Elbow Bursitis from Aerobars

author : AMSSM
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Member Question

I did my first HIM this past weekend and my elbow was like a baseball later that evening. By the morning, it had filled up with more fluid and I had to make a Dr.’s appointment to have it drained. They got most of it, but not all of it and recommended I take some Naproxen. It’s still bothersome but I really want to get back on my Cervelo P2 and not have to use my road bike without aerobars. What can I do to alleviate this and prevent it from happening?

Answer by Sam Schimelpfenig, MD, FAAP
Member AMSSM

Elbow Bursitis (more specifically termed Olecranon Bursitis) is a medical condition that occurs when the bursa overlying the olecranon process of the elbow becomes inflamed. The olecranon process is a part of the ulna bone of the forearm and is what causes that bony bump on the back of the elbow joint. A bursa is a fluid-filled sack that overlies such bony prominences and acts as a cushion and smooth surface so that other structures such as tendons can slide smoothly over that area. Occasionally, a bursa can become inflamed and swollen (bursitis) – typical causes affecting the olecranon bursa in particular include both acute trauma (i.e. from a fall) or from a mild, but repetitive, trauma (such as leaning directly on the elbows on a hard surface); infection and gout are other causes. Olecranon bursitis is diagnosed based on the characteristic area of swelling on the back of the elbow, and in your case, it most likely occurred from the compression between your elbow and the aerobars on your bicycle.

Treatment of acute olecranon bursitis depends on how large and symptomatic the area of swelling is. Mild cases can be left alone. More significant cases are treated with NSAID’s (to reduce inflammation), compression, and avoidance of further trauma to the area. In these instances, the fluid is often drained by a physician who can then send a sample to a laboratory to make sure there is no infection or signs of other illnesses present. In cases of infection, an antibiotic will also be necessary to treat the bursitis. Sometimes, the fluid will need to be drained several times and/or a steroid may need to be injected into the bursa to help keep the fluid from coming back. For chronic cases that do not respond to the usual treatment options, surgery is occasionally required to remove the bursa entirely.

After the bursitis has resolved (which can take days to weeks, depending on the cause and severity), it is even more important to engage in preventative strategies. Padding of the elbow with activity, and avoiding placing the flexed elbow on hard surfaces is usually all that is needed. Assuming the aerobars on your Cervelo are to blame, I would make sure the part on which your elbow rests has some extra padding, and you might visit with a bicycle fit specialist to see if the aerobars can be adjusted so that the point of maximal pressure is not directly over your elbow joint. If the condition continues to occur, you may re-visit the issue with your doctor to see what other treatment options need to be considered.

Sam Schimelpfenig, MD, FAAP

CAQ Sports Medicine

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date: November 11, 2013

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The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

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The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

FIND A SPORTS MEDICINE DOCTOR

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