C. Noel Henley, MD

Hand and Upper Extremity Specialist

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Weightlifter Elbow Dislocation – How Does An Elbow Dislocate?

August 3, 2012 by Dr. Henley Leave a Comment

Champion weightlifter Sa Jae-hyouk sustained an elbow dislocation during a second lift of 162 kg (357 lbs) during the men’s 77 kg class event in London this week. Here’s how it happened.

The 27 year old weightlifter’s right elbow dislocated as he tried came out of the squatting position and pushed the bar up overhead into a final locked position.

How did Sa Jae Hyouk dislocate his elbow?

In order to lift and stabilize such tremendous weight, the two ends of the bar must be maintained perfectly parallel to the shoulders.

The elbow is a complex hinge joint, formed by the humerus (arm bone) and the two forearm bones (radius and ulna).

Muscles on all sides of the elbow start on the humerus, or arm bone, cross the elbow as tendons, and attached on the radius and ulna bones of the forearm.

During a heavy lift in competitive weightlifting, these muscles are constantly firing as the athlete struggles to maintain the balanced position of the bar throughout all phases of the lift.

In this case, the right end of the bar begins rotating behind Jae Hyouk’s right shoulder, so his right arm muscles have to contract much stronger to keep the bar from falling and rotating even more. Eventually the bar started going one way, and his muscles pulled violently the other way – dislocating the elbow.

The muscles and tendons of the arm literally pulled the forearm bones away from their ligament attachments on the humerus.

What structures are injured in a dislocated elbow?

As the muscles contract violently, they pull on their attachements to the radius and ulna. This can tear ligaments apart or even pull tendons off the bone.

Also, as the forearm bones are pulled violently against the humerus after the ligaments tear loose, the ulna or radius bone can splinter and fracture.

Other, more unusual injuries can include muscle tears or nerve stretch injuries. These happen as the bones push suddenly against muscles and nerves during the dislocation.

So, elbow dislocations like this one at the London Olympic Games can involve

  • ligament tears
  • fractures (same as a broken bone)
  • tendon tears
  • muscle tears
  • nerve stretch injuries

How are elbow dislocations treated?

The elbow must be put back into place emergently. This is usually done under sedation with IV medicine, either in an emergency room or in surgery.

Once the elbow is back in place, an orthopedic elbow specialist must decide the next step.

Depending on what structures are injured (may require MRI or CT scan to diagnose), surgery may be necessary. This could involve fixing fractures, repairing ligaments or tendons, or even pins on the outside of the elbow.

A specially-made hinged elbow brace is used during rehabilitation to prevent too much stress on the healing ligaments.

Many weeks of therapy are required to regain motion, flexibility, and strength in a weightlifter’s elbow.

Fractures usually heal in 6 weeks; ligaments take about 4 weeks to heal to the point where aggressive motion is safe in therapy.

Other weightlifting elbow injury videos

These are other videos of similar elbow injuries in weightlifting athletes.

In the above video of Janos Baranyai, you can see at 0:35 where the bar twists back behind him on his right. Amazingly, he’s still trying to hold onto the bar, but the elbow has already dislocated. You can see the prominence of the olecranon (tip) process of the ulna bone pointing up in the air.

In the video above, a tendon in this weightlifter’s knee tore, and he lost control of the bar, dislocating his left elbow.

Above, another injury video of a weightlifter who came back from his elbow dislocation.

And, above: another right elbow dislocation weightlifting injury, occuring the exact same way.

Are you picking up on a pattern here?

Conclusion

Weightlifting accidents like Jae Hyouk’s are devastating injuries that require expert care and treatment.

Similar injuries can also happen in car wrecks, falls, and in other sports where the elbow is put through violent stresses.

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