Triceps Tendon Injury

The triceps muscle is made up of three separate muscles that attach at the shoulder and the elbow. At the shoulder, the triceps has three tendons: one attaches on the shoulder blade and two attach to the humerus (upper arm bone). At the elbow, the triceps attaches to the olecranon (the pointed part of the elbow). The triceps is primarily involved in extending the elbow.

Injuries to the triceps at the elbow are very rare, but can occur when lifting a heavy load. These injuries can be a complete tear of the triceps tendon or a partial tear of the triceps tendon. Risk factors for injury include age, use of anabolic steroids, poor blood supply to the tendon, systemic illness (such as kidney disease), use of steroid injections near the tendon, or participation in activities with high impact (sports, work-related activities) 

Symptoms & Diagnosis

Patients may feel or hear a pop when the triceps tendon injury occurs. Bruising may appear along the back of the elbow and upper arm. Patients will have pain and may feel weakness of certain movements, such as elbow extension.

Triceps tendon injuries are diagnosed using physical examination and imaging studies to confirm the diagnosis. The physical examination is used to identify areas of pain, weakness, tendon defects, and an evaluation of the nerves of the arm. X-rays are used to look at the bones of the elbow. MRI (magnetic resonance imaging) may be used to take a closer look at the muscles of the elbow and identify any damaged tissue. If a patient has symptoms suggesting an injury to a nerve, an electromyography (EMG) test may be ordered to look at nerve function.

Treatment

Treatment of triceps tendon injuries can be done with non-surgical or surgical means. The goal of treatment is to reduce pain and regain function of the elbow. Non-surgical treatment is used in patients with partial tears of the triceps or elderly patients who are willing to accept a decrease in elbow strength and function. If the triceps is not repaired, patients will notice a decrease in strength, or inability, to extend the elbow. The therapies listed below are used to reduce inflammation associated with injury and allow you to strengthen the elbow muscles and regain function. Non-surgical treatment options include:

• Rest: Modifying your activities, particularly sports, is an important part of the treatment of a triceps tendon injury.

• Non-steroidal anti-inflammatory medications (NSAIDs) can help decrease inflammation

• Brace: Use of an elbow brace during the first few weeks after injury can help decrease inflammation and encourage healing of a partial triceps tendon injury, or help decrease pain of a complete triceps tendon injury.

• Physical therapy: This is an important tool to help you strengthen and retrain the muscles of the elbow to work better together

Surgical treatment is recommended for most patients, in order to regain strength and function of the arm. Surgery should be performed as soon as possible, ideally within 2 weeks of the injury to prevent scar tissue.

• Triceps tendon repair: This procedure is performed through an incision on the back of the elbow and uses stitches and either small anchors or tunnels in the bone to reattach the triceps tendon to the ulna bone. Patients will be immobilized after surgery and will slowly advance movement and strengthening of the elbow over a period of 3-4 months.