Posterior Elbow Impingement: Expert Care and Rehabilitation at Palms Physiotherapy & Allied Health

What is Posterior Elbow Impingement?

Posterior elbow impingement occurs when there is mechanical compression or irritation of the structures located at the back of the elbow. The condition typically involves the olecranon (the bony prominence at the back of the elbow) and the surrounding soft tissues. It is often caused by repetitive activities or acute trauma that result in restricted movement or excessive pressure on the elbow joint.

Causes of Posterior Elbow Impingement

• Repetitive Elbow Extension: Activities that require frequent full extension of the elbow (e.g., throwing, lifting, or sports like tennis and baseball) can cause irritation of the soft tissues and bony structures at the back of the elbow.

• Trauma or Injury: A fall onto an outstretched arm or a direct blow to the elbow may lead to damage or inflammation at the back of the joint.

• Overuse: Chronic overuse or overloading of the elbow, such as repetitive flexion and extension, can lead to wear and tear of the elbow's soft tissues, contributing to impingement.

• Osteophyte Formation (Bone Spurs): The development of bone spurs at the back of the elbow due to age-related changes or previous injury can narrow the joint space and cause impingement when the elbow is extended.

• Elbow Instability: Instability or misalignment of the elbow joint may also contribute to abnormal movement patterns and posterior impingement.

Symptoms of Posterior Elbow Impingement

• Pain at the Back of the Elbow: The most common symptom is localized pain at the back of the elbow, which may be worse with extension or pushing movements.

• Limited Range of Motion: Difficulty fully extending the elbow or a feeling of stiffness when moving the joint.

• Swelling: Swelling may develop at the back of the elbow, particularly if inflammation is present due to overuse or injury.

• Weakness: Weakness or discomfort in the elbow when performing activities requiring strength, such as lifting objects or pushing.

• Clicking or Popping Sensation: Some individuals experience a clicking or catching sensation in the elbow when moving it, which may indicate impingement.

• Pain with Repetitive Activity: Individuals often experience increased pain with repetitive activities like throwing, lifting, or sports motions that involve elbow extension.

Diagnosis of Posterior Elbow Impingement

Diagnosing posterior elbow impingement involves a comprehensive evaluation, including:

1. Clinical Examination:

   • The physiotherapist will assess your elbow for pain, swelling, and limited range of motion. Specific tests may be conducted to reproduce the impingement pain by extending the elbow or pushing on the back of the joint.

2. Imaging Tests:

   • X-rays: An X-ray may be ordered to check for any bone spurs or structural abnormalities that could be contributing to impingement.

   • MRI: Magnetic resonance imaging (MRI) can provide detailed images of soft tissues, including cartilage, ligaments, and tendons, helping identify any damage or inflammation in the elbow.

   • Ultrasound: Ultrasound imaging can be used to evaluate soft tissue injuries or inflammation in real-time.

Treatment Options for Posterior Elbow Impingement

Conservative (Non-Surgical) Treatment

The majority of individuals with posterior elbow impingement will benefit from non-surgical treatments, which aim to reduce inflammation, improve mobility, and prevent further damage:

• Rest:

  • Limiting activities that aggravate the elbow, such as heavy lifting or repetitive extension, is essential in the initial stages of treatment.

• Physical Therapy & Rehabilitation:

  • Stretching: Gentle stretching exercises to improve the flexibility of the elbow and surrounding muscles.

  • Strengthening: Progressive strengthening exercises targeting the muscles around the elbow, forearm, and shoulder to improve stability and reduce the load on the joint.

  • Manual Therapy: Techniques like joint mobilisation to reduce stiffness, alleviate pain, and restore proper movement patterns in the elbow.

  • Proprioception: Exercises to restore joint stability and awareness of elbow position to prevent further irritation.

• Pain Management:

  • NSAIDs: Nonsteroidal anti-inflammatory drugs, such as ibuprofen, may be used to control pain and inflammation in the elbow joint.

  • Ice Therapy: Applying ice to the elbow can help reduce swelling and pain, particularly after activity.

  • Corticosteroid Injections: In cases where pain is persistent, corticosteroid injections may be considered to help reduce inflammation and provide temporary relief.

• Bracing or Splinting:

  • A brace or elbow sleeve may be used to stabilize the joint and protect it from further strain, especially during recovery or physical therapy.

Surgical Treatment

If conservative measures are unsuccessful or if the impingement is severe, surgery may be necessary:

• Debridement or Osteophyte Removal:

  • Surgery may involve removing any bone spurs or damaged tissue around the elbow to increase joint space and reduce impingement.

• Elbow Arthroscopy:

  • In some cases, an arthroscopic procedure may be used to visualize and treat the impingement by removing damaged tissue or re-aligning the joint.

• Post-Surgery Rehabilitation:

  • A detailed rehabilitation program will follow surgery to regain mobility, strength, and function in the elbow joint.

Rehabilitation and Recovery at Palms Physiotherapy & Allied Health

Our physiotherapists specialise in treating posterior elbow impingement and provide a structured rehabilitation program designed to restore optimal elbow function:

• Initial Phase:

  • Focus on reducing pain and inflammation, improving mobility, and protecting the elbow from further stress.

• Strengthening Phase:

  • Gradual strengthening of the elbow and forearm muscles to improve stability and support the elbow joint.

• Restoration of Full Range of Motion:

  • Targeted exercises to restore full elbow extension and eliminate stiffness, ensuring that the joint moves freely without pain.

• Return-to-Activity Plan:

  • A progressive return-to-activity plan will be implemented for athletes or individuals who need to use their elbow for work or sports, ensuring a safe transition back to full function.

Preventing Posterior Elbow Impingement

While not all elbow impingements can be prevented, you can reduce your risk by:

• Proper Technique:

  • Use proper form when performing activities that involve elbow extension or overhead motions, such as lifting or throwing.

• Strengthening Exercises:

  • Strengthening the muscles around the elbow, shoulder, and forearm can provide added support and stability, reducing stress on the joint.

• Avoiding Overuse:

  • Taking breaks during repetitive activities that stress the elbow can help prevent overuse injuries and reduce the risk of impingement.

• Warm-Up and Stretching:

  • A proper warm-up routine and stretching before activities will prepare the elbow for movement and reduce the risk of strain.

Why Choose Palms Physiotherapy & Allied Health?

At Palms Physiotherapy & Allied Health, we are committed to providing personalized care for posterior elbow impingement. Whether you’re recovering from an injury, managing chronic pain, or returning to sport, our team of expert physiotherapists will design a tailored rehabilitation plan to meet your needs and help you recover fully.

Contact Us Today

If you’re experiencing symptoms of posterior elbow impingement, don’t hesitate to contact us at Palms Physiotherapy & Allied Health. Our team is here to help you regain full function and return to your activities as quickly and safely as possible.