by James Hubbard, M.D., M.P.H.

The poor nursemaid. I mean, we don’t even have nursemaids anymore, at least not by that name. Maybe it should be called Daddy’s or Mommy’s elbow. How about children’s elbow since they’re the injured ones? Or its medical name, subluxation of the radial head?

Okay. Nursemaid’s elbow is easier to say, easier to remember, and, most importantly, puts the blame on someone else.

Actually, no one’s to blame. The injury doesn’t come from abuse–usually. It happens while you and the kid are playing or when you get in a hurry. You swing a young child around by the arms. Wheee. Wheee. Waaaa. Or you’re walking, holding hands; you give a little jerk, or the child decides to use your hand for a swing, and suddenly … what happened?

What Is Nursemaid’s Elbow?

In young children, say, under six, the ligaments attaching the forearm bones to the upper-arm bone are lax. A jerk can pull one of the forearm bones (radius) a little out of place–not fully dislocated. Subluxed.

The elbow hurts to move. The child holds that arm with the other hand or holds the arm out, not using it. Sometimes they may get back to playing, just without using the injured arm.

Treatment for Nursemaid’s Elbow

Something More Serious?

With nursemaid’s elbow, there’s minimal swelling. If there’s swelling, the injury may be more serious, like a break.

Since too much swelling in the elbow can lead to circulation and nerve damage, get help if at all possible and as soon as possible. Until you can, ice it.

The best thing to do is get to a medical facility, have it X-rayed to make sure nothing’s broken, and have a provider put it back into place.

If there’s no way you can get to a facility, leave the arm alone. Sometimes it’ll work its way into place. You’ll know because the child will start using that arm again, pretty much like nothing’s happened.

If it’s been over about a day, and it’s not swollen, and you can’t foresee getting to a provider in the near future, here’s how I would put it back into place.



Never forcing!

  • Try to get the child’s mind off the elbow. Talk. Ask questions. Get the child to talk.
  • Rotate the forearm until the palm is up.
  • Then flex the elbow fully. (Move the forearm as close to the upper arm as it usually would go.)
  • That’s it. Wait a while and see if the child begins to use it.
  • If not, repeat the steps again.

If that doesn’t work after two or three tries, leave it alone. Better that than risk making matters worse.

Let me know what you think of the video.