Photo by Greg Younger under creative commons license
Injury: Olecranon Bursitis, Elbow Bursitis
Mechanism: Bursitis is swelling and inflammation of a very thin fluid filled sac, called a bursa. The purpose of a bursa is to protect a bony prominence against friction and rubbing. In particular, olecranon bursitis is located at the bony point of one's elbow. We have bursas throughout our body, but they are mostly unnoticed until they become inflamed or infected. The most common mechanism is from direct contact, either through a direct trauma or from repetitive pressure to the area. This type of injury can be seen often in grappling sports.
Exam: Athletes will typically have swelling directly over the posterior aspect of the elbow. The medical provider should take care to inspect the area for a cut or abrasion that could suggest the possibility of infection. The injury can generally be confirmed on physical exam however one might obtain an x-ray to confirm no fracture is present.
Treatment: The treatment for olecranon bursitis is typically aggressive icing and compression to the area, while maintaining good range of motion. Anti-inflammatories can be helpful with pain and inflammation. It is possible for an olecranon bursitis to become infected, usually when there is an open cut or wound in the area. In that case, medical providers would also add an antibiotic to treat the condition. The usual teaching for a non-infected olecranon bursa is not to drain it, because that can actually put it at risk for infection. There is research that suggests that drainage of the olecranon bursa can speed up recovery, however I would consider that controversial. If a drainage procedure is done, another option is to inject a cortisone medication and numbing medication back into the bursa. If the bursitis is chronic and recurrent, surgical removal is a possibility.
Return: The length of time for full return to play will depend on if it is infected or not, but I would say a couple of weeks to get everything settled down. Depending upon the athletes position and sport they may be able to participate right away with simple compression.
Sports Considerations: Depending upon the athletes position and sport they may be able to participate right away with simple compression. For example, a hockey player may have no issues with immediate return as they have significant padding and the ability to compensate. On the other hand, a tennis player may be significantly impacted by the injury.
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