"[134] He then proceeded to describe the two bruised areas present on the left elbow of the victim, and with regard to these, he stated that these were not marks caused by restraining, but hypostatic stains. But since he could not absolutely exclude that they might be bruises stemming from an effort of the victim to defend herself, he noted that the fact that they were present only on the left forearm at the level of the elbow would mean that the forearm remained free, making it difficult to attribute the bruises to the fact of having been restrained."
IMO, the bruises on her elbows which seem to be much lighter than the bruises on her chin and face, were caused by the shoulders of her hoodie jacket being pulled down over her arms to the elbow area. Please try it before laughing at me.
I put on a jersey hoodie, zipped halfway up. With the shoulders pulled down around my elbows, I could only move my forearms, could almost reach my neck but not quite. I stopped before the jacket tore, but there was definitely pressure on my skin at the inside of the elbow area.
If nothing else had happened, sure, she would have been able to wriggle free of the jacket, but it would have been an effective restraint while a hand was clamped over her face, her hair was being pulled back, etc. all those horrible things.
If her arms had been restrained by someone else's hands, the bruises would have been deeper, more like the bruises on her face. IMO