Two weeks ago I performed a foolish ladder stunt and fell from a second story onto the metal ladder that was flat on the ground. The back of my bicep hit the ladder near the elbow. The emergency room (what a healthcare disaster those are) stiched up the split skin on the point of the elbow and sent me home. My pain level was not severe so they skipped the photo shoot. I did the ice and advil routine and watched the arm turn different colors along with a fluid build-up that moved into the forearm. Apparently a lot of internal contusion around the ulnar nerve. One week into recovery I was able to cover 90% range of motion and resumed light weight workouts. The only major limitation was a refusal of the arm to perform a downward pressure activity when outstreched in front of me. Stiches were out and I even played a round of golf at 12 days with mild irritation. Two days ago, Wham! I performed a two handed shovel jab into a moving dirt mound atop a mole in my lawn and experienced pain in the elbow that rivaled the original injury. The mole is dead but now the elbow is back on ice and has a more locallized and sharper pain on the underside of the joint. What have I done? There is some new swelling just behind the elbow and some ROM has reduced. I can't turn my had downward past 90 degrees with the arm straight. Palm up turn is tight but doable. I have read about nerve neuropraxia and heterotopic bone formation and wonder if I am at risk for these complications. Thanks to anyone able to share their knowledge.