Most people think of a Popeye muscle, not a Popeye elbow. However, if you have ever seen olecranon bursitis, you will recognize it as looking like Popeye’s. Fortunately, this type of bursitis responds well to treatment. Read on to learn more about olecranon bursitis. Let’s start with anatomy.
The elbow
The elbow joint is where the humerus, ulna, and radius come together. The humerus is the upper arm bone and forms individual joints with the ulna and radius, which are the forearm bones. The radius and humerus form the humeroradial joint and the ulna and humerus form the humeroulnar joint. The radius and the ulna will also form a joint which is called the radioulnar joint. These 3 joints make up the elbow joint.
Movements of the elbow include flexion and extension. Flexion is when the forearm and upper arm come closer together (bending the elbow) and extension is when they move farther apart (straightening the elbow). The radioulnar joint allows for the movements of pronation and supination. Pronation is rotating the forearm, so the palm faces downward, and supination is forearm rotation where the palm faces upward.
The olecranon
The olecranon is the part of the ulna that connects to the humerus in order to make the humeroulnar joint. It helps to provide the flexion and extension movement of the elbow. The olecranon is a very superficial bone, and you can easily feel it under the skin. It is the bony point in the back of the elbow.
What is a bursa?
Bursas are fluid filled sacs that are located all around the body. They reduce friction and act as cushions for structures such as bones, tendons, and muscles. The olecranon bursa is located between the olecranon and the skin. Its job is to decrease the friction between the olecranon bone and the skin. This allows the elbow to bend and straighten freely without damage to the surrounding tissue.
Olecranon bursitis
Bursitis occurs when the bursa becomes irritated and inflamed. This causes the bursa to fill up with fluid. Olecranon bursitis has several causes. These include:
- Repetitive motions
- Playing sports such as tennis or golf
- Prolonged pressure on elbow
- Leaning on elbow while typing
- Certain occupations which require crawling on hands and knees – like plumbers
- Direct trauma to the elbow
- Falling onto or being hit at the tip of the elbow
- Infection
- An injury that breaks the skin such as an insect bite or scrape could allow bacteria to get inside the bursa and cause an infection in the bursa.
- Elbow surgery
- Autoimmune conditions
- Certain conditions such as rheumatoid arthritis and gout are more susceptible to olecranon bursitis.
What are the symptoms of olecranon bursitis?
There are several symptoms associated with olecranon bursitis. These include:
- Swelling at the tip of the elbow
- Redness at the tip of the elbow
- Elbow stiffness especially when trying to bend the elbow
- Pain when putting pressure on the tip of the elbow
- Increased bumping of the elbow because it protrudes farther
Who should I see?
- Orthopedic physician – This condition usually responds well to conservative treatment. If the bursa is not infected, then your physician will probably prescribe an anti-inflammatory medication. Antibiotics will be prescribed if there is an infection. Your physician might also choose to aspirate or remove the fluid from the bursa. Those with recurrent infection or fluid build-up would be possible candidates for surgical removal of the bursa.
- Physical therapy – Physical therapy may not be needed if this is an isolated event. However, if the problem is recurrent or the elbow is stiff and weak from non-use, then physical therapy can help. PT can help decrease pain and inflammation with techniques including manual therapy and stretching. PT can evaluate and address abnormal joint mobility, muscle weakness, muscle tone, and flexibility. They can assess your posture during work or sports to prevent the problem from happening again.
What can I do?
- Relative rest – Resting the area to decrease further pain and damage from occurring is one of the best ways to treat olecranon bursitis. Basically, stay away from the activities that are causing pain and inflammation. This gives the bursa time to rest, relax, and heal. If you keep doing what is causing the injury, it is not going to get better. This might include not participating in your sport or changing how you perform a task or job. If you are not able to participate in your activity or sport, then you can supplement with non-irritating activities such as biking, walking, or jogging while your condition is being treated.
- Ice – Ice can help decrease pain and symptoms at the elbow. Ice the painful area for 15 to 20 minutes at a time. I would recommend using an ice pack every 2 to 3 hours while swelling is present.
- Elbow brace or pads – An elbow brace could be helpful to decrease pressure on the elbow once bursitis is present. Elbow pads could help prevent the problem from reoccurring.
- Elbow stretches – The elbow might have limited motion in certain directions because of the swelling of the bursa. Be gentle with stretching while the bursa is still swollen. Once the swelling has gone down, then you can be more aggressive. Typically, elbow flexion is more limited with olecranon bursitis. See the video below to learn how to stretch the muscles around the elbow.
- Wrist flexion and extension stretching – You may also need to stretch out the wrist flexors and extensors. These muscles attach at or near the elbow and could be tight. See the video below.
- Strengthening the muscles around the elbow and wrist – Strengthening the muscles around the wrist and elbow are also important in being able to return to your activity. This is especially true if you allowed your elbow to rest for several days to weeks in order to decrease the swelling. Begin strengthening once the swelling has gone down. Using dumbbells or resistance bands can increase strength and difficulty. See the video below.
In review
- The elbow joint is where the humerus, ulna, and radius come together.
- The radius and humerus form the humeroradial joint and the ulna and humerus form the humeroulnar joint.
- The radius and the ulna will also form a joint which is called the radioulnar joint.
- These 3 joints make up the elbow joint.
- Movements of the elbow include flexion, extension, pronation, and supination.
- The olecranon is the part of the ulna that connects to the humerus to make the humeroulnar joint. It helps to provide the flexion and extension movement of the elbow.
- The olecranon bursa is located between the olecranon and the skin. Its job is to decrease the friction between the olecranon bone and the skin.
- Bursitis occurs when the bursa becomes irritated and inflamed.
- Symptoms include swelling, redness, and stiffness at the elbow.
- See an orthopedic physician if the condition does not improve with ice and rest.
- Physical therapy will play a role if there is difficulty in regaining strength and mobility in the elbow.
- There are things you can do.
- Ice
- Soft tissue mobilization
- Use an elbow brace or pads
- Elbow stretches
- Wrist stretches
- Strengthening of the muscles around the elbow and wrist
As always, If you have questions about the content of this post or any other musculoskeletal questions, please e-mail me.
Additional resources
https://www.physio-pedia.com/Olecranon_Bursitis