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Nursemaid's Elbow

 

By Deanie Barth, MSPT, Physical Therapist

 

Have you ever been walking down the street with your toddler when he decides it’s a perfect time to throw a temper tantrum? You grasp his hand to pull him along and in defiance and anger he turns his palm down to the ground and tries to pull away from you by sitting down, or worse, lifting his feet in the air? You might respond by pulling even more firmly on his arm in an effort to get him moving before there’s a full-scale tantrum. While pulling harder usually won’t harm your child, once in a while these actions could result in what is known as “Nursemaid’s Elbow”.

 

Nursemaid’s elbow is a subluxation (incomplete dislocation) of a bone in the elbow (the radius). Children between the ages of 1-3 are most at risk for this injury. At this age, the ligaments are still developing, which is part of the reason babies and toddlers always seem so flexible. There is a small ligament in the elbow (annular ligament) which serves to stabilize the elbow and when a child’s arm is pulled by the hand with the palm turned downward (pronated), this ligament can be easily torn which results in the subluxation of the bone.

 

After subluxation, a child will usually start crying and hold his elbow bent at 90 degrees against his stomach with the palm turned downward. He may rub his elbow and some swelling or bruising may occur. Even after he stops crying, he will continue to hold his elbow in the protected position and may not be able to turn his palm up or bend and straighten his elbow all the way. If you suspect your child sustained this injury, do not attempt to diagnose it by moving it around – take him to the doctor immediately.

 

Once a diagnosis is made, the physician will reduce the elbow (pop it back into place) and may choose to sling the elbow. In the first 3-5 weeks following the injury, the elbow is more likely to sublux if pulled on, so it is very important to avoid doing so. Your doctor will most likely instruct you on exercises or refer you to a physical therapist to ensure the return of full range of motion.

 

To avoid dislocation injuries of the elbow and shoulder of your toddler, refrain from pulling him by the hands with any force. If you need to pick your child up, pick him up from under the armpits. If you choose to swing your child in circles, don’t hold him by the hands, once again, hold under his armpits and you should be able to avoid any unwanted injuries. Except in the case of extreme ligament laxity, risk of subluxation is minimal after the age of 7 when the ligaments have had a chance to fully develop. In the meantime, if you need help with dealing with your child’s tantrums, please refer to a previous article written by our special educator, Gopi Patel, Help! My Child Has Tantrums.

 

If you liked this article, you may also want to read our other developmental articles:

 

Untitled Document
Guidelines for Summer Activities Gopi K. Patel, MSE.d
Learning Through Movement… A Sensory-Rich Way to Help Children Barbara Greenspan, OT
Five Elements of Successfully Disciplining Your Toddler Andy Eig, PhD.
Preventing Family Headaches Andy Eig, PhD.

Let's Get... Potty Trained!

Gopi K. Patel, MSE.d
Play is A Lot More Than Fun and Games Shari Harpaz, MS, CCC-SLP
Understanding Your Child's Personality Gopi K. Patel, MSE.d
Nursemaid's Elbow Deanie Barth, MSPT
Torticollis – What Every Parent Should Know Barbara Greenspan, OT
Getting to Know Your Body Barbara Greenspan, OT
Learning to Read Starts Young Shari Harpaz, MS, CCC-SLP
It’s All In The Hands - Ways to Develop Fine Motor Skills Barbara Greenspan, OT
Understanding the Different Modes/Styles of Learning Shari Harpaz, MS, CCC-SLP
Achieving Gross Motor Milestones and Play Skills Through Summer Time Fun Deanie Barth, MSPT
Help With Grandparents Andy Eig, PhD.
Helicopter Parenting Barbara Greenspan, OT
Eye-Hand Coordination Barbara Greenspan, OT
Five Major Milestones for Early Physical Development Deanie Barth, MSPT
It's All About the Core Deanie Barth, MSPT
Using Time Outs Properly and Effectively Andy Eig, PhD.
Making Room for Two Andy Eig, PhD.
Giving is MORE than Toys Gopi K. Patel, MSE.d
Using the  5  7 Senses Barbara Greenspan, OT
Have You Spanked Your Children? Gopi K. Patel, MSE.d
What to Expect During the Sixth Year of Your Baby's Life Gopi K. Patel, MSE.d
What to Expect During the Third Year of Your Baby's Life Gopi K. Patel, MSE.d
What to Expect During the Second Year of Your Baby's Life Barbara Greenspan, OT
What to Expect During the First Year of Your Baby's Life Deanie Barth, MSPT
Psychiatric Medication and Young Children: Is there too much pill popping? Andy Eig, PhD.
Exersaucers, Swings and Jumpers— A help or hindrance to development? Deanie Barth, MSPT
Technology — A Chief Culprit in Language Delays Shari Harpaz, MS, CCC-SLP
HELP! My Child Has Tantrums Gopi K. Patel, MSE.d
Great Indoor Winter Play Ideas Barbara Greenspan, OT