Elbow injuries in rugby are less common than shoulder injuries.
Of course, the overuse injuries such as tendinopathy (tennis, golfer’s elbow and biceps tendinopathy) can occur and these are treated in line with other causes of the same problem. This usually involves a period of avoidance of the precipitating causes, a physiotherapy programme and modification of technique. If that fails, then a PRP injection is the next line. Surgery is required for the minority of patients.
Elbow dislocation sometimes occurs during rugby. A dislocated elbow requires emergent reduction in hospital. The integrity or fracture of bones around the elbow determines the best treatment pathway:
If there is no fracture, the dislocation is called ‘simple’. An MRI will assess the structures you’ve injured and help guide your surgeon as to your need for a general anaesthetic examination of your elbow +/- fixation of your ligaments and muscles if your elbow is still unstable. It is usually those with muscle origin avulsions as well as ligament injuries who require this approach. For those without muscle origin injury, the standard short period of splintage followed by controlled active motion is advocated.
A fracture dislocation normally requires surgery to address both the bony injuries and the ligament injuries. A CT scan helps your surgeon to plan fixation. Occasionally an external fixator is required to augment your repair for 6 weeks after your surgery, but normally controlled active motion is encouraged (sometimes in a brace) soon after your operation.
After a dislocation your ligaments need to heal. This will take a minimum of three months and then you will need to strengthen your joint. It is therefore likely that you will be off competitive play for 5-6 months. A degree of elbow stiffness (loss of end-range of motion) is common after elbow dislocation, but the recovered range is normally ‘functional’.
Recurrent instability is uncommon, but can be a challenging problem to treat. Ligament reconstruction procedures can restore stability and function. A synthetic ligament or a donor tendon can be used to create these reconstructions.
Distal Biceps rupture
Rugby players are stronger now than ever before. Heavy weight training regimes are the norm for serious players. As we enter our thirties, the ability of our tendons to adapt declines and we become prone to degenerative tendinopathies. An overwhelming force, or a sudden eccentric contraction can cause the distal biceps tendon to rupture. This causes a pop or a crack, swelling pain and bruising. In complete ruptures, your biceps muscle contour changes and you will notice weakness in both elbow flexion and forearm rotation. These injuries are best treated with early surgical repair (within 2 weeks ideally). Results of fixation are generally excellent with 95% or more of full strength returning once healed. Occasionally the tendon is only partially ruptured. In this case an MRI is useful to characterise the injury and plan whether to fix the injury or rehab without surgery.
Fractures around the elbow often require surgical fixation. Please see the elbow conditions section: ‘common elbow trauma’ for more detail. The aim is to restore enough fracture stability through fixation to allow immediate controlled rehabilitation of your elbow. In general, healing bones around the elbow will become pretty strong by three months, so you will begin to strengthen from then. Your return to competitive play will then be planned.
Mr Granville-Chapman was very polite and his examination and explanation of my symptoms and expected treatment was thorough
I found Mr Granville-Chapman to be very knowledgeable and professional. He put me very much at ease and explained all the options that I have thoroughly. He also told me to look for further information on the condition and procedures that I needed on his website, which gave lots of information and detail. It was also easy to understand for those without a medical background. I would highly recommend his services to anyone that has shoulder problems and requires a solution.
I attended for a repair of my right bicep tendon. After a thorough examination, Mr Granville-Chapman arranged an operation to be undertaken within 2 days which was extremely quick; he explained his reasoning which was both thorough and reassuring, explaining both the options of undergoing surgery and deciding to undertake conservative management.On the day of the surgery Mr Granville-Chapman was again very reassuring as although this is minor surgery I was still somewhat apprehensive. He came to fully explain the procedure and afterI woke up was quick to check on how I was doing.Overall I am very happy with the careMr Granville-Chapman
I have been very pleased with my treatment so far. Mr Granville-Chapman combines brisk efficiency with a pleasant, sympathetic manner. My operation, however, is still to come ...
From the initial consultation, through surgery on a fractured wrist, and now post-operative follow up, it has been a very positive and reassuring experience with Mr Granville-Chapman. I would have no hesitation in recommending him to someone else.
A first class clinician. A skilled surgeon with an excellent bedside manner.
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I recently broke my right clavicle in a mountain bike accident and it was repaired by Mr Granville-Chapman by adding a plate on top of the bone. Having just finished the last post-op consultation, I can confirm that I have been very happy with the process all along. In particular, Jeremy took time to explain in detail why a plate was needed, what the procedure would entail, and also was very patient answering my questions comprehensively beforehand and after during the recovery phase. Would certainly trust this competent surgeon to fix any future fractures I might sustain.
Mr Granville-Chapman has looked after my 15 year old son brilliantly, explaining the surgery, recovery and best way forward, and Kate has been very supportive helping with logistics etc, thank you so much.
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