full range of motion in the elbow joint. It is crucial to undergo elbow arthrolysis to treat symptoms associated with severe stiffness within the elbow joint such as reduced range of movement, significantly decreased upper limb function and muscle weakness. Taking part in a comprehensive physiotherapy programme before and after elbow arthrolysis is extremely important to ensure that the surgery is a success, to prevent the likelihood of problems in the future and to help guarantee the full or near to full return of full range of movement and function with the elbow joint and consequently the entire upper limb. Physio.co.uk offers a personal physiotherapy course that can help you regain as much function as possible within your elbow joint and upper limb which in turn will rapidly get you back to your everyday tasks, job, hobby or sport. Call Physio.co.uk now on 0330 088 7800 for more information or contact us to book an appointment.
