Olecranon Impingement
What is Olecranon Impingement?
Olecranon impingement refers to pain and irritation at the back of the elbow, where the olecranon process of the ulna contacts the humerus. Repeated extension can lead to bony or soft tissue friction.
- Often seen in overhead throwing athletes
- May cause posterior elbow pain and limited extension
Overview of the Condition
Chronic repetitive stress in full elbow extension can cause bone spurs, cartilage damage, or synovitis. Olecranon impingement is common in baseball pitchers and gymnasts.
Symptoms
- Posterior elbow pain, especially at end-range extension
- Possible locking or catching if loose bodies form
- Swelling or tenderness around the olecranon
Causes
Repetitive high-velocity elbow extension leads to repeated contact between the olecranon and distal humerus. Over time, this can produce osteophytes (bone spurs) and soft-tissue impingement.
Diagnosis
Clinical evaluation focuses on pain at terminal extension. X-rays or MRI may show bony overgrowth or chondral damage in the posterior elbow compartment.
Treatment Options
- Activity modification and rest
- NSAIDs to reduce inflammation
- Physical therapy to improve biomechanics
- Surgical debridement of spurs in persistent cases
Conservative Management
Early intervention involves reducing repetitive extension, using ice, and engaging in exercises that limit aggravation. Technique adjustments in sports are also crucial.
Rehabilitation Exercises
- Gentle range of motion without forcing end-range extension
- Strengthening of shoulder and core to reduce elbow stress
- Gradual return-to-throwing programs
When is Surgery Needed?
Surgery is indicated if conservative measures fail, persistent mechanical symptoms occur, or if imaging shows large osteophytes or loose bodies causing ongoing impingement.
Surgical Procedures
- Arthroscopic debridement to remove spurs or loose fragments
- Open surgery in severe cases or if large bone blocks extension
- Post-operative rehab emphasizing controlled extension
Anatomy Overview
The olecranon process is the proximal prominence of the ulna that fits into the olecranon fossa of the humerus during extension. Chronic friction can damage cartilage and bone.
Affected Areas
- Posterior elbow joint (olecranon and olecranon fossa)
- Synovial lining between olecranon and humerus
- Adjacent soft tissues involved in extension
Frequently Asked Questions
| Question | Answer |
|---|---|
| Is olecranon impingement the same as 'pitcher's elbow'? | Pitcher's elbow can refer to several pathologies, including medial elbow injuries. Posterior impingement is a distinct entity but often co-exists. |
| Will I lose range of motion permanently? | With timely management and proper rehab, most regain near-normal extension. Severe cases may have residual limitation. |
Prevention Strategies
- Monitor pitch counts and avoid excessive throwing
- Improve shoulder and trunk mechanics
- Address elbow pain early to prevent chronic changes