01/08/2025
Nursemaid’s elbow, or radial head subluxation, is a common injury in young children (typically ages 1-4) where the radial head slips out of the annular ligament. Physiotherapy management focuses on education, prevention, and gentle rehabilitation after reduction, as the condition usually resolves with a simple manual reduction.
1. ✅ Post-Reduction Care
• 👉 Assessment: After successful reduction, assess the child’s elbow for pain, range of motion (ROM), and function. Ensure the child is using the arm normally (e.g., reaching, grasping).
• 👉 Pain Management: If mild discomfort persists, recommend ice application (wrapped in a cloth, 5-10 minutes) and over-the-counter pain relief (e.g., acetaminophen).
• 👉 Rest and Observation: Advise short-term rest (1-2 days) to avoid re-injury, but encourage gentle use of the arm as tolerated to prevent stiffness.
2. ✅ Restoring Function
• 👉 Gentle ROM Exercises: Once pain-free, guide parents on gentle active ROM exercises to restore full elbow and forearm motion (e.g., supination/pronation, flexion/extension). Examples:
• Encourage play-based movements like turning a doorknob, rolling a ball, or reaching for toys.
• Avoid forced movements to prevent re-subluxation.
• 👉 Strengthening: Typically not needed, as children regain strength through normal play. If weakness persists (rare), light activities like squeezing a soft toy can help.
3. ✅ Education and Prevention
• 👉 Parental Education: Teach caregivers how to avoid situations that may cause recurrence, such as pulling or lifting the child by the arm or swinging them by the hands.
• 👉 Activity Modification: Advise on safe play and handling techniques (e.g., lifting under the armpits).
• 👉 Recurrence Awareness: Inform parents that nursemaid’s elbow may recur until the child is older (around 5-6 years) due to ligament laxity. If it recurs, they should seek medical attention for reduction.
4. ✅ Monitoring and Follow-Up
• 👉 Follow-Up: If symptoms (pain, limited ROM) persist beyond 1-2 days post-reduction, refer back to a physician to rule out complications (e.g., fracture, ligament damage).
• 👉 Red Flags: Advise parents to seek immediate care if the child develops swelling, bruising, or deformity, as these may indicate a more serious injury.
