It was a late spring day. My then two-year-old son, newborn, and I were at a local gym for their tot-lot with friends. We had a great time playing with ride-on toys, going down slides, and bouncing balls. Soon, it was time to go — and we had an unfortunate accident, which turned into learning what Nursemaid’s Elbow is.
How It Happened
At the time, my son was very much into basketballs. I was gathering my diaper bag, getting my daughter and her car seat loaded into the stroller, and getting ready to head out. My son spotted a rack of basketballs in the hallway next to the gym. I had his hand as I was finishing up and saying goodbye to our friends. He took off towards that rack of basketballs as I was holding his hand. I remember saying to him, “please stay with me.”
He wanted to hold that basketball. Suddenly, he started sobbing. He was clearly in pain.
We sat down on the floor and I was trying to figure out what happened. He was holding his arm and would not let go of it. He said, “my arm hurts!” I looked at his arm not seeing anything that looked out of place or bruised. I was at a loss for what to do.
As I was sitting there trying to comfort him, another mom came over asking if we needed help. I explained what happened and where he was hurting. She revealed that she is a nurse and she said she wondered if he had nursemaid’s elbow. I had no idea what that wasd but she explained that it was basically a dislocated elbow. I thanked her and got my kids loaded in the van and I called our pediatrician’s office. I explained what happened and asked if I could get in as soon as possible. Unfortunately, our pediatrician was unavailable until later in the day, so we got in with a pediatrician who was available.
The Doctor Visit
What happened next was not something I was prepared for. We got to the doctor’s office and checked-in. Soon after, the doctor came in. I politely greeted her. She immediately went to my son to ask him what happened. She wouldn’t even look at me. She was asking my two-year-old what happened. He was crying due to the pain in his arm. Despite the fact that he was in pain, he was also two and could not eloquently share the events of the day. I was trying to answer for him but the doctor would not look at me or acknowledge what I was saying. I then tried to encourage him to tell the doctor what happened.
So, why wouldn’t she talk to me? Why wouldn’t she look at me? After everything was done and we were cleared to leave, I did a lot of thinking. Was it that her bedside manner was just so poor that she couldn’t even look at the parent? Then it dawned on me. She had to be extra sure that what happened was not done intentionally. When that thought occurred to me, I was mad.
Why would I ever do something like that to my child and why would she even think that? I am a perfectly competent, loving parent. But, she does not know me. She is not our normal doctor. She does not know the way we parent.
A Sad Realization
Unfortunately, she has probably seen too many cases where things like this or worse have occurred when the action was intentional. It made me completely sympathize with parents whose kids have accidents or are accident prone. They may have perfectly good intentions but are like our situation and a fluke accident happens. When I realized that, I took a step back and appreciated her caution. Unfortunately they see too much of the bad stuff that makes them more guarded when situations like this occur.
Eventually, she did say that she was pretty sure he had nursemaid’s elbow. She held his arm in her hands and with a few quick movements all of a sudden the crying stopped. His elbow was back in place. After that, she did talk to me and explained what nursemaid’s elbow was. She ordered an x-ray to be sure there was no other damage.
He checked out just fine. The doctor did share that once this has happened, it could happen again because once those ligaments and tendons had been moved out of place once it could happen again. This tends to happen to kids aged one to four. The reason being is that those bones and muscles are still developing.
So, what exactly is nursemaid’s elbow? According to Orthoinfo from the American Academy of Orthopedic Surgeons, “nursemaid’s elbow occurs when there is a partial separation of the radiocapitellar joint. Because a young child’s ligaments—the strong tissues that attach bones to each other—are not fully formed, even a mild force on the joint may cause it to shift, or partially dislocate. The annular ligament surrounds the radius and may be particularly loose in some young children, which may lead to nursemaid’s elbow recurring over and over again.”
The American Academy of Orthopedic Surgeons goes on to say, “Nursemaid’s elbow often occurs when a caregiver holds a child’s hand or wrist and pulls suddenly on the arm to avoid a dangerous situation or to help the child onto a step or curb. The injury may also occur during play when an older friend or family member swings a child around holding just the arms or hands. Nursemaid’s elbow is rarely caused by a fall. If a child injures the elbow when falling onto an outstretched hand or directly onto the elbow, it may be a broken bone rather than nursemaid’s elbow. The primary symptoms of nursemaid’s elbow may include the following: Because moving the injured arm may be painful, the primary symptom of nursemaid’s elbow is that the child will hold the arm still at his or her side, and refuse to bend or rotate the elbow, or use the arm.”
For more information on nursemaid’s elbow, the University of Iowa Hospitals and Clinics has more information.
This incident taught me the danger of pulling when our child is trying to go another way. I learned that lesson the hard way, but I was extra cautious after that moment. From that day on, if my son or my girls, would pull when holding my hand, I would let go so as to not cause this again.
Admittedly after this incident, I had a lot of guilt. How could I have done this to my child? What I realized and what I shared with a friend who recently went through this with her child, was that unfortunately, these things happen, and so quickly. What I can do to make this better is to learn what not to do.
Since then, if one of my kids was pulling in a way that could cause this, I would let go and gather them a different way. We do not swing our kids while holding on to their hands. We now swing them by holding them under their arms. Even well intentioned and cautious parents can make mistakes. It is my hope that by sharing our story is that you will learn and can avoid this happening to your family.