Anatomy of the Triceps Brachii

Your triceps brachii muscle, or “triceps” for short, runs along the back of your upper arm. It is named “tri-” because it has three heads: the long head, medial head, and lateral head.
The triceps originates at your shoulder, with attachments to your shoulder blade (scapula) and upper arm bone (humerus). At the bottom, it attaches to the point of your elbow. This is the bone on the pinky side of your forearm, called the ulna.

The triceps causes movement at the shoulder and the elbow joint. At your shoulder, it performs extension (backward movement of your arm) and adduction (moving your arm in toward your body). However, the main function of this muscle is at your elbow, where it performs extension (straightening of your elbow).

The triceps works the opposite of your biceps muscle on the front of your upper arm, which performs flexion (bending of the elbow).

What Is a Triceps Tear?

Tears can occur anywhere along the length of a muscle, or in its tendon—the structure that attaches the muscle to your bones. Triceps tears most commonly occur in the tendon that attaches your triceps to the back of your elbow. However, even this injury is rare.

Muscle and tendon tears can be graded from 1 to 3, based on how severe they are.

• Grade 1 (mild): These are small tears that cause pain that is worse with movement, with some swelling, bruising, and minimal loss of function.
• Grade 2 (moderate): These tears are larger and have moderate amounts of swelling and bruising, with up to 50% loss of function. Fibers are partially torn and stretched.
• Grade 3 (severe): This is the worst type of muscle tear, where the muscle or tendon is completely torn. These injuries cause severe pain and disability.

What Are the Symptoms of Triceps Tears?

Triceps tears cause immediate pain in the back of your elbow and upper arm that worsens if you try to move your elbow. You might also feel (or hear) a popping or tearing sensation. You will have swelling, and your skin will likely be red and/or bruised.

If you have a partial tear, your arm will likely feel weak. If you have a complete tear in your triceps muscle or tendon, you’ll have significant weakness when straightening your elbow. You might also notice a lump on the back of your arm where your muscle has “bunched up.”

What Causes the Triceps to Tear?

Triceps tears usually happen during trauma when your triceps muscle is contracted (tightened) and an external force tries to push your elbow into a bent position.
One of the most common ways this happens is by falling on an outstretched arm.

Triceps tears also occur during sports activities, such as throwing a baseball, boxing, blocking players during a football game, gymnastics, or when a player falls and lands on their arm. Tears can also happen when using very heavy weights during exercises that target the triceps, such as the bench press.

Less commonly, triceps tears happen from direct trauma to the muscle, such as a motor vehicle accident.

  Torn Tricep Pictures 

Long-Term Causes

Triceps tears can develop over time as a result of tendonitis, which is inflammation in the tendon that connects your triceps to the bone. This condition usually occurs from repetitive use of your triceps muscle during activities such as manual labor or exercise. In fact, triceps tendonitis is sometimes called “weightlifter’s elbow” for that reason.5

Strain on tendons causes tiny tears that the body typically heals. However, if you put more strain on your tendon than your body can keep up with, these tiny tears turn into larger tears.

Risk Factors

Risk factors can make it more likely that a person could have a triceps tear. Certain underlying medical conditions can weaken tendons, making them more likely to be injured. These include

Chronic tendonitis or bursitis in your elbow can increase your risk of tendon tears. Triceps tendon tears are also more likely to happen if you’ve had cortisone shots in the tendon or if you use anabolic steroids.

Triceps tears also occur more commonly in males between the ages of 30 and 50.7 Participating in activities such as football, weightlifting, bodybuilding, and manual labor can also increase the risk of this injury.

How Is a Torn Triceps Treated?

Treatment for a torn triceps depends on which part of the triceps is affected (muscle belly versus tendon) and what the extent of the damage is. It can be as simple as resting your elbow for a few weeks, or it could require surgery.

Nonsurgical Treatment

Partial tears in the triceps that involve less than 50% of the tendon can often be treated without surgery.

Initial treatment includes splinting the elbow in a slightly bent position (about 30 degrees) for four to six weeks to allow the injured tissue to heal. During this time, ice can be applied to the area for 15 to 20 minutes several times per day, to help decrease pain and swelling.

Non-steroidal anti-inflammatory medications (NSAIDs), such as Aleve (naproxen), Advil (ibuprofen), and Bayer (aspirin) can help reduce inflammation. Other over-the-counter medications, such as Tylenol (acetaminophen) can also be used to help decrease your pain.

Once your splint is removed, physical therapy will help you regain movement and strength in your elbow. Full movement of the elbow is expected to return within 12 weeks, but you won’t be back to full strength until six to nine months after your injury.

Surgical Treatment

Triceps tendon tears that involve more than 50% of the tendon require surgery. In some cases, surgery is also recommended for tears that are smaller than that, particularly if you have a very demanding job or plan to resume playing sports at a high level.

Tears in the muscle belly (the area where the muscle and tendon join each other) are typically sewn back together. If your tendon is no longer attached to the bone, it will be screwed back on.

Timeframes for recovery in physical therapy after surgery depend on your specific surgeon’s protocols. In general, you’ll spend a couple of weeks in a brace. Around four weeks after surgery, you’ll be able to start moving your elbow again. However, you won’t be able to start doing heavy lifting for four to six months

Video  Distal triceps rupture repair: the triceps pulley-pullover technique. This video describes the steps to perform the technique. The patient is in the lateral decubitus position with left arm over a horizontal bar. A tourniquet is in situ and the patient is prepped and draped to allow exposure of the dorsal aspect of the left elbow. The head is to the left of the screen, the feet towards the right.

Source vidéo sciencedirect.com

Complications

Complications can occur after triceps repair, whether you’ve had surgery or not. For example, you might not regain full elbow extension (straightening). You’re also at a higher risk of re-rupture, especially if you try to use your arm before it’s fully healed.

How Long Does a Torn Tricep Take to Heal?

The amount of time it takes for a torn triceps to heal depends on the severity of the tear, and whether it is treated with a surgical or non-surgical approach.

For triceps tears treated with non-surgical approaches, full strength and extension of the triceps usually return within six to nine months of starting treatment. Keep in mind, however, that partial tricep tears can always progress to full tears, delaying recovery.

A torn triceps that is repaired with surgery will also take months to heal. Very light exercises that do not involve resistance can typically be started around the eight- to 12-week mark. At the earliest, you can expect to return to sports and recreational activities about five to six months post-operation.

When to See a Healthcare Provider

See a healthcare provider for the following:

• Limited range of elbow motion; for example, you are unable to straighten your elbow or push open a door.
• Difficulty sleeping due to elbow pain
• Numbness or tingling in your arm or shoulder
• Weakness that progressively gets worse
• A bump on your elbow coupled with pain or weakness

Seek medical care right away if you experience a sharp pain in the back of your elbow during any activity—especially if you hear a “pop” or feel a “tearing” sensation. Triceps tears that are treated promptly have a higher chance of full recovery.

Summary

While triceps tears are uncommon, they can be serious. This injury affects men more often than women and usually occurs from trauma or sports/exercise activities.

Treatment depends on the extent of your injury. Conservative treatment includes splinting, ice, medications, and physical therapy. Some triceps tears require surgery, followed by splinting and physical therapy to regain movement and strength. In both cases, recovery can last for six months or more.