Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

Featured on Channel NewsAsia

Bursitis (Student’s Elbow)

Just below the tip of the elbow (olecranon) there is a bursa into which bleeding can occur following an accidental blow to the area or a fall on the elbow. In many sports, including orienteering, wrestling, volleyball, basketball, soccer, rugby, and team handball, this injury is common as the participants wear no elbow guards; in others, such as ice hockey, the guards may provide incomplete protection.

After bleeding into the bursa, and also after prolonged loading of the elbow, the bursa can become inflamed and swollen. The condition is often called ‘student’s elbow’ since it was popularly supposed to
have affected students who rested their elbows on the desk while supporting their head in their hands when studying.

Symptoms and diagnosis

– Pain is felt at rest and during movement.
– Swelling and tenderness occur over the tip of the elbow after acute bleeding into the bursa following a violent impact. Sometimes the skin is broken.
– Small blood clots form in the bursa and cause irritation of the surrounding tissues. This results in inflammation and effusion of fluid.
– When there is inflammation of the bursa, or when it has been subjected to prolonged pressure, it becomes distended with fluid and the overlying skin becomes red and tender. The swelling can extend to the forearm.
– There is limitation of mobility in the elbow joint.

Preventive measures

Elbow guards that protect the olecranon should be used, especially by goalkeepers in team handball and soccer.

Treatment

The athlete should rest until symptoms have resolved.

The doctor may:
– puncture the bursa and drain out blood or fluid;
– apply a bandage to be kept in position for 4–7 days;
– administer a local steroid injection when inflammation is persistent;
– remove the bursa surgically if it has been affected by repeated inflammation, especially when loose bodies or adhesions are present. This can be done arthroscopically.

Healing

After an episode of mild inflammation of a bursa in the elbow, the athlete can return to training 1 week after medical treatment has started. A severe bursitis can force rest for a long period.

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