Olecranon Bursitis

with Rehab

A bursa is a fluid filled sac that is located between soft tissues (ligaments, tendons, skin) and bones. The purpose of a bursa is to allow the soft tissue to function smoothly, without friction. The olecrenon bursa is located between the back of the elbow (olecrenon) and the skin. Olecrenon bursitis involves inflammation of this bursa, resulting in pain.

SYMPTOMS

  • Pain, tenderness, swelling, warmth, or redness over the back of the elbow.

  • Reduced range of motion of the affected elbow.

  • Sometimes, severe pain with movement of the affected elbow.

  • Crackling sound (crepitation) when the bursa is moved or touched.

  • Often, painless swelling of the bursa.

  • Fever (when infected).

CAUSES

Olecranon bursitis is often caused by direct hit (trauma) to the elbow. Less commonly, it is due to overuse and/or strenuous exercise that the elbow is not used to.

RISK INCREASES WITH:

  • Sports that require bending or landing on the elbow (football, volleyball).

  • Vigorous or repetitive athletic training, or sudden increase or change in activity level (weekend warriors).

  • Failure to warm up properly before activity.

  • Poor exercise technique.

  • Playing on artificial turf.

PREVENTION

  • Avoid injuries and the overuse of muscles whenever possible.

  • Warm up and stretch properly before activity.

  • Allow for adequate recovery between workouts.

  • Maintain physical fitness:

  • Strength, flexibility, and endurance.

  • Cardiovascular fitness.

  • Learn and use proper technique.

  • Wear properly fitted and padded protective equipment.

PROGNOSIS

If treated properly, olecranon bursitis is usually curable within 2 weeks.

RELATED COMPLICATIONS

  • Longer healing time, if not properly treated or if not given enough time to heal.

  • Recurring symptoms that result in a chronic problem.

  • Joint stiffness with permanent limitation of the affected joint's movement.

  • Infection of the bursa.

  • Chronic inflammation or scarring of the bursa.

TREATMENT

Treatment first involves the use of ice and medicine, to reduce pain and inflammation. The use of strengthening and stretching exercises may help reduce pain with activity. These exercises may be performed at home or with a therapist. Elbow pads may be advised, to protect the bursa. If symptoms persist, despite non-surgical treatment, a procedure to withdraw fluid from the bursa may be advised. This procedure may be accompanied with an injection of corticosteroids, to reduce inflammation. Sometimes, surgery is needed to remove the bursa.

MEDICATION

  • If pain medicine is needed, nonsteroidal anti-inflammatory medicines (aspirin and ibuprofen), or other minor pain relievers (acetaminophen), are often advised.

  • Do not take pain medicine for 7 days before surgery.

  • Prescription pain relievers may be given, if your caregiver thinks they are needed. Use only as directed and only as much as you need.

  • Corticosteroid injections may be given by your caregiver. These injections should be reserved for the most serious cases, because they may only be given a certain number of times.

HEAT AND COLD

  • Cold treatment (icing) should be applied for 10 to 15 minutes every 2 to 3 hours for inflammation and pain, and immediately after activity that aggravates your symptoms. Use ice packs or an ice massage.

  • Heat treatment may be used before performing stretching and strengthening activities prescribed by your caregiver, physical therapist, or athletic trainer. Use a heat pack or a warm water soak.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Symptoms get worse or do not improve in 2 weeks, despite treatment.

  • Signs of infection develop, including fever of 102° F (38.9° C), increased pain, redness, warmth, or pus draining from the bursa.

  • New, unexplained symptoms develop. (Drugs used in treatment may produce side effects.)

EXERCISES

RANGE OF MOTION (ROM) AND STRETCHING EXERCISES - Olecranon Bursitis

These exercises may help you when beginning to rehabilitate your injury. Your symptoms may resolve with or without further involvement from your physician, physical therapist or athletic trainer. While completing these exercises, remember:

  • Restoring tissue flexibility helps normal motion to return to the joints. This allows healthier, less painful movement and activity.

  • An effective stretch should be held for at least 30 seconds.

  • A stretch should never be painful. You should only feel a gentle lengthening or release in the stretched tissue.

ExitCare Image RANGE OF MOTION – Elbow Flexion, Supine

  • Lie on your back. Extend your right / left arm into the air, bracing it with your opposite hand. Allow your right / left arm to relax.

  • Let your elbow bend, allowing your hand to fall slowly toward your chest.

  • You should feel a gentle stretch along the back of your upper arm and elbow. Your physician, physical therapist or athletic trainer may ask you to hold a __________ hand weight to increase the intensity of this stretch.

