Posterior Impingement of the Elbow

Overview

Posterior impingement of the elbow is a condition in which structures at the back of the elbow become compressed during extension (straightening of the arm). This can lead to pain, stiffness, and limited range of motion, particularly in individuals who perform repetitive overhead or throwing activities.

Early evaluation and treatment by an orthopedic specialist can help relieve symptoms, restore motion, and prevent further joint damage.

What Is Posterior Impingement of the Elbow?

Posterior impingement occurs when bone or soft tissue at the back of the elbow becomes pinched during extension. This often involves the olecranon (tip of the ulna) contacting the humerus, especially with repeated forceful motion.

A common mechanism is valgus extension overload, seen in throwing athletes, in which repetitive stress leads to bone spurs (osteophytes) and soft-tissue irritation.

Over time, this can result in inflammation, cartilage damage, and restricted motion.

Common Symptoms of Posterior Elbow Impingement

Symptoms may develop gradually and worsen with activity. Common signs include:

• Pain at the back of the elbow
• Pain with full extension of the arm
• Stiffness or decreased range of motion
• Catching, locking, or clicking sensations
• Swelling or tenderness

If you are experiencing persistent elbow pain, especially with extension, an orthopedic evaluation is recommended.

Causes and Risk Factors

Posterior elbow impingement is typically caused by repetitive stress or structural changes. Common causes include:

• Repetitive throwing or overhead activities
• Formation of bone spurs
• Previous elbow injuries
• Overuse or high-demand activities

Risk factors may include participation in sports such as baseball, tennis, or weightlifting.

An orthopedic specialist at UTHealth Houston can evaluate your condition and determine contributing factors.

How Is Posterior Elbow Impingement Diagnosed?

Diagnosis begins with a physical examination and a review of symptoms and activity history. Orthopedic providers will assess motion, pain with extension, and joint function.

Imaging studies may include:

• X-rays to identify bone spurs or joint changes
• MRI to evaluate soft tissue and cartilage
• CT scans in more complex cases

These tests help confirm the diagnosis and guide treatment planning.

Posterior Elbow Impingement Treatment Options

Non-Surgical Treatments

Many patients can manage symptoms with conservative care, including:

• Activity modification
• Rest and anti-inflammatory medications
• Physical therapy to improve strength and flexibility
• Gradual return-to-activity programs

Surgical Treatment

Surgery may be recommended if symptoms persist or mechanical blockage is present.

Surgical options may include:

• Arthroscopic removal of bone spurs or loose bodies
• Debridement of inflamed tissue
• Treatment of cartilage damage

The goal of surgery is to relieve impingement, restore motion, and improve function.

When to See an Orthopedic Specialist

You should seek orthopedic care if you experience:

• Persistent pain in the back of the elbow
• Pain with full extension
• Catching or locking sensations
• Limited range of motion

Early evaluation can help prevent progression and improve outcomes.

Expert Orthopedic Care at UTHealth Houston Orthopedics

Our orthopedic hand surgeons can provide comprehensive evaluation and personalized treatment, from conservative care to advanced surgical options. If you’re experiencing wrist pain, hand numbness, or tingling, you can request an appointment (external link) to receive expert care and lasting relief.