Bursitis is a condition affecting the bursae near a joint. A bursa is a small, fluid-filled sac found near a joint. These slippery sacs help the tendons, ligaments, muscles and skin glide smoothly over the bony surfaces of the joints. Though they contain only a small amount of fluid, they also provide cushioning to the area. These bursae play such an important role that there are actually more than 150 of them in the body.

The elbow joint connects the forearm to the upper arm. The forearm consists of the radius and ulna bones while the upper arm consists of the humerus. The elbow joint is the articulation between the larger forearm bone, the ulna, and the humerus as well as between the end of the radius and the humerus. These bones form a hinge joint that allows for flexion and extension of the elbow.

The elbow joint is encapsulated by a fibrous joint capsule. Within that joint capsule is the articulation between the ulna and humerus as well as that between the radius and ulna which allows you to turn your palm up and down (supination and pronation). Though they exist within the same joint capsule, most anatomists consider these two separate joints. Various muscles, tendons, nerves and ligaments are also present at the elbow.

Most commonly, elbow bursitis involves the olecranon bursa–hence why the formal name for elbow bursitis is olecranon bursitis. The bony prominence that most refer to as their elbow is the olecranon process. Between the bone and the skin lies the olecranon bursa. Though you have bursa throughout your body, the olecranon bursa is one more commonly affected by bursitis.

Acute or repetitive trauma leading to inflammation is typically the cause of olecranon bursitis. In some cases though, an infection in the bursa can be the cause. Anyone can be affected by olecranon bursitis but men between 30 and 60 years of age are at the highest risk. Falling onto your elbow on a hard surface is an example of an acute cause of olecranon bursitis while constantly resting your elbow on a hard surface is an example of repetitive trauma that can eventually cause irritation, inflammation or damage to the bursa.

SYMPTOMS OF ELBOW BURSITIS

• Focal swelling over the bony prominence of the elbow
• Chronic or recurrent, painless swelling over the elbow
• Pain with pressure over the swollen elbow such as leaning onto a hard surface
• Tendency to bump the swollen elbow
• Pain, warmth, redness and swelling over the inflamed bursa with or without fever can indicate septic bursitis (bursitis caused by infection)

If you decide to work with a physical therapist to help correct your elbow bursitis issues, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

PHYSICAL THERAPY TO ADDRESS BURSITIS

While many individuals with olecranon bursitis will not require any physical therapy, when needed, physical therapists can help you recover and educate you on ways to prevent recurrence.

In the first couple days of an acute episode of bursitis, your physical therapist will counsel you on how to minimize irritation and reduce inflammation in the area. Resting, avoiding painful movements and applying ice for 15-20 minutes every couple of hours can help. If pain and inflammation are severe, your doctor may recommend an anti-inflammatory medication or possibly a steroid injection into the area to reduce the inflammation. In some cases, aspiration of the extra fluid or even surgery to remove the bursa may be needed.

As the pain and inflammation subside, your physical therapist can take the following steps to help you recover:

• Modify your activities to decrease irritation on the bursa
• Teach you stretching and mobility exercises to restore full range of motion in the elbow joint. This allows you to use the elbow functionally and allows the muscles around it to perform optimally
• Apply manual therapy techniques to the elbow and soft tissue to improve joint alignment and movement to reduce irritation on the bursae
• Strengthen the muscles around the joint to avoid excessive stress on the bursa and help you return to activities without pain
• Observe how you perform the activities and movements that may have caused the bursitis and advise you on how to optimize or modify these movements to prevent a future episode of bursitis
• Help you slowly return to the activities that led to the development of bursitis now that you have improved strength, flexibility and movement coordination and optimized your movement patterns.