Last month we talked about the soft tissue injuries in the elbow including tendinitis, bursitis, and injuries to the joint capsule. Last month we talked about the soft tissue injuries in the elbow including tendinitis, bursitis, and injuries to the joint capsule. This month we’ll discuss the injuries to the cartilage and bones. As a general rule our bones are the strongest parts of our bodies, but it is not uncommon for the connective tissues to withstand more force than the bones before being damaged. We all grimace when we see replays of what happened to Tim Sylvia’s forearm in his fight against Frank Mir in UFC 48. When an armbar is applied, the knees and thighs are squeezed around the arm while the hips are extended upwards exerting a tremendous amount of force on the elbow joint and bones in the forearm. The resistance supplied from the inherent strength of the ligaments and tendons in the arm along with the additional resistance from the action of an opponent’s muscles pulling upwards can put more stress on the bones in the forearm than the joint itself. This can lead to a fracture in the shaft of the radius or ulna. A fracture to the ulna is referred to as a Monteggia fracture and almost always requires surgical repair through open reduction and internal fixation with plates and screws.
The likelihood for dislocations occurring in the elbow from an armbar is minimal. Dislocations are more commonly the result of falls on an outstretched arm to brace for impact or to soften a landing. If the elbow is dislocated, immediate referral to the hospital is recommended for evaluation by a physician or emergency medical staff. Since 35-40% of all elbow dislocations involve a fracture, it is important to have x-rays performed before any attempt at reduction (putting the bones back in place) is made. Immediate treatment involves immobilization for 7-10 days followed by bracing in a hinged elbow brace for approximately 3-4 weeks with gradual increasing in the range.
Anytime you sustain an elbow injury from an armbar, the most important thing to do is avoid further trauma. There is no good that comes from continuing to train or compete with a serious injury. Tenderness and swelling around the elbow are obvious signs of injury. Popping or clicking sounds are also common following armbar injuries. This should not be a cause for concern unless the elbow locks or is painful as it makes the noises. Clicking sounds in the elbow that are associated with pain may indicate tiny loose fragments of cartilage and bone which is referred to as osteochondritis dessicans. Any visible deformities around the elbow or forearm could indicate more serious injuries including fractures or dislocation and should be evaluated by a physician immediately. X-rays, CT scans, and MRIs can rule out conditions like osteochondritis, bursitis, bone fragments, and stress fractures.
Once the elbow pain has subsided and you are able to do basic drills, a solid rehab routine is always recommended. Any strength training or resistance exercises to increase grip, wrist, and forearm strength along with biceps and tricep exercises would be appropriate. Elbow braces and certain taping techniques may help with problems with laxity in the joint and can help prevent further injury during training, but they probably won’t do much during the heat of competition. Elbow injuries are inevitable in BJJ and submission grappling so be prepared to deal with the consequences the next time you decide to go for an armbar or refuse to tap out from one. For more information on elbow injuries in mixed martial arts, you can reach Dr. Park at the address below.
Contact info: Dr. John H. Park, D.C., C.S.C.S.Progressive Spinal & Sports Rehab10076 Darnestown Road Suite 200Rockville, MD 20850www.ProSpineRehab.comwww.yourMMAdoctor.comPhone: (301) 294-5101
Dr. Park is a chiropractor specializing in sports medicine and orthopedics. He has studied martial arts for over 10 years including karate, tae kwon do, Muay Thai boxing, and Brazilian jiu jitsu. Dr. Park holds a black belt in tae kwon do and is a BJJ blue belt under Mike Moses/Lloyd Irvin (www.evolveacademy.com).