Triceps Tendon Tear Treatment
A triceps tendon rupture is the rarest of the major tendon injuries around the arm, and it is also the one most often missed on first presentation. The tendon attaches at the point of the elbow and straightens the arm, so a complete tear takes away the ability to extend against resistance, and a patient who can still partially straighten the elbow is frequently sent home with a diagnosis of a bruise.
Because it is uncommon, it benefits from a surgeon who sees the full range of arm and shoulder injuries rather than one specific joint. Steven Struhl, MD is board certified in orthopedic surgery and separately in sports medicine, completed his sports medicine fellowship at Penn State University, and is a Fellow of the American Academy of Orthopaedic Surgeons. He treats tendon injuries of the shoulder, arm, and elbow at offices in Manhattan and White Plains.
What Is a Triceps Tendon Tear?
The triceps is the large muscle at the back of the upper arm, and its tendon attaches to the olecranon, the bony point of the elbow. Its job is straightening the arm, so the injury shows up as an inability to push, press, or extend against resistance. The usual mechanism is a fall onto an outstretched hand while the triceps is contracting, which loads the tendon in the position where it is most vulnerable.
- Complete Avulsion: the tendon pulls entirely off the olecranon, requiring surgical repair.
- Partial Tearing: some fibers remain intact, which may allow non surgical treatment.
- Musculotendinous Tear: the tear occurs where muscle transitions into tendon.
- Associated Fracture: a fragment of bone pulled away with the tendon at its attachment.
Certain factors raise the risk, including anabolic steroid use, chronic kidney disease, hyperparathyroidism, and prior corticosteroid injection near the tendon.
Triceps Tendon Tear Symptoms
- Pain At The Elbow Point: discomfort concentrated at the back of the elbow after the injury.
- Extension Weakness: difficulty straightening the arm, particularly against any resistance.
- A Palpable Gap: a defect that can sometimes be felt just above the point of the elbow.
- Swelling And Bruising: discoloration at the back of the elbow within the first days.
The partial preservation of function is why this injury gets missed. Other muscles assist elbow extension enough that a patient may still straighten the arm against gravity, and the deficit only becomes apparent when resistance is added.
Dr. Struhl treats an incomplete examination as the main risk in this injury, noting that “it is our goal to establish tissue specific diagnosis early in the course of treatment, avoiding the weeks of therapy and repetitive injections that are typically given as initial treatment.” – Steven Struhl, MD, Board Certified Orthopedic and Sports Medicine Surgeon
Triceps Tendon Repair and Recovery
- Imaging Confirmation: X ray identifies an avulsed bone fragment and MRI defines the tear.
- Non Surgical Care: splinting and therapy for partial tears with preserved extension strength.
- Surgical Reattachment: the tendon is secured back to the olecranon with sutures or anchors.
- Protected Motion: a brace controls the arc of movement while the repair heals.
Complete tears are repaired, and repaired early, for the same reason distal biceps tears are. The tendon retracts with time, and a delayed repair may need graft reconstruction rather than direct reattachment.
Frequently Asked Questions About Triceps Tendon Tears
- Complete tears in active patients are generally repaired, because the loss of extension strength is significant and does not compensate away. Partial tears with preserved strength against resistance can often be treated with splinting and therapy.
- Because patients can frequently still straighten the arm against gravity, since other muscles assist the motion. The weakness only appears when resistance is applied, so an examination that does not test extension against resistance can miss a complete tear entirely.
- Early repair, generally within the first weeks, produces the most reliable result. The tendon retracts and scars over time, and a chronic tear may require reconstruction with a tendon graft rather than direct reattachment to the bone.
- Anabolic steroid use, chronic kidney disease, hyperparathyroidism, and prior corticosteroid injection near the tendon all weaken the tissue. It is also seen in weightlifters and in football players, particularly linemen, where the loading pattern is repetitive and heavy.
- A brace protects the repair for the first several weeks with a controlled arc of motion, strengthening begins once healing is established, and return to unrestricted lifting or contact sport generally falls between four and six months.
- After early repair most patients recover extension strength close to the uninjured side. Patients treated without surgery for a complete tear typically retain a measurable deficit in pushing and pressing strength that does not fully resolve.
Why Patients Choose Dr. Struhl for Tendon Repair
- Academy Fellowship: Fellow of the American Academy of Orthopaedic Surgeons.
- Sports Medicine Fellowship: subspecialty training at Penn State University in athletic injury.
- Shoulder Through Elbow: the full arm treated within a single practice.
- Thorough Examination: extension tested against resistance, which is what reveals a complete tear.
Schedule a Triceps Tendon Evaluation in New York City
An elbow injury that was called a bruise but left you unable to push a door open deserves a second examination, because a complete triceps rupture repaired early does considerably better than one repaired late. Dr. Struhl evaluates triceps and elbow tendon injuries at his Manhattan and White Plains offices. Call the New York City office at (212) 207-1990 or the Westchester office at (914) 328-4111 to schedule an appointment.
