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Elbow Anatomy and Mechanics: The Olecranon and the Triceps
The elbow is a complex anatomical structure that joins three long bones: the humerus (the upper arm bone), the radius (the outer forearm bone) and the ulna (the inner forearm bone).
At the tip of the ulna is a pointed, protruding part of the elbow which is called the olecranon. The triceps muscle, which is the long muscle at the back of the arm attaches to it by a tough band or tendon. Together these structures enable a person to extend or straighten the arm.
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Elbow Pain: Tendonitis and Calcification
Elbow pain can commonly come from degenerative changes or traumatic injury to any of the parts of the bones, cartilage and tendons forming or surrounding it.
Olecranon tendonitis or tendinitis is an inflammation of the tendon of the triceps muscle that attaches to the pointed bony prominence of the elbow. Although less common than other conditions of the joint like elbow arthritis, olecranon bursitis, tennis elbow or golfer’s elbow, it is sometimes mistaken for these because of its location.
With constant use and inflammation, bony spurs may develop and olecranon tendonitis calcification can occur over the insertion of the triceps tendon on the ulnar olecranon and the olecranon bursa. Symptoms of calcific tendinitis include:
- Elbow pain either at rest or during exercise, especially during stretching or extension of the elbow
- Pain in the lower back part of the arm upon lifting objects
- Swelling at the back of the elbow
- Limited range of motion of the elbow
The cause of olecranon tendonitis may be a sudden severe strain to the triceps as in javelin throwing. A sudden fall onto the hands, overdoing weights, or trying to push something too heavy can injure this tendon and cause inflammation through over use. With time, degenerative changes such as calcification occur.
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Diagnosis and Treatment
Consultation with an orthopedic surgeon is the first step to evaluate and confirm the diagnosis. Olecranon tendonitis can be evaluated through history, physical examination and imaging exams. By eliminating other possible causes of elbow pain, which are more common, diagnosis can be confirmed by radiography, MRI and CT scanning techniques.
Treatment consists of the following:
- Rest from activities that cause the elbow pain is the initial step to treating tendinitis of the elbow.
- Analgesic that may be obtained over-the-counter such as ibuprofen can help relieve pain and inflammation.
- Application of ice packs alternately with hot compress on the affected area will help reduce swelling and pain. This may be done for the first two days after injury.
- Physical therapy and rehabilitation are recommended. Doing exercises under the guidance of a physical therapist can help improve mobility of the joint and strengthen the muscles.
- Conservative treatment for olecranon tendonitis and calcification are usually effective although it may take a while for complete healing.
- In cases where bony spurs cause severe pain that cannot be relieved by medical treatment surgical debridement and tendon re-attachment may be advised.
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Medcyclopedia, “Tendinitis” accessed 2/2/11
Sports Injury Clinic, “Inflammation and Rupture of the Triceps Tendon” accessed 2/2/11
Tendonitis Surgery, “The Details of Triceps Tendonitis” accessed 2/2/11
Pain Clinic, “Joint Pain: Elbow Joint” accessed 2/2/11