  • Hold for __________ seconds. Slowly return your right / left arm to the upright position.

Repeat __________ times. Complete this exercise __________ times per day.

ExitCare Image STRETCH – Elbow Flexors

  • Lie on a firm bed or countertop on your back. Be sure that you are in a comfortable position which will allow you to relax your arm muscles.

  • Place a folded towel under your right / left upper arm, so that your elbow and shoulder are at the same height. Extend your arm; your elbow should not rest on the bed or towel

  • Allow the weight of your hand to straighten your elbow. Keep your arm and chest muscles relaxed. Your caregiver may ask you to increase the intensity of your stretch by adding a small wrist or hand weight.

  • Hold for __________ seconds. You should feel a stretch on the inside of your elbow. Slowly return to the starting position.

Repeat __________ times. Complete this exercise __________ times per day.

STRENGTHENING EXERCISES - Olecranon Bursitis

These exercises will help you regain your strength. They may resolve your symptoms with or without further involvement from your physician, physical therapist or athletic trainer. While completing these exercises, remember:

  • Muscles can gain both the endurance and the strength needed for everyday activities through controlled exercises.

  • Complete these exercises as instructed by your physician, physical therapist or athletic trainer. Increase the resistance and repetitions only as guided by your caregiver.

  • You may experience muscle soreness or fatigue, but the pain or discomfort you are trying to eliminate should never worsen during these exercises. If this pain does worsen, stop and make certain you are following the directions exactly. If the pain is still present after adjustments, discontinue the exercise until you can discuss the trouble with your caregiver.

ExitCare Image STRENGTH - Elbow Extensors, Isometric

  • Stand or sit upright on a firm surface. Place your right / left arm so that your palm faces your stomach, and it is at the height of your waist.

  • Place your opposite hand on the underside of your forearm. Gently push up as your right / left arm resists. Push as hard as you can with both arms without causing any pain or movement at your right / left elbow. Hold this stationary position for __________ seconds.

  • Gradually release the tension in both arms. Allow your muscles to relax completely before repeating.

Repeat __________ times. Complete this exercise __________ times per day.

ExitCare Image STRENGTH - Elbow Flexors, Isometric

  • Stand or sit upright on a firm surface. Place your right / left arm so that your hand is palm-up and at the height of your waist.

  • Place your opposite hand on top of your forearm. Gently push down as your right / left arm resists. Push as hard as you can with both arms without causing any pain or movement at your right / left elbow. Hold this stationary position for __________ seconds.

  • Gradually release the tension in both arms. Allow your muscles to relax completely before repeating.

Repeat __________ times. Complete this exercise __________ times per day.

ExitCare Image STRENGTH – Elbow Flexors, Supinated

  • With good posture, stand or sit on a firm chair without armrests. Allow your right / left arm to rest at your side with your palm facing forward.

  • Holding a __________ weight, or gripping a rubber exercise band or tubing,

  • bring your hand toward your shoulder.

  • Allow your muscles to control the resistance as your hand returns to your side.

Repeat __________ times. Complete this exercise __________ times per day.

ExitCare Image STRENGTH – Elbow Flexors, Neutral

  • With good posture, stand or sit on a firm chair without armrests. Allow your right / left arm to rest at your side with your thumb facing forward.

  • Holding a __________weight, or gripping a rubber exercise band or tubing,

  • bring your hand toward your shoulder.

  • Allow your muscles to control the resistance as your hand returns to your side.

Repeat __________ times. Complete this exercise __________ times per day.

ExitCare Image STRENGTH – Elbow Extensors

  • Lie on your back. Extend your right / left elbow into the air, pointing it toward the ceiling. Brace your arm with your opposite hand.*

  • Holding a __________ weight in your hand, slowly straighten your right / left elbow.

  • Allow your muscles to control the weight as your hand returns to its starting position.

Repeat __________ times. Complete this exercise __________ times per day.

*You may also stand with your elbow overhead and pointed toward the ceiling, supported by your opposite hand.

ExitCare Image STRENGTH - Elbow Extensors, Dynamic

  • With good posture, stand, or sit on a firm chair without armrests. Keeping your upper arms at your side, bring both hands up to your right / left shoulder while gripping a rubber exercise band or tubing. Your right / left hand should be just below the other hand.

  • Straighten your right / left elbow. Hold for __________ seconds.

  • Allow your muscles to control the rubber exercise band, as your hand returns to your shoulder.

Repeat __________ times. Complete this exercise __________ times per day.