Physical Therapy After a Radial Head Fracture

Physical therapist helps woman raise arm
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If you have suffered a fall or a FOOSH injury, you may have a specific injury called a radial head fracture. This type of fracture can limit your ability to participate in athletics or work-related activities that require the use of your arm. If you have a radial head fracture, you may benefit from physical therapy to help you fully recover. Goals of physical therapy after a radial head fracture typically include regaining normal elbow and hand range of motion and strength and controlling pain and swelling.

The Radial Head

Your elbow joint consists the articulation of three bones: your humerus, your ulna, and your radius. Your humerus is your upper arm bone, and the radius and ulna make up your forearm. The radial head is the end of your radius near the elbow. There it is a cylindrical shape and allows your radius to roll over during motions that require you to turn your forearm and hand up and down.

Surrounding the radial is a ligament called the annular ligament. This structure helps to keep your radial head in place.

First Steps to Treatment

If you have suffered a fall and are experiencing elbow pain as a result, you must see your doctor or visit your local emergency department right away. Your doctor can take an x-ray to see if you have suffered an upper extremity fracture or other injury to your elbow or arm.

If an x-ray confirms you have a radial head fracture, your doctor will do specific things to ensure that the fracture is properly reduced.

Once your fracture is stable, you may be required to have your elbow in a cast, and a sling may be used to keep your elbow immobilized while it heals.

Physical Therapy

The main goals of physical therapy after a radial head fracture are to improve your upper extremity range of motion (ROM) and strength, control your pain and swelling, and improve your upper extremity function.

Your first visit with your PT after a radial head fracture is an initial evaluation. During this session, your PT will ask you questions about your injury, and specific tests and measures will be taken to get a baseline of your condition. Your PT will then be able to develop a plan of care to help improve your overall mobility.

Your physical therapist will likely choose to do a variety of different treatments and exercises for your radial head fracture rehabilitation. These may include:

  • Home exercise program. One of the most important components of your radial head fracture rehab is the home exercise program—exercises you do on your own to help augment your PT program. Your therapist can show you specific exercises to do to improve the mobility of your entire upper extremity.
  • Elbow ROM exercises. Your physical therapist can teach you exercises to help improve your elbow ROM. This can help maximize your elbow mobility.
  • Wrist strengthening exercises. After a radial head fracture, you may be required to wear a sling while your elbow heals. This may cause your hand and wrist muscles to weaken. Your PT may have you perform dumbbell wrist strengthening exercises to strengthen the muscles that control motion at your wrist.
  • Handgrip strengthening exercises. Performing exercises, like the towel handgrip exercise or the putty grip program can help improve the strength and function in your hand and wrist.
  • Shoulder mobility exercises. Immobilization in a sling may cause your shoulder to feel tight. Your PT may perform techniques and exercises to improve the way your shoulder moves. Shoulder mobility exercises typically start out as passive movements, and then active shoulder ROM and shoulder strengthening exercises can be incorporated into your radial head fracture rehab.
  • Therapeutic modalities for pain and swelling. Once your radial head fracture has healed, you may still be feeling pain and be experiencing swelling around your elbow. Your PT may use specific modalities, like heat, ice, or electrical stimulation, to help control your pain and improve your elbow swelling.

    The most important component of your rehab for radial head fracture is you. Be sure you are engaged in your therapy, and ask a lot of questions to ensure you do the right things during your recovery.

    How Long Physical Therapy Might Take

    In general, most PT programs for a radial head fracture last about 4 to 6 weeks. In that time, you should notice significant gains in your elbow and shoulder mobility, your upper extremity strength, and your ability to use your arm normally. It is not uncommon to continue with slight elbow ROM deficits after a radial head fracture, even with the best efforts of you and your PT. 

    If you have questions or concerns about your specific progression during your radial head fracture rehab, talk to your physical therapist and doctor. By having a therapeutic alliance with your PT, you can be sure to have a positive rehab outcome with your radial head fracture rehab.

    A Word from Verywell

    A radial head fracture can be a painful injury that limits your ability to use your arm normally. By engaging in physical therapy to work on your mobility and strength, you can be sure to quickly get back to your normal lifestyle.

    Source:

    Motisi, M. et al. Trends in Management of Radial Head and Olecranon Fractures. Open Orthop J. 2017; 11: 239–247. Published online 2017 Mar 31. doi: 10.2174/1874325001711010239

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