Elbow Bursitis: Overview
There are many bursae in the body protecting underlying tendons. Bursitis most often occurs in the following joints:
Acute bursitis may be caused by:
- a blow to an area containing a bursa
- overexertion of a joint (for example: swimming a long distance or throwing a ball many times)
Chronic bursitis is usually caused by long-term overuse of one muscle-tendon unit, for example a joint. The repeated motion of that muscle-tendon unit causes friction in the bursa. As the activity continues, the bursa becomes inflamed and may fill with fluid. The bursa thickens and does not function well. Both bursa and tendon may become irritated.
Risk factors that increase your chances of getting elbow bursitis include:
- repetitive motion activities when done to an extreme (such as swimming, running, or tennis)
- contact sports
- sporting gear that does not fit well
Symptoms of elbow bursitis include:
- pain in the area of the bursa
- reddened skin
- decreased motion of the nearby joint
- decreased function of the nearby limb
The doctor will ask about your symptoms and your physical activities, and examine the painful area. Tests may include:
- magnetic resonance imaging (MRI)
- rest the affected area
- ice the painful area
- take anti-inflammatory medications
- receive a cortisone injection
- protect the area from trauma
- stop the activity causing pain
- take anti-inflammatory medications
- protect the bursa from trauma
- undergo physical therapy, including exercises and applying heat
- receive a cortisone injection
- undergo surgery
To help prevent elbow bursitis:
- Do not overdo sports and other activities.
- When doing a new activity, gradually increase the length of time you do it.
- Make sure you perform activities correctly.
- Wear protective equipment if you play contact sports.
Preventing elbow bursitis?
The simplest way to avoid another episode of elbow bursitis is to avoid the activity that caused it, of course, this may be impossible for the serious athlete. For these people, quality elbow pads should be used during activity, and frequent breaks from the causative activity should become routine. It's also wise to reduce or stop the activity at first sign of pain and to ice the elbow following each training session or game.
Improving Sports Performance
The key to improving sports performance after recovering from elbow bursitis is a proper a rehabilitation program, and adhering to some of those same principles after the injury is gone.
The single most important aspect of improving performance is stretching before and after you step onto the field, court, ice or golf course.
Benefits derived from stretching include:
- increased physical efficiency and performance
- decreased risk of injury
- increased blood supply and nutrients to joint structures
- increased coordination
- improved muscular balance and postural awareness
- decreased risk of lower-back pain
- reduced stress
- enhanced enjoyment
As an athlete, your number one concern is getting back to full strength as soon as possible so that you can return to training and competition. That is why appropriate rehabilitation is extremely important.
The most common rehabilitation for elbow bursitis often includes the following:
Reduce activity during acute phase.
Apply ice or a cold pack to the outside of the elbow for 15 to 20 minutes, 4 times a day for several days. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin.
Take ibuprofen to help reduce inflammation and pain.
Wrap your elbow in an elastic compression bandage (Ace bandage). This will limit swelling and support your elbow.
When the acute pain is gone, start gentle stretching of the wrist and elbow as recommended by your doctor. Stay within pain limits. Hold each stretch for about 10 seconds and repeat 6 times.
Begin strengthening exercises for your wrist extensor muscles as recommended by your doctor.
Although rest, nonsteroidal anti-inflammatory drugs, and avoiding the activity that caused the injury are the main steps for rehabilitating your bursitis, the following exercises, which place no extreme mechanical or weight-bearing stress on the elbow, can be very effective during rehabilitation:
- Wrist flexor stretch
Extend affected arm forward with palm up and elbow straight. Place fingers and palm of opposite hand across palm and fingers of the extended hand and draw back with it until stretch is felt in the forearm. Hold this position for 3 to 5 seconds, then relax for 3 to 5 seconds. Perform this exercise 10 times.
- Wrist extensor stretch
Extend affected arm forward with palm down, elbow straight, and fingers slightly curled. Grasp the affected side hand with other hand and draw affected side hand down until stretch is felt in the forearm. Hold this position from 3 to 5 seconds, then relax for 3 to 5 seconds. Perform this exercise 10 times.
- Pronation/Suppination stretch
Extend affected arm forward in a hand-shaking position with palm facing up. Slowly rotate the hand from a palm-up position to a palm-down position. Hold for 3 to 5 seconds and then rotate back. Perform this exercise 10 times. When you work your way up to strength training, you may use a small weight while rotating the hand and wrist.
- Tricep stretch
Stand erect with feet at about shoulder width. Raise injured arm at the shoulder with elbow bent and place the forearm behind the head. Grasp the injured elbow with opposite hand and draw it toward the center of the body until stretch is felt. Hold this position for 3 to 5 seconds, then relax for 3 to 5 seconds. Perform this exercise 10 times.
- Bicep stretch
Stand erect with arms raised to shoulder height and palms up. Press arms backward until stretch is felt. Hold this position for 3 to 5 seconds, then relax for 3 to 5 seconds. Perform this exercise 10 times. The bicep is stretched by this exercise as well as the muscles of the shoulder and upper chest.
The following exercises develop strength of the muscles of the forearm and upper arm. To maintain symmetry of the arms in terms of strength and appearance, perform these strength exercises with the uninjured arm as well as the injured arm.
- Wrist extension
Sit in a chair with forearm resting on the end of a table, palm down. Grasp a light weight dumbbell and raise the weight up as high as possible while maintaining contact with the table top. Hold this position for 3 to 5 seconds. Relax for 3 to 5 seconds. Repeat this exercise 5 to 10 times. Substitute a heavier dumbbell as strength increases.
- Arm curls
Either standing or sitting, grasp a 2- to 4-pound dumbbell in one hand. With palm up, flex elbow and draw the dumbbell up to the same side shoulder while maintaining erect posture. Do not bend at the waist or swing the dumbbell. Lower dumbbell slowly and with control to the starting position. Repeat this exercise 10 times. Use a heavier dumbbell as strength increases.
During the period when normal training should be avoided, alternative exercises may be used. These activities should not require any actions that create or intensify pain at the site of injury. They include:
- swimming (if pain allows)
- stationary bicycle
How long will the effects of my injury last?
Symptoms may disappear within 10 days or persist for more than 2 weeks and recur from time to time. Bursitis caused by overuse often resolves after two weeks if you refrain from the activity that caused the problem.
When can I return to my sport or activity?
The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your activity is determined by how soon your bursitis recovers, not by how many days or weeks it has been since your injury occurred.
Generally, full use of the affected elbow should be delayed until all symptoms subside. In the interim, activities that place no pressure on the elbow, such as swimming or cycling, can maintain cardiovascular fitness.
You may safely return to your sport or activity when pain is gone, and you have full strength and range of motion in the injured elbow compared to the uninjured elbow.