What is the Recovery Time for a Fractured Elbow? Physical Therapy Tips

Elbow fractures (such as olecranon and radial head or neck fractures) are common injuries that physical therapists are used to treating.

It’s totally normal to have questions about how to treat and recover after a broken elbow: Why surgery in some cases? How long will it take to heal, and how long will I need to wear a cast? What exercises should I do, and what kind of physical therapy should I expect?

As a physical therapist with extensive experience and research in international medical literature, I’m here to answer those questions for you!

Broken elbow, radial head / neck fracture, medial/lateral epicondyle or olecranon fracture: the same thing?

Elbow fracture, or commonly known as a broken elbow, is the term used to describe fractures in one or more of the bones that make up the elbow (the humerus, radius, and ulna).

Depending on which bone is fractured, and therefore the location of the fracture, the precise name of the fracture is different:

• Fracture of the radial head (or head of the radius, or radial cup), the most common (50% of elbow fractures);
• Radial neck fracture;
• Olecranon fracture;
• Fracture of the humeral shaft (or humeral fracture);
• Medial or lateral epicondyl fractures;
• Capitellum fracture;
• Coronoid fracture;
• Epitrochlear fracture;
• Elbow dislocation fracture (the elbow is the second joint that dislocates the most, after the shoulder. In 1/4 of elbow dislocation cases, a fracture is associated).

The type of fracture can also vary. For example, you may have:

• An elbow crack;
• A micro-fracture (or small / minor elbow fracture);
• A simple fracture (non-displaced);
• A complex fracture (displaced, comminuted or shattered );
• A bone avulsion;
• An open fracture.

No matter the location or type of fracture you have, the information provided here applies generally to all elbow fractures.

⚠️ Only healthcare professionals who are taking care of you (doctors, surgeons, physiotherapists) can individualize and specify this information based on the type and location of the fracture, as well as your medical history, age, and other characteristics that are unique to you.

How to know if your elbow is really broken? Symptoms

These are the symptoms of an elbow fracture:

• significant pain in the elbow that may radiate into the arm and forearm. The arm is often unusable;
• difficulty bending or straightening the elbow;
• swelling of the elbow;
• bruising around the elbow, arm, or forearm.

An X-ray is always performed to confirm a suspected fracture from questioning and examination. Other tests are sometimes performed to check if nerves or blood vessels passing through the elbow are not affected.

The elbow is most commonly fractured in:

• young athletic men, following a violent trauma;
• people over the age of 65 (elderly people) who fall, particularly women with osteoporosis.

What are the treatment for fractured elbow?

Here are the different things to implement (or avoid) to allow the consolidation of the elbow. And the typical treatment after fractured elbow.

Surgery after fractured elbow

Sometimes, an elbow fracture requires surgery, which often involves the placement of a plate attached to the bone.

The decision to operate depends on the:

• severity and location of the fracture,
• orthopedist’s habits,
• your overall condition.

Immobilization with cast, splint or nothing?

For simple elbow fractures, immobilization may not be necessary, and the elbow can be mobilized from the beginning, depending on the patient’s pain. The healthcare team that is familiar with your case will determine with you what is best to do.

Whether or not surgery is required, the upper limb may be immobilized by a cast, splint, sling, or nothing at all.

However, the elbow can become stiff quickly if immobilized, particularly with a cast that encompasses the elbow. Stiffness is, in fact, the main complication of an elbow fracture.

That is why surgery is often preferred to limit the time of immobilization in flexion.

Should the splint be kept on 24/7?

Usually, the immobilization device should not be worn 24 hours a day after a broken elbow.

However, it would be best to ask the healthcare professionals who are treating you and are familiar with your specific case.

Your physiotherapist may prescribe a second immobilization device if the Velcro straps are no longer holding or if you wish to wash it.

How long should the splint be worn?

Once again, it is up to the team that is following you and knows your medical history to decide with you. Here are the situations I encounter most often:

• The person is instructed to keep their cast or splint until the follow-up X-ray and appointment with the orthopedist. This occurs six weeks after the fracture. They are only allowed to remove the splint to wash themselves.
• The person is instructed to use their splint or sling only if they experience pain. Bending the elbow and bringing it against the belly is what we call an analgesic position; it relieves pain, so we do it spontaneously. The splint is kept on for a few days and then completely removed after a few days or generally a few weeks.

There is still little data on the benefits of early mobilization or immobilization after elbow fractures.

A study followed 81 people aged 14 to 87 years with a fracture of the radial head (Mason stage 1 or 2) for several years.

1. One group was not immobilized,
2. one group was immobilized in elbow flexion for 2 weeks in a cast,
3. and the third was immobilized for 2 weeks in a cast with the elbow extended.

In all three situations, the pain, elbow mobility, and ability to use the arm were identical. There were no complications in any of the three situations, and all people were able to return to their work and lifestyle as before.

