Posterolateral Rotatory Instability of the Elbow With Rehab
ImagePosterolateral rotatory instability of the elbow is caused by a tear (sprain) of the lateral ulnar collateral ligament (LUCL) of the elbow. Ligaments are soft tissue structures that attach bones to bones and help maintain proper bone alignment across a joint. The LUCL helps maintain the alignment of the upper arm bone (humerus), and the forearm bones (the ulna and the radius). Injury to the LUCL often causes the ligament to be stretched, causing the elbow joint to be loose. Injuries to the elbow, such as dislocation, falling on an outstretched hand, or even surgery, may cause damage to the LUCL. Sprains are classified into three categories. Grade 1 sprains cause pain, but the tendon is not lengthened. Grade 2 sprains include a lengthened ligament due to the ligament being stretched or partially ruptured. With grade 2 sprains there is still function, although the function may be diminished. Grade 3 sprains are characterized by a complete tear of the tendon or muscle, and function is usually impaired.
SYMPTOMS
CAUSES
A sprain occurs when a force is placed on a ligament that is greater than it can withstand. Common mechanisms of injury include:
RISK INCREASES WITH:
PREVENTION
PROGNOSIS
Posterolateral rotatory instability does not heal naturally. If you begin noticing symptoms, a brace may help alleviate pain and improve function. Surgery is often necessary to regain complete function, followed by 6 months of rehabilitation.
RELATED COMPLICATIONS
TREATMENT
Treatment initially involves the use of ice and medication to help reduce pain and inflammation. The use of strengthening and stretching exercises may help reduce pain with activity. These exercises may be performed at home or with referral to a therapist. Your caregiver may recommend that you wear a brace to help reduce symptoms. Surgery is usually recommended to regain full function of the elbow. Surgery involves replacing the ligament with other tissue (reconstructing) the ligament. After surgery the elbow will be immobilized for a period of time to allow for healing. After immobilization it is important to perform strengthening and stretching exercises to help regain strength and a full range of motion.
MEDICATION
HEAT AND COLD
SEEK MEDICAL CARE IF:
EXERCISES
RANGE OF MOTION (ROM) AND STRETCHING EXERCISES - Posterolateral Rotatory Instability of the Elbow
These exercises may help you when beginning to rehabilitate your injury. Your symptoms may resolve with or without further involvement from your physician, physical therapist, or athletic trainer. While completing these exercises, remember:
RANGE OF MOTION – Supination, Active-Assisted
Repeat __________ times. Complete this exercise __________ times per day.
RANGE OF MOTION – Pronation, Active-Assisted
Repeat __________ times. Complete this exercise __________ times per day.
ImageRANGE OF MOTION – Supination, Active
Repeat __________ times. Complete this stretch __________ times per day.
ImageRANGE OF MOTION – Pronation, Active
Repeat __________ times. Complete this stretch __________ times per day.
ImageRANGE OF MOTION – Extension
Repeat __________ times. Complete this exercise __________ times per day.
ImageRANGE OF MOTION – Flexion
Repeat __________ times. Complete this exercise __________ times per day.
ImageRANGE OF MOTION – Elbow Flexion, Supine
Repeat __________ times. Complete this exercise __________ times per day.
ImageSTRETCH – Elbow flexors
Repeat __________ times. Complete this exercise __________ times per day.
ImageRANGE OF MOTION – Wrist Flexion, Active-Assisted
Repeat __________ times. Complete this exercise __________ times per day.
*If directed by your physician, physical therapist, or athletic trainer, complete this stretch with your elbow bent rather than extended.
ImageRANGE OF MOTION – Wrist Extension, Active-Assisted
Repeat __________ times. Complete this exercise __________ times per day.
*If directed by your physician, physical therapist or athletic trainer, complete this stretch with your elbow bent, rather than extended.
STRENGTHENING EXERCISES - Posterolateral Rotatory Instability of the Elbow
These exercises may help you when beginning to rehabilitate your injury. They may resolve your symptoms with or without further involvement from your physician, physical therapist, or athletic trainer. While completing these exercises, remember:
ImageSTRENGTH – Elbow Flexors, Supinated
Repeat __________ times. Complete this exercise __________ times per day.
ImageSTRENGTH – Elbow Flexors, Neutral
Repeat __________ times. Complete this exercise __________ times per day.
ImageSTRENGTH – Elbow Extensors
Repeat __________ times. Complete this exercise __________ times per day.
*You may also stand with your elbow overhead and pointed toward the ceiling and supported by your opposite hand.
ImageSTRENGTH - Elbow Extensors, Dynamic
Repeat __________ times. Complete this exercise __________ times per day.
ImageSTRENGTH – Forearm Supinators
Repeat __________ times. Complete this exercise __________ times per day.
ImageSTRENGTH – Forearm Pronators
Repeat __________ times. Complete this exercise __________ times per day.
ImageSTRENGTH – Wrist Flexors
Repeat __________ times. Complete this exercise __________ times per day.
ImageSTRENGTH – Wrist Extensors
Repeat __________ times. Complete this exercise __________ times per day.
ImageSTRENGTH - Ulnar Deviators
Repeat __________ times. Complete this exercise __________ times per day.
ImageSTRENGTH - Radial Deviators
Repeat __________ times. Complete this exercise __________ times per day.
 
This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.
 
Document Released: 12/18/2006 Document Revised: 05/03/2016 Document Reviewed: 04/01/2010
Elsevier Interactive Patient Education ©2016 Elsevier Inc.