Posterior Impingement Syndrome of elbow

Posterior impingement of the elbow joint usually occurs due to repeated extension of the elbow. This syndrome may lead to the development of bone spurs (extra bone that forms on the edge of an existing bone) and inability to extend the elbow.

Repetitive throwing motions force the bony tip of the elbow, called the olecranon, to repeatedly jam into the fossa (pit at the back of the elbow). This motion causes wear and tear, as well as inflammation of the tissues at the back of the elbow joint. Baseball pitchers and tennis players are often at risk for this condition due to the repetitive extension of the elbow required in their sports.

• Elbow impingement is common in these sports:
• Baseball
• Softball
• Tennis and other overhead racket sports

Signs and symptoms of posterior impingement syndrome include:

• Pain at back of elbow, especially when throwing or serving in racket sports.
• Stiffness
• Difficulty or inability to straighten the elbow
• Locking and catching of the elbow

If you have pain in the back of your elbow associated with loss of the ability to straighten your elbow, consult with your doctor. A physical examination usually allows for a diagnosis of elbow impingement. Your doctor may also order an x-ray to help identify if bone spurs are present and an MRI to rule out other causes of your symptoms.

Generally, conservative treatment is recommended for posterior impingement syndrome, including:

• Rest: It is important to avoid activities that place stress on the elbow to give inflamed tissues time to heal. Athletes should discontinue activities that fully extend their elbow.
• Ice: Applying ice or a cold compress to your elbow three or four times a day for 20 minutes can help reduce swelling and alleviate symptoms.
• Medication: Over-the-counter (OTC) medications, like aspirin or another nonsteroidal anti-inflammatory medication (NSAID) like ibuprofen or naproxen, can help alleviate symptoms.
• Physical Therapy: Stretching and other exercises can help ensure an optimal recovery. Your doctor can recommend specific exercises for your condition.

You can also try these exercises at home to stretch and strengthen the muscles surrounding the elbow:

Posterior Impingement Syndrome

Surgical treatment for posterior impingement syndrome may occasionally be needed in throwing athletes. If conservative treatment options are ineffective, particularly if you have bone spurs that require removal, your doctor may recommend arthroscopic surgery. This type of surgery is a minimally invasive procedure that allows surgeons to remove bone fragments causing the damage in your elbow.

For mild cases, athletes usually can return to sports within six weeks with conservative treatment. If you undergo surgery because conservative treatment options were ineffective, a longer recovery time is required. After surgery, it usually takes three to six months before you can return to play.