For simple elbow fractures, immobilization of the elbow is not necessarily essential. The elbow can be mobilized from the beginning, depending on the pain. It is the medical team who knows your medical history and determines with you what is best to do.

Quitting smoking to speed up bone healing

We often know well the negative effects of smoking on overall health (risk of lung cancer, cardiovascular diseases, etc.). What is less known is that smoking has a negative impact on:

• The healing of the skin and other tissues in the body;
• Bone healing after a fracture.

In other words, if you smoke, you have every interest in quitting, reducing, or suspending your tobacco consumption. This way, you increase your chances of recovering quickly and effectively, regardless of the severity of your fracture and the treatment (surgery or not).

Physical therapy and exercises after fractured elbow

The rehabilitation of an elbow fracture is usually done by physiotherapists, mostly in private practice (at home or in a clinic).

A survey was conducted among more than 300 physiotherapists in the United States and Canada to learn about their methods for rehabilitating people who have had an elbow fracture. Their opinion?

Here is their opinion on the things that improve the chances of maximum and rapid healing (better prognosis), and on which you have a possible impact as a patient.

• Doing exercises on your own (97% of physiotherapists think it is very important for patients to do exercises on their own)
• Being patient (91% of physiotherapists think that the passage of time is crucial for recovery)
• Having a good lifestyle (80% of physiotherapists think that comorbidities have a significant influence on recovery)

Note that this is only the opinion of physiotherapists. There are no studies comparing the progress of patients by looking precisely at these parameters.

Here is also what these physiotherapists most often do during this phase:

• inform patients of precautions to take (95%);
• inform them of modifications to make in daily activities (88%);
• have patients perform active mobility exercises of the arm (the patient moves the arm himself) (87%);
• inform the patient on pain management (86%).

Massage or passive mobilization by the physiotherapist are not part of the things that physiotherapists in the United States and Canada implement. There is no reason to think that it would be useful.

Tele-rehabilitation is therefore possible for elbow fracture rehabilitation.

Exercises during immobilization (and after)

The goal is to prevent stiffness in your other joints (wrist, hand, shoulder, neck). Your physical therapist will show you exercises that also involve the shoulder joint and cervical spine.

Stay active as well: walking is strongly recommended to improve your physical fitness.

Exercises after immobilization : straightening arm after broken elbow?

Once you can perform these exercises throughout the full range of motion (compared to your other arm), you can start adding weight gradually (e.g. a 1L water bottle).

For daily activities such as eating, drinking, or self-care, we naturally use the full range of flexion permitted by the elbow (about 150°), so it’s important to try to regain that range of motion.

However, if your elbow remains stiff in extension (fully straightened), a small range of 5-10° shouldn’t be a problem in your daily life.

Don’t forget to continue working on other joints that may have also become stiff or weakened, such as the hand, wrist, shoulder, and neck.

Gradually resume activities that require using the elbow joint and muscles in strength:

• Carrying objects (grocery bags, dishes, etc.)
• Ironing, cleaning
• Driving
• Engaging in sports

Resume these activities gradually, without experiencing pain during or after the activity. If you do feel pain, it’s either too early to resume or you have resumed too frequently or intensely. You should feel discomfort at most, but not pain that makes you grimace or struggle to breathe.

What is the recovery & healing time for an elbow fracture?

It is always tricky to give a precise timeline.

The healing and recovery time after an elbow fracture depends on many factors. In any case, it takes a minimum of 6 to 12 weeks for the bones to be fully healed, whether there was surgery or immobilization or not.

However, healed bones do not necessarily mean that you have regained 100% function of your arm. On the contrary, it is from 4 to 8 weeks after the fracture that you begin to regain good use of your arm.

Here is the average timeline for recovery from the day of the fracture:

Timeframe from the day of the fracture	Stage
2 weeks	You have significantly less pain
6-12 weeks	Your bones are well healed
4-12 weeks	You gradually regain good mobility of the elbow, you straighten your arm
2-3 months	You start using your arm a little in everyday life (housework, getting dressed, eating, cooking, gardening, etc.)
2-4 months	You can drive a car or ride a bike again
4-6 months	You gradually return to sports that are not too demanding for the arm (running, soccer, etc.)
6-9 months	You gradually return to sports that demand more from the arm (tennis, swimming, handball, etc.)

Note that no physiotherapy technique can accelerate the natural process of bone consolidation. This timeline is non-negotiable.

