Nursemaid's Elbow (Pulled Elbow) in Baby or Toddler
The short answer
Nursemaid's elbow is the most common orthopedic injury in children under 5. It happens when a ligament in the elbow slips out of place, usually after a pulling or swinging motion on the arm. The child suddenly stops using the affected arm, holding it still at their side with the palm turned inward. It is not a dislocation or fracture, and it is easily fixed by a doctor with a quick, gentle maneuver. Recovery is immediate - most children use the arm normally within minutes of reduction.
Parents everywhere have the same worry. You are doing the right thing by looking into it.
By Age
What to expect by age
0-12 months
Nursemaid's elbow is less common in babies under 1 year but can happen when a baby is pulled up by one arm, lifted by the hands, or when an arm gets caught in crib rails or during a roll. The baby will suddenly stop moving the affected arm and may cry briefly then become quiet, holding the arm limply at their side. Seek medical evaluation - the fix is quick and painless.
1-4 years
This is the peak age for nursemaid's elbow. Common scenarios include: pulling a toddler by the hand to prevent a fall, swinging a toddler by the arms during play, pulling a toddler's arm through a jacket sleeve, or a toddler catching their arm while rolling or falling. The child will immediately stop using the arm. Do not try to fix it yourself. A medical professional can reduce it in seconds with a specific rotation of the forearm.
What Should You Do?
When to take action
- Your child uses the arm completely normally within 15-30 minutes after medical reduction
- Brief crying at the time of injury that settles quickly
- No visible swelling, bruising, or deformity of the arm
- Your child has had nursemaid's elbow and you want to learn how to prevent recurrence
- Your child has had multiple episodes of nursemaid's elbow
- You want to learn the warning signs so you can seek quick treatment
- Your child is not using one arm after any pulling, swinging, or lifting event
- Your child's arm is visibly swollen, deformed, or bruised (may indicate fracture rather than nursemaid's elbow)
- Your child's arm does not return to normal use after medical reduction
- There was no clear pulling mechanism and the child stopped using their arm (other causes need evaluation)
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
Worrying about your baby means you care. That is a good thing.
Related Physical Concerns
Baby Not Using One Arm or Hand
If your baby consistently avoids using one arm or hand, it deserves evaluation. Before 18 months, babies should use both hands roughly equally - strong hand preference before this age can indicate a concern with the less-used side. Possible causes include brachial plexus injury (Erb's palsy) from birth, nursemaid's elbow, fracture, or neurological differences. Early identification leads to better outcomes with therapy.
Baby Fell Off the Bed or Couch
Falls from beds, couches, and changing tables are one of the most common accidents in infancy. Most falls from furniture height (2-3 feet) do not cause serious injury, but every fall involving the head deserves careful monitoring. If your baby cried immediately after the fall and is now acting normally - alert, feeding, and moving all limbs - serious injury is unlikely. However, certain warning signs require immediate medical evaluation.
Signs of a Broken Bone or Fracture in Baby
Children's bones are more flexible than adults' and often bend or partially break (greenstick fracture) rather than snapping completely. Signs of a possible fracture include: swelling, deformity (the limb looks bent or crooked), inability or refusal to use the limb, severe pain when the area is touched, and a snapping or popping sound at the time of injury. If you suspect a broken bone, immobilize the area (do not try to straighten it), apply ice wrapped in a cloth, and take your child to the emergency room or urgent care for an X-ray.
My Baby Seems to Use One Side More Than the Other
Babies should use both sides of their body fairly equally during the first 18 months of life. While slight preferences can be normal, a consistent pattern of favoring one side - using one arm much more than the other, crawling with one leg dragging, or turning the head predominantly one way - should always be discussed with your pediatrician. Early identification of asymmetry leads to the best outcomes.
My Baby Only Army Crawls
Army crawling (also called commando crawling) is a completely valid and normal way for babies to move. Many babies army crawl for weeks or even months before transitioning to hands-and-knees crawling, and some skip hands-and-knees crawling entirely. What matters is that your baby is independently mobile and exploring their environment.
One Side of My Baby's Body Moves Differently
Babies should generally use both sides of their body equally. If one side consistently moves differently, is weaker, stiffer, or less coordinated, this warrants evaluation. Asymmetric movement can indicate hemiplegia (cerebral palsy affecting one side), brachial plexus injury, or other neurological conditions that benefit from early therapy.