Smark Out Moment

Welcome to another edition of Smark Out Moment WRESTLING DOCTOR'S NOTES where we discuss medical issues that are either being reported in the wrestling world or generally afflict wrestlers. As always, please review the disclaimer at the bottom of the article.

On this spotlight article, I will be discussing Jordan Devlin's recent elbow injury and its implications.

What Happened?

On Sunday February 23rd Jordan Devlin announced that he would be pulling out of the PROGRESS 103 wrestling event due to "elbow bursitis." In addition to being the WWE NXT Cruiserweight Champion, Devlin is also the PROGRESS Tag Team champion and was set to defend his belt at the event.

He tweeted the following:

"Sorry to the@ThisIs_Progress fans and mgmt for missing #Chapter103 today. Very strenuous schedule lately and picked up a bit of elbow bursitis. It'll be fine in a week or so, I just didn't want to risk infection or aggravating it and prolonging my time out. See you guys soon."

The Irish Ace celebrates his Cruiserweight Championship win, elbows apparently intact. Image courtesy of prowrestling.com.

What Is The Diagnosis?

The major joints of our body are synovial joints, defined by a capsule lined with cells that produce fluid. The small amount of fluid that is normally in joints provides a natural cushion to forces across the joint and promotes smooth motion. A bursa is a small sac of fluid around but not connected to a joint that also contains synovium and acts as a cushion. They exist in places where muscles and tendons attach to a joint to allow the muscles to move smoothly and not be impeded by bony protuberances.

"Elbow bursitis" as Devlin has referred to it is more correctly named olecranon bursitis. The olecranon is a large part of the ulna - one of the two bones in our forearm - that acts as a hinge for our elbow joint. Our triceps muscle which runs along the back of our arm attaches at the olecranon. The olecranon bursa lies between our triceps tendon and the olecranon to allow the tendon and muscle to move smoothly over the thick and angled bone.

MRI of the elbow. The cup shaped bone towards the top is the olecranon. The "ball in the cup" so to speak is the distal part of the humerus, our upper arm bone. The bright sac of fluid on the left side of the image is an enlarged and inflamed olecranon bursa. Image courtesy of radiopedia.org.

Bursitis refers to inflammation of a bursa and the olecranon bursa is one of the more common places it occurs. Bursitis can occur due to a direct impact on the bursa where the bursal sac might bleed into itself. It most commonly occurs though just due to overuse. If the triceps is being engaged heavily and frequently, constant friction can just cause the olecranon bursa to become irritated and swell up. Rarely olecranon bursitis can occur due to infection or gout. Jon Moxley recently dealt with infectious olecranon bursitis which required surgery and him missing his match with Kenny Omega at All Out.

What Is The Prognosis?

Very good overall. From the tone of Devlin's post this sounds like an overuse injury due to a loaded schedule. It seems like he's just taking precautions to make sure the swelling goes down. When a bursa is inflamed it can become infected, though this isn't common.

The diagnosis is easily made clinically with characteristic swelling at the back of the elbow. The pain will be worse with extending the arm as the triceps muscle engages and rubs over the inflamed bursa. Imaging is rarely required unless the clinical course is complicated.

What olecranon bursitis looks like clinically. It's bigger than it should be, red, and swollen. And it's over the olecranon. It's not a tough diagnosis to make. Image courtesy of Medscape.

If Devlin takes a week or two off and lays off on triceps based exercises at the gym, he should be back in action in no time. I anticipate we'll see him with an elbow wrap on the next time he's in the ring as this can help with the swelling and also acts as a reminder to the person to protect the elbow from any additional trauma.

In Conclusion

Bursitis is a common condition and is especially common in wrestlers who are working a heavy schedule of physical activity and also frequently take impact on their joints. I respect Devlin for listening to his body and taking a break to let his bursitis calm down rather than trying to work through it and risk serious complications.

Disclaimer: These articles are general discussions about medical topics/diagnoses. As we are not personally interacting with wrestlers and do not have intimate knowledge of their maladies, we cannot comment specifically on their medical courses unless information has been previously freely reported. These articles reference wrestlers as examples based on what is either reported by them or their companies, but what is said beyond that is only speculation based on the general course of a given diagnosis. Any information here should not be used for self-diagnosis. If you are experiencing medical issues yourself, I advise you to see a licensed physician for a full evaluation.