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Nursemaid's Elbow in Toddlers: What it Is and How to Prevent it

Written by Sophie Lung, M.D. on Dec 6, 2017 8:42:00 AM

Kids can seem clumsy, unstable and accident prone. They're learning to get their bearings, learning to walk and exploring the world around them. Add to that their growing bones and ligaments and you have a perfect storm for some fairly common injuries in infants and toddlers. Nursemaid's elbow is one of these injuries. 

Pulling a Kid by the Arms Is a Risk

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Nursemaid’s elbow is common in early childhood. Also called pulled elbow, it is caused when there is a partial dislocation of a child's elbow. Because the muscles, bones, and ligaments are still developing in young children, it is easy for a child to suffer a pulled elbow. Something as simple as pulling a child by the arm can cause the injury. 

In fact, the name itself hearkens back to a time when nannies, or nursemaids, were common. Because nursemaids often played with and picked up children, many injuries were innocently caused by them. 

Nursemaids weren't the only ones responsible for these injuries, however. Children often cause them by putting their arms out to break a fall, causing the ligament to slip, rolling over in an awkward way in their bed or on the floor or by playing on playground equipment such as monkey bars.

Nursemaid’s elbow can also be caused by swinging a child around by their hands or wrists, pulling a child up by their hands or jerking their arm too rough or suddenly. 

Behaviors to Avoid

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You can't prevent all instances of nursemaid’s elbow, like a child bracing himself for a fall, but there are some things you can be aware of to avoid it. When you're picking up a child, be sure to lift the child from underneath their armpits instead of by their hands. While most children enjoy being swung around by their arms, it's not a good idea to do so as their little muscles and ligaments are still developing. Also, don’t tug or jerk a child's arms.

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Signs to Watch for

The predominant symptom of a pulled elbow is that your child will experience pain when moving their arm. Typically there’s no swelling, bruising, or other sign of injury associated with nursemaid’s elbow. 

The injury can occasionally correct itself, but in most cases, you will need to take your child to their pediatrician, who will perform a gentle movement of the arm to slip the ligament back into place. 

If you have any concern that your child has nursemaid's elbow, get them in to see the doctor immediately as the injury can be quite painful, though it is unlikely to cause long-term damage. As your child grows, their ligaments will tighten, which means it’s unusual for children older than 5 to experience this type of injury. 


Dr. Lung is a board-certified pediatrician who cares for her patients at Kelsey-Seybold Clinic – The Woodlands. She enjoys that she’s not only caring for children, but giving them the tools they need to grow into healthy, young individuals and successful adults.


Topics: nursemaid's elbow, pulled elbow

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