Elbow Rehabilitation

Elbow Replacement Rehab

SlingWhen will I go home?What can I do?What can’t I do?
4 weeksYou will be discharged on the day after the operationGentle range of movementNo active movements, no lifting

Acute phase (0-6 weeks)


  • Reduce pain
  • Keep arm in a comfortable yet functional position
  • Wrist and finger mobilization


  • Out of sling/elbow splint as tolerated
  • Patient education regarding proper positioning, range of movement precautions, joint protection techniques
  • No lifting of objects greater than 1 kilogram with operated upper extremity
  • No excessive stretching or sudden movements (particularly extension)
  • No forced flexion
  • Avoid varus/valgus stress to the elbow
  • No upper extremity weight bearing with the involved side
  • Gentle active assisted range of movement elbow extension and flexion exercises initiated with elbow held close to the body (adducted position) with forearm in neutral to pronation bias
  • Unless otherwise instructed, forearm rotations are to be completed with the elbow held at the side at 90 degrees of flexion to minimize strain on ligamentous structures
  • Assisted range of movement of cervical spine, shoulder, wrist, and hand
  • Gentle gravity-assisted elbow extension range o movement stretching
  • Frequent cryotherapy for pain, swelling, and inflammation management
  • Compressive wrapping/garments for oedema management as indicated

Criteria for progression

  • Pain control

Intermediate phase (6-12 weeks)


  • Encourage functional range of movement and strength of the elbow for activities of daily living, while protecting healing soft tissues
  • Minimize pain and inflammation
  • Re-establish dynamic elbow stability & proprioception


  • 6 weeks postop: begin submaximal painfree elbow/forearm/wrist/hand isometrics at mid range of available elbow range of motion (all planes)
  • 8 weeks postop: progress to submaximal painfree elbow/forearm/ wrist/hand isometrics at multiple angles of available elbow range of motion. However, no isometrics at end ranges of motion
  • 10-12 weeks postop: progress to sub maximal pain free shoulder and elbow/wrist/hand isotonic strengthening as motor control improves
  • Initially single plane elbow movement then progress to composite movements as appropriate
  • If patient has not achieved functional elbow range of motion of at least 120 degrees flexion then consider the use of a dynamic or static progressive splint
  • Continue use of cryotherapy and oedema management for pain and inflammation

Criteria for progression

  • Pain free range of movement

Late phase (>12 weeks)


  • Restore full range of movement


  • Maintain a home program with focus on pain free functional arc of elbow motion, strength and proprioception
  • Continue previous exercises 2-3 times a week to maintain range of movement, strength, and function upon discharge from physiotherapy
  • No heavy lifting of objects (no heavier than 5kg) for life
  • No tennis or throwing activities for life

Guidelines for return to functional activities





3 monthsNo more than 5kg for life3 months4 months
Matthan Mammen

Mr. Matthan Mammen

MS, FRACS (Orth)

Mr. Matthan Mammen is an internationally qualified orthopaedic surgeon, who is a Fellow of the Royal Australasian College of Surgeons and the Australian Orthopaedic Association.

Shoulder Bone IconShoulder Bone Icon

Shoulder Joint

Elbow IconElbow Icon

Elbow Joint

Wrist IconWrist Icon

Wrist Joint

Hand IconHand Icon

Hand Joints

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