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Student’s Elbow (Bursitis)

Today’s blog is about a common elbow injury. Ever heard of student’s elbow? “But I’m not a student!” we hear you say. Well you don’t have to be to fall victim to this condition. Students elbow, or ‘Olecranon Bursitis’ is a condition where a small sack of tissue over the tip of your elbow becomes inflamed and swollen. The pointy bit of bone at the end of your elbow is called the ‘olecranon’ and the small sack which sits between the bone and the skin is called a ‘bursa’. The ‘itis’ part of bursitis simply refers to inflammation of that bursa.

 What Are The Causes?

The most common way to develop student’s elbow is repetitive trauma to the tip of the elbow, which slowly irritates the bursa and causes inflammation over time. Think of a student who sits for hours, day after day writing at a desk with their elbow resting on the table. The constant pressure on the tip of the elbow could be enough to kick things off. Anyone whose elbows are subject to repetitive pressure could develop this problem; plumbers and office workers are other good examples.

Other causes include:

  • A single blunt force trauma or fall onto the tip of the elbow
  • Infection
  • Having an olecranon spur (an extra small bony growth which rubs against the bursa)
  • Having an extra pointy olecranon (some peoples skeletons are just a bit different)

This condition may also develop as part of having another medical condition, such as Diabetes Mellitus, Gout, Rheumatoid Arthritis (RA) , HIV or alcoholism.

Signs And Symptoms

So, what does student’s elbow look like? Signs and symptoms include:

  • A painful or (often) non-painful swelling on the end of your elbow
  • Pain with leaning on your elbow
  • Painful elbow movement
  • Restricted elbow movement (although this is often unaffected)
  • Redness, warmth and a fever (if associated with infection)

Will I Need To Have Any Tests Done?

Possibly. As with all lumps on the body, we will want to rule out anything serious going on first. We ask lots of questions so we can paint a picture of what’s going on in our clinical head. Depending on your signs and symptoms, if you have a history of cancer or if infection is suspected, you may be directed to your GP for tests. This is to make sure you are receiving the best treatment in the best time frame. Your doctor may need to take a sample of the fluid inside the swelling to be sent off for lab testing. This will be able to tell us if infection is playing a part or not.

Treatment

The treatment of bursitis is very much dependent on the cause. If the cause is infection, then your GP will start you on a course of antibiotics and anti-inflammatories to fight it off and control the pain. Other treatment may include the use of ice or contrasting hot/cold bathing to help reduce the swelling. In severe cases, your elbow may need to be splinted or elevated in a sling. Elbow pads and changes to your general activities may also help to protect the elbow from further injury. Your GP may offer to drain the swelling (this is called ‘aspiration’ and requires a needle to remove the fluid), and this can help to provide relief by reducing pressure around the elbow.

Once clear of infection, or if you have a non-infective bursitis, then we can step in with osteopathic treatment. 

During the inflammatory process, swelling and pain may have affected how you use your arm. With pain, people often stop using that part of the body and swelling can affect the joint’s ability to move smoothly through its range of motion. This can have a knock-on effect on the muscles and other tissues which surround the elbow joint. Many muscles which cross the elbow and are involved in elbow movement also cross the shoulder and wrist to aid in their function. So, you can see how a problem at the elbow could affect the whole limb (and beyond).

Here at Beaches Osteopathic Centre, we will get to work at restoring full function to the shoulder, elbow and wrist. We look at your spinal movements too to see if they have been affected. You can expect to be mobilised and massaged and we may also perform some lymphatic drainage techniques to help restore fluid movement through the limb (which may have stagnated during the injury process). Your biceps, triceps and other arm/forearm muscles may have shortened over time so we may perform some stretching techniques and will give you some exercises to do at home to back up what they do in the clinic room. If necessary, strengthening exercises may be given to reduce the risk of future episodes.

If your bursitis doesn’t resolve with the above treatments or keeps coming back, a decision may need to be made on whether the bursa should be removed surgically. This is called a ‘bursectomy’ and is usually a last resort. Extra pointy olecranons or spurs can also be treated surgically if needed.

