Nursing a Nursemaid’s Elbow

“History will judge us by the difference we make in the everyday lives of children.” – Nelson Mandela.

Our obligation as adults is to protect our youth by any means necessary. The best way to do that is by staying informed about new scientific studies and taking advice from medical professionals on how to best help and nurture the children of the world. Because of their lack of knowledge and experience, toddlers depend on us to guide them through all the dangers and illnesses that may come their way. Even the safest and most responsible adults make mistakes now and again, which is why we are going to dive into everything you need to know about—”nursemaid’s elbow”.

What is Nursemaid’s Elbow?

When most people hear the words “nursemaid’s elbow” they are surprised to learn that it has anything to do with young children due to its strange name. In simple terms, nursemaid’s elbow occurs when the radius (one of the bones in the forearm) slides out of place from where it is normally attached to the elbow joint. It is a common condition in children younger than four years of age. Other names include pulled elbow, slipped elbow, or toddler’s elbow. The medical term for Nursemaid’s Elbow is “radial head subluxation”.

Let’s say you are out on the town, taking a leisurely stroll with your toddler. The youngster notices something that catches their eye, and they begin to run towards the excitement, when the parent grabs their arm to stop them, pulls too hard, and suddenly contracts the hand or forearm. This causes the radius to slip out of the ligament holding it into the elbow. It can also occur when an infant rolls himself or herself over, from a fall, or from pulling or swinging a young child by the hand. We all love picking up a baby and playing with them, but it’s important not to be too overzealous because the child is not fully developed to withstand such quick movements.

What Are the Signs and Symptoms of Sursemaid’s Elbow?

Nursemaid’s elbow is a tricky injury because it usually occurs to toddlers and young children who may not be able to articulate what exactly the problem is, leaving it up to the parent or guardian to figure it out. At first glance, nursemaid’s elbow may not be obvious and can easily go unnoticed, but the child will usually cry from the discomfort. Other important signs to look for would be: if the child avoids moving their arm below the shoulder, supports one arm with the other hand, holds their arm straight or slightly bent and close to the body, or if they refuse to rotate their palm.

In other words: if the child lacks mobility and demonstrates discomfort and flexibility in the arm, there is a good chance they are experiencing nursemaid’s elbow.

Now that you know the symptoms, the next question is:

Is Nursemaid’s Elbow an Emergency?

The simple answer is: Yes.

Normal use of the arm will be painful and inhibited until the injury is corrected, which is why it is crucial to seek medical attention as soon as possible. There are certain cases where nursemaid’s elbow has corrected itself, but there is no reason to take that gamble, especially when dealing with children. Let your healthcare provider be the one to examine your child to make sure there are no fractures or breaks and once the examiner does that, they can begin the process of correcting the injury.

Diagnosis & Treatment of Nursemaid’s Elbow

After your child has been officially diagnosed by your healthcare provider, they will perform a physical exam and ask a series of questions about what happened at the time of the injury. This physical exam will test your child’s range of motion and see if there is any tenderness at the elbow. The treatment is a simple, but effective physical maneuver called “nursemaid elbow reduction”. Lasting only a few seconds, the healthcare provider will perform the reduction by gently flexing and rotating the arm. If you hear a “pop” sound, don’t be alarmed! This is simply the joint moving back into place. As far as imaging tests are concerned, they often won’t show evidence of nursemaid’s elbow, however, an X-ray can be used to rule out a fracture or break.

Even though you should seek medical attention to have the joint corrected by a professional, there are forms of treatment you can do on your own. There are plenty of over-the-counter drugs to help your child manage the pain and applying ice to the injured area will also help. There are some adults out there who have attempted the correction maneuver themselves, this is not well advised.

Recovery begins immediately after your child’s elbow has been reduced. The best part is your child will only feel pain for a few seconds, but soon after will feel as good as new!

Prevention of Nursemaid’s Elbow

Now that you know what nursemaid’s elbow is and what signs to look for, let’s discuss a few simple ways to prevent this from happening. The best thing to do is avoid pulling or jerking your child by the arm or hand. This may sound simple, but when a child attempts to cross a street before looking both ways or their curiosity gravitates them to something that can harm them, your parental instincts kick in, telling you to pull them out of the way. Even though you are trying to protect them, you may actually hurt them in the process. Another method would be to use verbal cues instead of physical ones to get their attention and lastly, try not to swing your child around by the hands or arms for fun. Many parents do this because it’s entertaining and puts a smile on their child’s face, but this is probably the most common way children suffer from nursemaid’s elbow.

Afterthought

If the healthcare provider has successfully corrected the joint, nursemaid’s elbow should not come back but it is worth noting that a child who has had this injury is more likely to have it again, than someone who hasn’t. This is because the injury stretches the ligaments, making it harder to hold the bone in place. A child who has experienced Nursemaid’s Elbow may have looser ligaments in general too. Fortunately, as children grow, their bones and ligaments will become stronger, making nursemaid’s elbow highly unlikely after a child turns five years old.

We are privileged to live in a country where we have countless urgent care facilities that are staffed with exceptional medical professionals who can easily help if your child experiences nursemaid’s elbow. This is an injury that should not go un-diagnosed and luckily for you, Chai Care will always be here to supply you with the top-notch service and sensitive care that your child deserves!

* Legal disclaimer: The content of this article and the entire Chai Care blog is for educational purposes only; it does NOT constitute medical advice and must not be considered as such. Please consult a medical professional regarding any symptoms or health concerns you or your loved ones.