Dealing with an injury that affects your fitness routine can be frustrating. Bursitis is the inflammation of a bursa, a small, fluid-filled sac that cushions bones, tendons, and muscles. When this inflammation occurs in the elbow, it challenges maintaining an active lifestyle. Understanding the condition is the first step in safely modifying activities to allow healing without sacrificing physical goals.
What Elbow Bursitis Is
Elbow bursitis involves the olecranon bursa, a thin sac located directly over the pointed bony tip of the elbow joint. This bursa normally contains lubricating fluid to reduce friction during movement. When the bursa becomes irritated or inflamed, it produces excess fluid, causing noticeable swelling and discomfort.
Inflammation is caused by four mechanisms: a single blow, prolonged pressure, repetitive friction, or infection. Repetitive actions or leaning on the elbow for extended periods cause microscopic trauma, leading the bursa lining to become inflamed and swollen. Pre-existing conditions like gout or rheumatoid arthritis can also contribute to the development of bursitis.
Activities to Immediately Avoid
The primary goal during a bursitis flare-up is to eliminate any force that compresses, rubs, or places load on the irritated olecranon bursa. Immediately stop any exercise that involves direct pressure on the back of the elbow. Activities like push-ups, planks, burpees, and any floor-based movement requiring the elbow to bear weight must be avoided entirely. These exercises force the bursa to absorb the body’s weight against a hard surface, which directly exacerbates the inflammation.
Limit movements that place a significant load on the joint, especially those involving repetitive flexion and extension. Heavy resistance training, such as weighted bicep curls, triceps extensions, or overhead presses, can place stress on the inflamed area by increasing tension on surrounding tissues. Exercises like rowing, which involve a strong, repetitive pull, should also be paused until the swelling reduces. Any activity that risks a direct blow to the elbow, such as contact sports, must be suspended to prevent further trauma.
Safe Movement and Exercise Alternatives
Maintaining fitness is possible by shifting focus to activities that isolate the lower body and core while completely unloading the elbow. For cardiovascular exercise, stationary cycling or walking are excellent choices that require no arm involvement. Lower-body focused elliptical machines can also be used, provided you avoid grasping the moving handles and rest your hands on the stationary bar. This modification allows for a vigorous workout without compromising the healing process.
Lower body strength training can continue as long as the exercises do not require the use of the arms for support or grip. Safe alternatives keep the elbows completely out of the kinetic chain:
- Squats
- Lunges
- Leg presses
- Hip thrusts
When performing exercises like split squats, avoid balancing with your hands and instead focus on core stability. If using dumbbells for resistance, ensure the weight is held by your side in a neutral grip, minimizing strain on the joint.
Once the initial pain subsides, gentle, pain-free range of motion exercises can be introduced to prevent joint stiffness. Begin with light, passive stretching, such as slow elbow flexion and extension without any resistance. You can also perform gentle forearm pronation and supination—turning the palm up and down—to maintain mobility in surrounding tissues. These movements encourage circulation and flexibility but must be immediately stopped if any sharp or increased pain occurs.
When Medical Intervention is Necessary
While many cases of elbow bursitis resolve with rest and activity modification, certain warning signs indicate the need for professional medical evaluation. A non-infected bursa typically presents with swelling and mild pain, but a sudden increase in symptoms suggests the condition is worsening. If swelling does not improve after 48 hours of using ice and rest, or if pain persists for more than a week, seek a medical opinion.
Signs of a possible infection, known as septic bursitis, require immediate attention. These red flags include:
- Fever
- Chills
- Spreading redness around the elbow joint
- Heat around the elbow joint
Pus or cloudy fluid draining from the swollen area indicates bacteria have entered the bursa and require antibiotic treatment.
Initial self-management often includes over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) and applying a cold pack for 15-20 minutes several times a day.