My toddler was playing and now won’t use their arm! This is something we commonly see as pediatricians, and often there is a simple explanation: a Nursemaid’s elbow.
What is a Nursemaid’s elbow?
Yes, it’s a quirky name! Simply put, it is a pulled or partially dislocated elbow joint. The medical term is “radial head subluxation,” and you may hear it referred to as any of these names. It may sound painful, but it generally doesn’t hurt when your child isn’t moving the arm and can be quickly fixed.
What causes a Nursemaid’s elbow?
Children, especially pre-K aged, have loose ligaments – the structures that hold bones and joints together. They also enjoy roughhousing, playing, and being swung and pulled. This combination leads to a Nursemaid’s elbow.
What we often hear is a situation that involves the following:
- I was swinging my child by the wrist or hands while playing
- I was pulling my child’s shirt/jacket sleeve on while holding their hand
- My child was pulled to standing or sitting by the hands or wrists
- I was holding my child’s hand, and they tripped
- My child was playing in the other room and had just a minor fall
And now they won’t use their arm!
How do I know if it’s a Nursemaid’s elbow, and what do I do?
It may be obvious, but it is sometimes tricky to diagnose. Usually, there is no sign of injury – no redness or bruising, or swelling – and your child will act normal until you try to get them to move their arm. Often, they will keep the elbow bent and the palm facing towards the ground.
Luckily your child’s medical provider sees this all the time, so give them a call! They will likely have you head to your local ER if you can’t be seen in the office.
In the Emergency Room (ER) or office, a medical provider will attempt to “pop” the elbow back in place. This takes just a few seconds. Your child may get a dose of Motrin or some laughing gas, but in general, the procedure is not too painful. Most children will start using the arm immediately – within minutes. The longer the arm hasn’t been moving, though, the longer it will take to start moving again.
It’s moving again! What now?
Statistically speaking, if it’s happened once, it is more likely to happen again. The good news? This injury generally doesn’t have long-term impacts on your child’s health or development. This also doesn’t mean you can’t play or swing your child. It does mean you should be mindful of how you are playing or helping your child in the situations like those listed above. Support or lift them under the arms or torso when you can. If you’re swinging them, hold them close to the body instead of by the hands.
Even if you take these precautions, your child may still experience a Nursemaid’s elbow. Just remember – it’s no one’s fault and can be easily fixed with some help from your child’s medical provider!
Wondering when else to go to the ER vs. call your pediatrician? Our Kid Care app guidelines help you make decisions on what level of medical care (if any) is needed and how to treat your child at home when it’s safe to do so. You can select from more than 100 pediatric topics and search from an alphabetical list or by body area.