Imagine, if you will, a scene of a bygone era, when a tantruming, obstinate toddler is grabbed on the wrist by his stern, nursemaid who exemplifies the antithesis of Mary Poppins and is briskly pulled up the steps of the manor.

What you probably wouldn’t imagine though is what might happen next: The child shrieks out in pain and the arm that had been pulled by the nursemaid now hangs motionless. Too hard to imagine? Well, it must have happened often enough, because doctors ended up giving it a name: “nursemaid’s elbow.”

While the position of nursemaid is largely antiquated nowadays, the elbow diagnosis still goes by that name. Given that this condition has been deemed the most common upper extremity injury in children younger than age 6, I think it’s clear that yesteryear’s nursemaid has been given a bum rap.

The condition is a common mishap that typically affects children between 1 and 3, but younger and older children can get it too. It’s rarely seen in children above the age of 6. Mostly the injury occurs innocently by swinging a young child by the arms or pulling a child’s arm while in a hurry.

The ligaments that hold the two bones of the forearm (the radius and ulna) together at the elbow become stretched or torn when the child’s arm is forcibly pulled. These elastic-like bands are developmentally looser in children of this age, and the bones involved are not yet fully formed.

When the child’s arm is tugged upon, and the ligaments stretch or tear, a widening of the elbow’s joint space is created causing part of the damaged ligament to slip in. The result is entrapment of some of the ligamentous fibers between the head of the radius and the adjacent bone. This pinching of the annular ligament can be very painful for some, but the hallmark sign to look for is the child’s inability, or refusal, to use his arm. Fortunately the injury does not cause long-term damage.

It’s important to seek care as soon as possible. Chiropractors and many medical professionals are trained to maneuver the elbow in such a way that the elbow bones are able to realign, allowing the ligament to return to its normal position. Oftentimes, the elbow will regain full function and relief of pain almost instantaneously.

Fortunately, as kids get older and their elbows grow, the ligaments tighten and the bones harden, and the risk of nursemaid’s elbow diminishes.

Parents, and the caregivers they employ, need to be mindful of the delicate nature of young elbows and avoid jerking, tugging, and pulling children by the arm. Remember as fun as it is, swinging a toddler by his arms is something that should be avoided.