Olecranon Stress Fracture

A stress fracture of the olecranon (tip of the elbow) manifests as a cause of chronic pain just as stress fractures in other parts of the body do. Athletes who throw frequently, especially baseball pitchers, are the athletes who frequently develop olecranon stress fractures. Just like other stress fractures, they result from too much microscopic stress to a bone without enough time to rest. In pitching, this usually means too much throwing (too many times per week, too many innings, or too many consecutive seasons) without enough time for the elbow to rest.

Olecranon stress fracture
Pain in these throwing athletes is felt at the fracture site just past the tip pf the olecranon (orange arrow).

A thrower with a possible olecranon stress fracture will notice pain that develops over time, but occasionally he might notice pain after one particular pitch. The pain usually is worst just past the tip of the elbow at the top of the forearm posteriorly. Frequently the pain will only exist with pitching or just after pitching, but when it gets particularly severe, the pain can exist during activities of daily living.

Athletes will often complain of pain that initially goes away after they stop pitching. It starts earlier and earlier with each consecutive outing. Usually the pain goes away pretty quickly, but as the problem progresses, it takes longer and longer for the pain to disappear.

In the office, a sports medicine physician will notice tenderness to palpation at the olecranon process or proximal ulna. Occasionally pain with resisted elbow extension is noticeable, but often the exam is otherwise unremarkable. X-rays can often show the stress fracture of the olecranon process, but occasionally an MRI is needed to definitively make the diagnosis.

Olecranon Stress Fractures in pitchers.

9 Responses to Olecranon Stress Fracture

  1. during a basketball game i had my arm get stuck between two people and heard a small cracking noise, my arm didn’t appear broken so i kept playing. during the next few days i was throwing a football a lot and it was bugging me constantly. the style of pain, the area that its coming from matches everything you said in this article but the way it happened is different. any advice? opinions?

    • Sorry! I really can’t know what it is without examining you and getting x-rays or other studies if needed. You might consider seeing your doctor or an orthopaedic surgeon.

  2. My arm has been bugging me directly on the point, but it’s gotten to the point where it starts to hurt whenever I lift something kind of heavy with my right arm. I play baseball and when I throw it hurts too, but the pain eventually goes away and I can throw normal. However, 2-3 hours after I finish a game it will hurt, but eventually goes away. Do you think it’s stress fractures.

  3. When baseball pitchers release their breaking pitchers over the top of their Index finger, they will lose extension range of motion, loose pieces, bone spurs and fractured olecranon process.

    When baseball pitchers use their Pectoralis Major muscle when they throw breaking pitches, they will lose extension range of motion, loose pieces, bone spurs and/or fraction olecranon process.

    When baseball pitchers use their Latissimus Dorsi muscle when they release their throw breaking pitches under the Middle finger, they will never lose extension range of motion, have loose bodies, bone spurs and never injure the olecranon process.

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