The triceps muscle is a three part muscle that runs along the back of the arm to attach at the back of the elbow on the olecranon process. Its main reponsibility is to allow forceful extension of the forearm to push objects away or help lift the body out of a chair.
Triceps mucle ruptures are rare injuries that typically result from a forceful contraction of the elbow. These injuries commonly result from a sudden contracture of the elbow in football players, weightlifters or older individuals. Males are two times more likely than females to tear their triceps and the typical range is between 30-50 years of age.
Most injuries will result from a fall on a flexed, outstretched upper extremity and the tear usually occurs where the tendon attaches to the back of the elbow on the olecranon. Athletes will often describe a pop or tearing sensation along the back of the elbow with the sudden inability to forcefully extend the forearm.
A good physical exam is important to identify the location and amount of pain, swelling and bruising that is associated with this injury. Weakness and loss of passive extension of the forarm with a modified Thompson test are important findings. X-rays are useful to identify any bone spurs or avulsion fractures that complicate the treatment options.
MRI scans are the most useful tests used to identify and confirm both the extent and location of the tendon disruption. The MRI scan will identify complete tears that have pulled away from the bony insertion site vs incomplete tears that are still partially attached.
Treatment options include a period of immobilization followed by physical therapy for incomplete tears and primary surgical repair for complete tears and for tears greater than 50% involvement. New surgical techniques have evolved to allow the tendon to be properly secured to the olecranon to allow for safe post-operative rehabilitation.
After successful repair, the elbow is generally immobilized for 2 weeks followed by passive range of motion for weeks 2-4. Active range of motion can be initiated at 4 weeks and progress with weightlifting avoided for 4-6 months.
Proper recongnition of this injury allows for timely repair and excellent outcomes once the tendon is secured.
