Post-Operative Exercises: Elbow Surgery

This guide should be used to guide your post-operative exercises for the first two weeks following your wrist surgery.

Dr James McLean will advise any changes or alterations which need to be made to this program for your individual case.

General Post-Operative Patient Advice

Goals

  • To allow healing.
  • To maintain and/or improve elbow range of motion.

Precautions

  • Keep your dressing clean and dry until your first review.
  • Avoid using a sling. Elbow stiffness is a result of a lack of elbow movement. Using a sling will delay the recovery of your elbow and potentially lead to a loss of elbow range or permanent elbow stiffness.

Restrictions

To avoid disappointment, ask Dr McLean to clarify your restrictions prior to surgery.

For 6 weeks following the operation, with the operated arm:

  • No lifting anything heavier than a ‘cup-of –tea’
  • No pulling or pushing
  • No assistive ambulation device should be used (i.e. a walking stick, crutches)
  • No driving until you are able to meet the safe driving considerations outlined here.

Exercises

The following exercises can be performed under the direction of your preferred Physiotherapist or at home on your own: • Unrestricted range of motion of your shoulder, wrist and hand (highly recommended to avoid stiffness in these joints).

Starting immediately, please perform your exercises at least 5 times a day for 10 repetitions (minimum).

1. Passive Forearm Rotations

  • Bend (flex) your elbow as far as you can.
  • Using your “good” hand, grasp the wrist of your of your
  • Keeping your elbow bent, use your “good” hand to gently rotate your forearm further.
  • Remember that the muscles of your injured arm must remain relaxed, while your “good” hand does all the work to rotate your arm.

PASSIVE FOREARM SUPINATION

  • Rotate your forearm further around to get your palm facing up.
  • Hold this stretched position for 3-5 seconds.

PASSIVE FOREARM PRONATION

  • Rotate your forearm further around to get your palm facing down.
  • Hold this stretched position for 3-5 seconds.
  • Repeat these alternating positions of PRONATION and SUPINATION 10 times (minimum).

NB. If these movements are restricted, it will feel like your forearm is stretching. Try and stretch your forearm to the point of discomfort but not pain. Too much pain will inhibit your ability to perform the exercises and contribute to a slower recovery.

Passive forearm supination and pronation 1
Passive forearm supination and pronation 2

2. Active Resisted Extension

  • Place your injured elbow on a table with the elbow as straight as possible.
  • Your thumb should be facing up (as much as possible).
  • Straighten (extend) your elbow as far as possible and
    hold for 5 seconds. Then...
  • Using your “good” hand, grasp the wrist of your injured elbow (cup your wrist in your hand comfortably so that the palm of your “good” hand is facing you).
  • Try to push against your hand to gain more extension (i.e. try and straighten your elbow further against resistance).
  • Push for 5 seconds. Repeat 10 times (minimum). Remember to keep your thumb facing up.

NB. This exercise promotes triceps muscle contraction and avoids inadvertent co-contraction of your biceps/ brachialis muscles that can inhibit elbow extension in a stiff or painful elbow

Active resisted-extension elbow exercise

3. Active Resisted Flexion

  • In the same position, bend (flex) your elbow as far as possible and hold for 5 seconds.
  • Remember to keep your thumb facing up.

Then...

  • Using your “good” hand, place 2 fingers on the wrist of your injured elbow in a position that resists further bending (flexion).
  • Your “good” hand should be turned into a position where your thumb faces the table and you are looking at the back of your “good” hand.
  • Try to push against your hand to gain more flexion (i.e. try and bend your elbow further against resistance).
  • Push for 5 seconds. Repeat 10 times (minimum).

NB. This exercise promotes biceps/brachialis muscles muscle contraction and avoids inadvertent co-contraction of your triceps muscles that can inhibit elbow flexion in a stiff or painful elbow.

Active resisted-flexion elbow exercise

Patient resources for elbow conditions

Check out Dr McLean’s articles on elbow related information and post surgery information.

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