The elbow joint is an important hub for stress transmission from the hand and forearm to the shoulder and trunk. The main movements are flexion, extension, and forward and backward rotation combined with forearm movement. The normal flexion angle of the elbow joint in most people is about 135°-160° active and 140°-170° passive; the extension angle is about -10°-0° active and passive; the rotation angle is about 80° active and 90° passive; the rotation angle is about 80° active and 90° passive. My personal opinion: for the elbow joint, the flexion function is the most important. If the flexion function is limited, many things in daily life such as eating, combing hair, etc. cannot be done on their own because they simply cannot get their hands close to their mouths or the back of their heads, and the same is true for some other things. Generally speaking, only active angles of 130 or more are able to complete the above types of movements. The next important function is the rotation back of the elbow joint and forearm, that is, the upper body upright, the shoulder joint naturally down, bending the elbow 90 °, the wrist fixed, the palm of the hand turned upward action (in the same position on both sides, the palm of the hand relative to each other as the neutral position of the rotation action). As you can imagine, if you can’t fully rotate back, when you do the action of washing your face, even if the flexion function is normal, you can’t hold the water in your hands to your face, so you still can’t fully take care of yourself. Only the active rotation angle to more than 60 °, to complete this type of action. Once again is the extension function, if the extension restriction is greater than 40 °, the upper limb is not easy to put on the sleeve, and if the extension restriction is not to this extent, it is still basically an aesthetic problem (except for individual patients who must be fully extended due to work needs), so the status of the extension function is placed in the third place. In elbow or forearm injuries, if braking is required, it is usually fixed in the anterior rotation position, so anterior rotation function is rarely a problem and is given the lowest status here. In summary the functional angles of the elbow joint should be: flexion active 130°, extension active 30°, rotation posterior active 60°, and rotation anterior active 60°. Once the mobility of the elbow joint is restricted, functional exercises are more difficult compared to other joints, the joint appears to be very fragile, the stress response is heavier, and a slight overexertion may cause a more serious inflammatory response, and in more severe cases there is a risk of ossifying myositis. The cause of this phenomenon is unknown at this time, but it is usually related to the degree of injury and violent exercise, and because of the unpredictability of external injuries, the amount of activity can only be controlled more precisely to ensure the quality of the joint. At the same time, adequate icing and rest are not to be neglected in the functional elbow exercises and should be done carefully according to the standards. Elbow joint loosening technique: (The following described way to practice a maximum of 1 group per day in each direction of movement, avoid multiple practice stimulation, strive to obtain the established effect within the specified practice time, try to avoid multiple repetitive stimulation, and arrange rest in time when you feel that the practice is too much and the pain is not relieved.) Flexion This is a method of practicing flexion on its own, especially when the angle of the flexed elbow is less than 90 degrees, as shown in the figure, the patient lies flat, the position of the affected limb is controlled with the healthy hand, the angle of the upper arm of the affected limb is not fixed, it can be ensured by adjusting the forearm level, apply a load on the distal forearm, barely insist on about 10 minutes under the premise of full relaxation, 1-2 times a day. If the stimulus is too strong to relax or the pain is too strong during the exercise, the load weight can be reduced or even removed. At this point, adequate relaxation as well as adherence to sufficient time is the most important factor, practice with attention to the quality of movement. This is another method that applies after the angle of flexion of the elbow beyond 90°. As shown in the figure, the patient sits on the edge of the bed or table, with the forearm on the edge of the bed, and uses the body to lean forward to increase the elbow flexion angle. Due to the high strength of the trunk, the strength of the lean forward should also be controlled to ensure safety. If you feel discomfort during the activity, you can also put a pad between your forearm and the edge of the bed to reduce the discomfort that can be avoided. Usually each exercise in 2-3 minutes, intervals of no more than half a minute, continuous 15-20 minutes group. Of course, you can also use your healthy side hand to assist in completing the movement. If the pulling sensation of the muscles of the posterior group of the upper arm (triceps brachii – antagonist muscles) is obvious when practicing elbow flexion, you can also strengthen the pulling effect of the antagonist muscles by performing elbow joint pulling exercises in a state of excessive forward flexion of the shoulder joint. Sitting at a table with the shoulder joint relaxed, elbow flexed (necessary), forearm flat on the table, and a long-handled weight held in your hand, let it tilt outward under the action of gravity. Take care to avoid excessive force when grasping, grasping is sufficient, at this time only the muscle groups involved in grasping are firing, but it does not affect the relaxation of the rotational muscles. If the rotation is severely limited, it is also appropriate to use the healthy side of the hand to assist in tipping the weight outward. This movement is less stimulating to the entire elbow joint and can be practiced for a longer period of time, and if the pain caused by it is not significant, the number of exercises can be increased daily. This maneuver is especially important for patients with “radial tuberosity” injuries and should be practiced as soon as reasonably possible after the injury. Extension As shown in the figure, the patient lies flat on the bedside with the forearm of the affected limb extended out of the bed, apply a load on the distal forearm, relax fully, and try to adhere to it for 15-20 minutes, 1-2 times a day, with a cushion under the elbow joint for comfort. Special attention should be paid to the extension exercises, which need to be performed 3-4 hours apart from each other due to the opposite direction of the flexion exercises. The anterior rotation is similar to the posterior rotation, but in the opposite direction, while the rest of the exercises are identical. Ice is the most important tool to control inflammation, but heat is not suitable for everyone, all the time. If the skin temperature is higher than normal, all treatments with thermal effects are strictly forbidden, and massage at the elbow joint is strictly forbidden. Once again, it is important to control the amount of elbow joint mobility exercises, not to overdo them, and to avoid violent operations as much as possible. Especially for patients with serious injuries such as fractures and dislocations, the setting of the amount of exercise is especially critical. In addition, ice and rest are essential to make sure to avoid causing repeated injuries during the exercises, further aggravating the damage to the tissue. During practice, if symptoms such as persistent pain, significantly increased joint skin temperature, swelling and stiffness occur, be sure to follow up with the hospital and monitor the occurrence of ossifying myositis by means of blood tests, ultrasound diagnosis, CT and X-ray.