After a fracture or injury around the elbow, immobilization in a cast or sling is often the right first step. But extended immobilization has a well-documented downside: the soft tissues around the elbow — the joint capsule, ligaments, and surrounding muscles — can shorten and stiffen when left in a cast or sling, leaving patients with limited range of motion long after the bone has healed.
This lasting stiffness is called an elbow contracture, and it’s a common reason patients come to see Dr. Fort after completing their initial treatment for elbow injuries.
Why The Elbow Is Particularly Prone To Stiffness
Compared to most other large joints, the elbow joint has low tolerance for immobility. The capsule (the tissue surrounding the joint) responds to prolonged positioning by developing dense scar tissue, and the muscles that cross the joint shorten when they’re held in a shortened position for weeks at a time.
A common result of this is a stiff elbow that won’t fully straighten (limited extension), bend (limited flexion), or do both. A mild contracture may mean losing 10 to 20 degrees of motion — frustrating, but usually manageable. However, a more severe contracture may limit motion significantly and interfere with reaching, lifting, dressing, and basic daily tasks.
What Recovery From A Contracture Involves
The primary treatment for most elbow contractures is physical and occupational therapy, and the earlier it begins, the better the results tend to be. Therapists use a combination of stretching, manual techniques, and progressive splinting, using dynamic splints or static progressive splints to apply sustained low-load stretch to the stiff tissues over time.
This process takes patience. Gains tend to come gradually, and the work must be sustained over weeks to months to achieve meaningful improvement. Most patients with mild to moderate contractures see functional gains with a consistent therapy program, and many are able to recover to elbow motion ranges they can live with comfortably.
When Surgery Becomes Part Of The Conversation
For severe contractures that haven’t responded adequately to therapy, surgical intervention is an option. Dr. Fort can surgically remove scar tissue or bony obstructions, release contracted ligaments, or repair damaged structures to restore movement. Recovery after surgery includes a therapy program to maintain and build on the motion gained during surgery.
The Sooner Stiffness Is Addressed, The Better
Stiffness that develops during elbow immobilization tends to worsen if it’s not actively managed. Patients who begin range-of-motion work as soon as their surgeon clears them, and especially those who stay consistent with it, generally do better than those who wait for the stiffness to resolve on its own.
If you’ve come out of a cast or sling and your elbow isn’t moving the way it should, Dr. Fort can evaluate what’s limiting your motion and recommend the right approach for where you are in recovery. Call (877) 709-5522 or contact us online to book your appointment with Dr. Fort today.