The most frequently asked questions about recovery time after a broken elbow

Location	Average recovery time
Non displaced radial head fracture recovery time	A non-displaced radial head fracture generally recovers a little faster than a displaced fracture. However, the time for healing remains often the same.
Radial head fracture recovery time	The average recovery time for a radial head fracture is the same as the average recovery time for an elbow fracture.
Minor elbow fracture recovery time	A minor elbow fracture generally recovers a little faster than a major fracture. However, the time for healing remains often the same.
Chipped bone in elbow recovery time	A chipped bone generally recovers and heals a little faster than a displaced fracture.
Broken elbow surgery recovery time	Elbow surgery may facilitate a better and faster recovery and consolidation compared to non-surgical treatment. However, surgery is often only performed in the case of a displaced or more severe elbow fracture. Therefore, the recovery time after elbow surgery is probably on average the same as that of a non-surgical elbow fracture.
Hairline fracture elbow recovery time	A hairline elbow fracture generally recovers less quickly that another type of elbow fracture

Can I work with a broken elbow?

It depends on:

• the severity of the fracture,
• and the nature of your work.

If your work involves physical labor or activities that put stress on your elbow, such as lifting heavy objects or using tools, it may not be possible to continue working with a broken elbow.

If your work is less physically demanding and can be performed without putting undue stress on your elbow, it may be possible to continue working with proper accommodations.

Ultimately, the decision should be made in consultation with your doctor and employer.

How to sleep with a broken elbow?

Sleeping with a broken elbow can be uncomfortable, but there are some tips that can help:

1. Elevate your arm: Try sleeping with your injured elbow propped up on a pillow to reduce swelling and discomfort.
2. Use pillows for support: Place pillows under your arm, behind your back, and between your legs to help you find a comfortable sleeping position.
3. Try sleeping on your back: Sleeping on your back can help prevent putting pressure on your injured elbow.
4. Use a brace or sling: To help keep your elbow in a stable position.
5. Take pain medication: If your doctor has prescribed pain medication, take it as directed before going to bed to help you sleep more comfortably.
6. Cold can also help.

Untreated elbow fracture: what to do?

We first need to define what we mean by an “untreated elbow fracture“. What matters is not so much what happened between the time you had the fracture and now.

Rather, it is your current state that matters, regardless of what you did before (we cannot go back, and we cannot know how things would have gone if it had been different!).

If you think you have an untreated elbow fracture, it is likely that you are experiencing one or more of the following problems:

• You have frequent pain, at rest or when using your arm;
• You have difficulty using your arm for certain daily activities (cooking or cleaning, using a computer, playing sports, driving);
• Your elbow is stiff and does not bend or straighten completely, causing discomfort;
• Your elbow is swollen (persistent edema) and you are concerned.

Consult your doctor or physical therapist to find out what you can do to address one or more of these issues. For example, in cases of significant and bothersome elbow stiffness, an operation (elbow arthrolysis) combined with rehabilitation may be possible.

Sometimes, it will “simply” be a matter of being a little more patient, and things will naturally return to normal over the course of several months, without doing anything special.

I know it can be very frustrating to hear a health professional say that there is nothing to be done and only to wait. But it is often intellectual honesty rather than indifference that leads us to make this type of statement.

In any case, if your elbow fracture is well consolidated, movement of the arm and, in fact, the entire body should be encouraged. Movement has a positive impact on pain, stiffness, edema, and lack of strength.

When can you return to sports after a broken elbow?

About 6 weeks after you have fractured your elbow, you will probably have a follow-up X-ray. This X-ray will determine if your elbow is well healed. If so, you can gradually resume activities that use your elbow, including sports.

1. Start by using your elbow in everyday activities such as
   • cleaning,
   • cooking,
   • DIY, and
   • carrying light loads.
2. If everything is going well, you can gradually resume sports that involve using your arm 2 to 6 months after the elbow fracture. Discuss this with your doctor or physiotherapist.
3. Resuming sports that use your arms before this follow-up X-ray is strongly discouraged. You could put too much strain on the bone of your elbow and prevent or delay consolidation.

How long is the recovery time for a child with a broken elbow?

16% of fractures in children occur in the elbow. This means that children fracture their elbows more often than adults.

The advice given in this blog post also applies to children. The main difference is that children usually heal more quickly, even though they tend to move more.

The healing and rehabilitation periods are therefore shorter in children: a few weeks instead of a few months.

Often, physiotherapy sessions are not necessary: the child spontaneously resumes their activities and manages to dose what is good for them on their own!

Children with elbow fractures may lose a little range of motion in flexion or extension, but this has no long-term consequences and will not bother them.

Be reassured if your child has an elbow fracture: children recover even faster and better than adults!

What are the complications after an elbow fracture?

Most people do not have any complication after an elbow fracture.

This is especially true for simple, non-displaced fractures.

It is possible to resume daily activities, work, and even sports activities that involve the arm.

When there are complications (remember that this is the exception rather than the rule), they may include:

• a delay or absence of consolidation;
• residual pain (not necessarily constant or disabling);
• stiffness in the elbow, either to bend or to straighten, which can be bothersome in certain daily activities.