References:

  1. Blackwell, JR. et al. 2014. Olecranon bursitis: a systematic review. Shoulder & elbow. 6 (3). 182-190. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4935058/
  2. Lockman, L. 2010. Treating nonseptic olecranon bursitis: a 3-step technique. 56 (11). 1157. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2980436/

 

Perfect Posture Program

If you want to lean more about posture and how to keep yourself mobile and pain free, then we have an educational program that maybe for you. Our Perfect Posture Program has been developed from 25 years of rehabilitation of chronic back pain, and 10 years of measuring balance and analysing posture with computerised posturography. The purpose of the program is to teach you how your postural system works, so that you can use it in any situation, whether you are standing at a meeting, sitting at your desk or putting your child in the back of the car.  This six week program is suitable for anyone who wishes to improve their posture from children aged eight and above, right through to seniors.

 

Join Us For An Introduction to the Perfect Posture Program

On the first Wednesday evening of every month, we run an hour long class where we teach the fundamentals of posture.

It's a FREE CLASS  where we explain what posture is, and why it is fundamental to moving well, maintaining good balance and preventing yourself from getting back pain.

This is a knowledge evening not an information evening. By that we mean that by the end of the evening you will have the experience of your natural posture in your body, not just in your head.

These classes are informal and in small groups.  Bookings are essential.

 

 

 

 

 

The Importance of Movement

arent or sibling), then we start to get rudimentary use of our upper limbs, then we learn to lift our head and role onto our stomach, and now we can use our arms to push ourselves up and our neck muscles to support our head. Then we start to get stability in our trunk muscles so that we can sit and start to reach out, and then we are crawling, toddling and eventually running.

In other words we go through a sequence of learning where we move with increasing complexity, from simple reflexes to the ability to stabilise ourselves against gravity and then the ability to perform complex volitional activity such as eating or running.

This means that if we need to restore movement, say after an injury or an illness, we need to think in terms of this hierarchy, reflexes - stability - complex movement.

Humans are unique in that we have a complex postural system that enables us to stand upright on two unstable pins, that's why it takes us three years to learn to walk efficiently.  But it is under constant stress and it's ability to perform this task starts to deteriorate as we age unless we take steps to keep it in top condition.

In research published in Queensland:  Falling is not just for older women: support for pre-emptive prevention intervention before 60 (J.C Nitz and N.L Low Choy 2008), the researchers assessed women between the ages of 40 and 80 for the risk of falling. 8% of women in their forties, 14% in their 50s, 25% in their 60s and 40% in their 70s had fallen in the previous 12 months. In addition, the risk of falling increased significantly if the woman had other health problems.

Their conclusions was that for women over 40 years old, the number of illnesses increase the risk of falling and the risks increased still further if they were over 60. Preventative program participation aimed at maintaining good health appears vital to prevent falls.

To put it another way, our stability starts to drop in our 40's.  Falls are a natural consequence of reduced stability but they are not the only consequence. The early consequences are less efficient use of posture which leads to stiffness and back pain. 

So, in order to perform any meaningful activity, we must first be stable. Stability is really the ability to maintain balance while we shift our weight. When it starts to drop it means that we have less ability to generate momentum to move forwards. And if we are unable to generate as much momentum, then our step gets shorter, and if our step gets really short we require a stick to help support ourselves. Thus our ability to move becomes compromised.

So as we get older we get stiffer and less stable, which leads to weight bearing changes. It also leads to restriction in movement.  It's important therefore to not only keep mobile but also work on keeping yourself stable. Exercise that can help this includes dance, yoga and Tai Chi. It is also important to work on your posture. Posture is basically how well you control your relationship to the ground and how efficiently you are able to shift your weight in order to generate momentum.

 

Perfect Posture Program

If you want to lean more about posture and how to keep yourself mobile and pain free, then we have an educational program that maybe for you. Our Perfect Posture Program has been developed from 25 years of rehabilitation of chronic back pain, and 10 years of measuring balance and analysing posture with computerised posturography. The purpose of the program is to teach you how your postural system works, so that you can use it in any situation, whether you are standing at a meeting, sitting at your desk or putting your child in the back of the car.  This six week program is suitable for anyone who wishes to improve their posture from children aged eight and above, right through to seniors.

 

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(private health fund rebates apply) 

*This offer is available for the initial appointment only. Standard fee for an initial Consultation is $115

Beaches Osteopathic Centre Pty Ltd
ABN:  48 105 006 728

21/20 Wellington Street
NARRABEEN NSW 2101
AUSTRALIA
​​​​​​​02 9913 7900

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