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What are Triceps Injuries?

The triceps or triceps brachii is a large muscle found on the back of the upper arm (humerus). It runs between the shoulder and elbow and is connected by a strong tendon to the back of the elbow. The triceps is the primary muscle which powers extension (straightening) of the elbow, allowing one to perform a push-up or lift an object overhead for example.

Types of triceps trauma or injury may include:

  • Triceps muscle strain (“pulled muscle”)
  • Triceps tendon rupture
  • Tendonitis, inflammation of the tendon

Causes of Triceps Injuries

Triceps injuries are common in athletes and individuals who are frequently performing heavy manual labor. The injury may occur suddenly or gradually over time. Some of the causes of triceps injuries include:

  • Receiving a sudden blow to the hand or elbow
  • Forcibly straightening the arm
  • Repeated overuse of the upper arm
  • Excessive force on the triceps resulting in rupture, such as lifting heavy weights

Signs and Symptoms of Triceps Injuries

Pain is the primary symptom of triceps injuries, which may be severe. Other common signs and symptoms of triceps injuries include:

  • Tenderness
  • Redness or bruising
  • Stiffness
  • Inability to bend or straighten the arm
  • Soreness
  • Swelling

What Happens If Triceps Injuries are Left Untreated?

Untreated triceps injuries can result in increased arm pain and inability to extend your arm fully. Left untreated, partial triceps ruptures can continue to rupture until they have reached the stage of a complete tear leading to serious complications. A completely torn triceps tendon can weaken your arm considerably leading to significant disability.

Diagnosis of Triceps Injuries

In order to diagnose triceps injuries, your doctor will review your medical history and conduct a thorough physical examination. During the physical exam, your doctor may press on the triceps area and also ask you to move your arm in different positions to check for range of motion and symptoms of pain, weakness, or swelling. If your doctor suspects any rupture of the triceps, then X-ray or MRI may be ordered to confirm the diagnosis.

Treatment of Triceps Injuries

Treatment of triceps injuries usually depends on the nature and seriousness of the injury. Minor injuries are amenable to conservative treatment, whereas serious high-grade partial ruptures or complete ruptures usually require surgical repair.

Non-surgical or conservative treatment will typically involve:

  • Application of ice (acute injury) or heat (chronic injury) to reduce swelling and pain
  • Rest and avoidance of pushing with the hand to minimize use of the triceps.
  • Physical therapy and controlled exercises
  • Use of over-the-counter pain medicines and nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Rarely, use of corticosteroid injection for severe pain

The surgical treatment will involve a surgical procedure to repair the ruptured triceps tendon. The procedure involves the following steps:

  • Medications through an intravenous line will be administered to help you relax.
  • Regional (block) anesthesia is administered to keep you comfortable and numb the arm during the surgery.
  • Your surgeon will make an incision behind the elbow and drill holes into the end of the ulna (bone in the forearm).
  • Heavy sutures are used to grasp the torn tendon and secure it back to the ulna
  • Your surgeon may in some cases use screws, buttons or other hardware to attach the tendon to the bone.
  • A tendon from another part of the body or from a deceased donor (allograft) may be used to lengthen the existing tendon in cases of chronic tendon injuries where there is insufficient tendon material for repair.
  • After the tendon is attached to the bone, it is sutured and the incisions are closed with surgical tape or bandages.
  • A cast is applied to immobilize the elbow and protect the repair.
  • When the wound is healed, sutures may be removed and physical therapy may begin
  • In most cases, patients regain all their motion and may begin strengthening the triceps muscle by 8 weeks after surgery.
  • NASS
  • AAOS
  • American Association of Hip and Knee Surgeons (AAHKS)
  • Tufts University School of Medicine
  • Newton-Wellesley Hospital