Injuries and Medical Advice

Not Bursitis

Q:

My elbow hurts when I lean on it, but outside of that it feels fine. An Internet search points to bursitis, but I don’t have swelling. Are there rehab exercises to alleviate my pain? Could the rehab exercises I’ve been doing for my golf and tennis elbow have caused my recent new problem? My elbow doesn’t hurt when I climb. Can I keep climbing?

—Craig Marcinkiewicz

A:

I’ll wager a hundred buckaroonies that, while you were moving your hand up to the next hold, you banged the tip of your elbow on the hold. You know that moment when everyone watching cringes, and you fall as if you banged into a glass ceiling? Think back. This will have happened sometime in the last six months or so. You will have hit your elbow hard enough to go into a fit of lalochezia and, although the pain subsided at the time, whenever you put the tip of your elbow onto a flat surface the pain grabs you like the searing bite of a Taipan snake.

Just under the skin that covers the back of the elbow (yes, the crusty skin that somehow is much older than the rest of your unblemished hide) lie a bursa and fascia. Under these is bone. This is not olecranon bursitis. I say this because, as you noted, bursitis is inflammatory, and you don’t have swelling.

I don’t know the exact source of pain, or possible combination of bone and soft tissue damage, but I do know that for the next six to eight months resting the tip of your elbow on the table in front of you will elicit pain that requires ninja discipline to tolerate.

There is also the possibility that you fell and decelerated your fall with outstretched arms, causing an avulsion fracture by virtue of your triceps tendon pulling a chunk of bone from the back of your ulnar. Sometimes this injury can be surprisingly painless unless you put pressure on the right spot. A fracture will likely be visible in an X-ray. If you have fractured your elbow, you should talk with a surgeon.


This article appeared in Rock and Ice 243


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