What to Know About Sprained Elbows

Medically Reviewed by Mahammad Juber, MD on October 19, 2022
5 min read

Elbows are made up of groups of muscles, bones, ligaments, and tendons. The ligaments in your elbows keep your elbow joints stable and allow your elbow to move properly. When you sprain your elbow, everyday actions can become difficult.

An elbow sprain happens when one of the ligaments in the elbow is overstretched or torn.

Ligaments are a type of connective tissue within your body. They’re fibrous, rope-like bands that connect bones and organs. Ligaments have several important jobs, including:

  • Helping your joints move in the right direction
  • Holding your bones together
  • Keeping your bones from dislocating
  • Keeping your joints from twisting
  • Stabilizing your bones and muscles
  • Strengthening your joints

You have over 900 ligaments in your body, and several of these are in your elbow. These ligaments mainly function to connect the upper arm bone, the humerus, and the lower arm bones, the ulna and radius, to the elbow joint. The primary ligaments of your elbow are:

  • Annular ligament: This ligament holds the radius and ulna together.
  • Radial collateral ligament: Also called the lateral collateral ligament, this ligament stabilizes the outside, or lateral side, of the elbow.
  • Ulnar collateral ligament: Also called the medial collateral ligament, this ligament stabilizes the inside, or medial side, of the elbow.

Sprains are divided into three categories based on severity:

  • Grade I: Grade I elbow sprains describes sprains where the ligament is stretched but hasn’t torn. Grade I sprains usually have small amounts of pain, swelling, and bruising, but you can still use the sprained area.
  • Grade II: In grade II sprains, the ligament has partially torn. You may have a higher amount of pain and swelling and trouble using that area of your body.
  • Grade III: If you have a grade III sprain, the ligament has torn completely. This type of sprain causes severe pain and you will likely not be able to use that part of the body or put any weight on it.

Elbow sprains can be caused by injury or overuse.

Elbow sprains caused by injury happen when your arm is bent or twisted in an odd position. This can happen while playing sports, by falling with your hand stressed out, or from a hard hit, like what might happen during contact sports or a car accident.

Overuse can happen when you use repetitive motion at work or while playing sports. Tennis players, golfers, and baseball pitchers commonly end up with elbow sprains or other elbow issues like strains and tendonitis.

The symptoms of an elbow strain may vary depending on the severity of your injury. In general, symptoms of a sprained elbow include:

  • Bruising around the elbow
  • Difficulty bending or extending your elbow
  • Inflammation in your elbow
  • Instability in your elbow
  • Pain in your elbow
  • Redness around your elbow

If you experience the following symptoms, you should consult with your doctor:

  • Inability to bear weight on your elbow
  • Inability to move your elbow
  • Numbness around the elbow
  • Pain directly over the bones of your elbow

To diagnose an elbow sprain, your doctor will first meet with you to discuss your medical history and the injury. They’ll also examine your elbow to determine where the pain is and see how well you can move or rotate it. In some cases, your doctor may order imaging tests to get a better look at the ligaments and see the full scope of your injury.

Ultrasounds.Ultrasounds use sound waves to create images of soft tissues like ligaments. Your doctor can use an ultrasound to differentiate between a sprain and a strain. Strains happen when muscles or tendons are stretched or torn. Ultrasounds can also help your doctor check for signs of overuse in the ligaments, such as tearing or stretching.

MRI.MRI stands for magnetic resonance imaging. This type of imaging creates scans of soft tissue using a large magnet and computer-generated radio waves. MRIs are able to see deeper into the soft tissue than an ultrasound is, and are often the preferred imaging method for sprains.

X-ray and CT scans. X-rays use a safe amount of radiation to look inside the body. Dense material, like bones, doesn’t absorb radiation the way that soft tissue does, and this allows bones to show up white on the X-ray. Your doctor can then check for fractures or dislocations that could be causing your pain, and can also look for a build-up of fluid that can point to a sprain. CT scans use X-rays to take cross-sectional images to give a more comprehensive view of what’s going on inside your body.

Treatment for your sprained elbow will depend on how severely you injured it.

Most of the time, elbow injuries heal without any surgical intervention. You can usually treat a mild sprain at home using the R.I.C.E. method: rest, ice, compression, and elevation:

  • Rest. Try to avoid activities that cause additional pain and swelling to your injured arm. 
  • Ice. Icing your sprain will help reduce swelling. Apply an ice pack for 25–20 minutes every two or three hours. Never place ice directly on the skin. 
  • Compression. Wrapping your injured elbow in an elastic bandage will also help reduce swelling. If the area becomes more painful, numb, or the area below the bandage becomes swollen, unwrap the bandage. Those are signs that the bandage is too tight and is cutting off your circulation.
  • Elevation. Another way to reduce swelling is to elevate your elbow above your heart. This allows gravity to bring the swelling down.

Using the R.I.C.E. method for the first three to five days can help combat initial pain and swelling. For additional help, over-the-counter NSAIDs like ibuprofen and aspirin will also help reduce pain and swelling.

If your injury is severe, you may need surgery. There are several surgical options depending on the specifics of your injury. 

One type of surgery, ulnar collateral ligament reconstruction, is often performed on baseball pitchers. It’s commonly known as “Tommy John surgery,” after the baseball pitcher who initially had the procedure in 1974. This procedure takes a tendon from elsewhere in the body to replace the tendon on the inside of your elbow.

Depending on the severity of your elbow sprain, recovery can take a few weeks to a few months. Your doctor will let you know what to expect.

In some cases, your doctor may recommend physical therapy to aid in your recovery. This will help strengthen and stabilize the ligaments and allow you to regain your full range of motion.