USA Hockey Magazine

When Your Elbow Looks Like A Golf Ball A S K D R . H O C K E Y 28 // NOV/DEC 2025 USAHOCKEYMAGAZINE.COM What you're describing—a sud- den swelling at the elbow about the size of a golf ball—may look alarming, but the good news is that it's often a very common and easily treatable condition called olecranon bursitis. The olecranon is the name for the somewhat pointy prominence of bone at the elbow joint, most clearly seen and felt when you bend your elbow. Right above the olecranon sits a flu- id-filled cushion called a bursa. Its purpose is to reduce friction between tissues. Normally, this bursa is flat and virtually undetectable; however, irritation and subsequent swelling can result from repetitive minor trauma, con- tinuous pressure, or a direct blow to the area. Why Does It happen In Hockey? Practice, Practice, Practice. Hockey players are highly susceptible to olec- ranon bursitis. It is not uncommon for the elbow to suffer a direct blow when a player falls on the ice. Similarly, players may be slammed into the boards with their elbows frequently taking a hit in the process. Blocking shots can also result in trauma to the elbow. As the olec- ranon is the part of the elbow joint that sticks out in back, it is commonly injured with any direct strike. Elbow pads that do not fit prop- erly or that have been worn thin from overuse can leave the elbow inadequately protected and the player vulnerable to olecranon bursitis. M o s t c a s e s r e s u l t f r o m i r r i t a t i o n a n d inflammation rather than infection. However, if there is an open wound or cut of the skin, bacteria may enter the space and cause infec- tion, namely septic bursitis. Distinguishing bursitis from septic bursitis is important because these two related diag- noses have very different treatments. If the symptoms are limited to swelling and do not involve significant pain, redness to the area, or fevers, this is likely simple bursitis. In these cases, scheduling a non-urgent visit with your doctor is a reasonable plan of care. If, on the other hand, the elbow is red, tender, and pain- ful to move or if there are systemic symptoms present, such as fevers, the player should seek more immediate medical attention. Treatment Plan Most cases of olecranon bursitis resolve with simple measures: Rest: Avoid excessive movement of the elbow and limit contact in practice. Protect: Wear a compression sleeve or donut pad to provide an extra layer of protection to the area. Ice: Apply ice to the inflamed area three times a day for 15 minutes each time. Compression: Using an elastic bandage, wrap the arm, starting from the wrist and wrapping upward, being sure the bandage extends above the elbow. Make sure the wrap is not too tight! Gentle compression is the goal. Anti-inflammatory medications: Over the counter ibuprofen or naproxen can be taken to treat pain/swelling. Monitor: Be sure to closely observe the area for red flags that could suggest septic bursitis. Antibiotics are the mainstay of treatment for septic bursitis. Removal of fluid/pus from the bursa, may be recommended if no improve- ment is seen in symptoms. Most athletes suffering f r o m o l e c r a n o n b u r s i t i s can return to the ice once swelling has improved, pain is well-controlled and the elbow is properly padded. In septic bursitis cases, the player can return once the infection has cleared. Tips for Parents • Check elbow pads each season to make sure they fit properly and have not worn thin. •Thoroughly clean any cuts or abrasions around the elbow to decrease risk of infection. •Players should never attempt to "pop" or drain the inflamed bursa on their own. This is dangerous and can drastically increase the chances of developing an infection. Final Whistle Olecranon bursitis can look dramatic, but with the right care, most cases resolve com- pletely, rarely causing any long-term issues. When in doubt, get that elbow checked out! P My 14-year-old came home from practice with a golf-ball sized lump on the back of his right elbow. What do you think this could this be? – David B. Mankato, Minnesota A Q T H E D O C I S I N A N D R E A D Y T O A N S W E R Y O U R H O C K E Y Q U E S T I O N S If you have questions for Dr. Hockey, please email Justin.Felisko@ usahockey.org ? g By Charles A. Popkin, MD PHOTO BY Big Stock O L EC RA N O N B U R S I T I S Radius Humerus Olecranon Inflammation of the bursa Ulna

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