Q & A Triceps Rupture

By Michael Camp, DPT, CSCS, PES

My Competitive Life has been receiving emails from athletes in varied sports asking questions in regards to tricep tears, surgery, rehabbing, and returning to sports or fighting.

A triceps tear can happen suddenly with fighting, playing contact sports, and even with overuse. Other causes of tricep tears can occur with motor vehicle accidents, skiing, and sudden fall.  MyCompetitiveLife has witnessed fighters being taken down to the ground and in trying to prevent this, landing in an awkward position and “pop” their tricep.  Lacrosse and football players have torn triceps either blocking a lineman, or falling hardonto the turf.  Degrees of tear can vary from a partial tear, to a full rupture with loss of elbow extension.  Swelling, bruising, and pain occur immediately and the first step is to head to the ER or a trusted Medical Professional.  To get the latest and relevant facts, MyCompetitiveLife had a chance to sit down and talk with top Orthopedic Surgeon Dr. Brian Neri, from Pro Health Care Associates.

MyCompetitive Life;First step to diagnosing a triceps tear is?

[Brian Neri, M.D.] 

Patient typically has a traumatic event (weightlifting, fall etc.) and c/o subsequent weakness on elbow extension-type maneuvers (pushing open doors).  Physical exam confirms weakness on resisted elbow extension and a palpable defect on the insertion. Confirmation can confirm with MRI or CT scan if tear is minor.

MyCompetitiveLife;is there any truth that there is a window of time to repair the triceps?

Yes, it is preferable to repair these acutely (<2 weeks from injury) however it is possible to attain a primary repair months out from the injury.  When seen chronically (>6 months), repair typically requires graft augmentation to span the defect and reinforce the repair.

If so, why is this?

The tendon retracts and scars and the muscle fiber units shorten–this places excessive tension on the repair which places patients at higher rates of retear.

Compare Performing surgery on a tear in the muscle belly vs. rupturing the tendon from the bone?

I do not recommend surgery on muscle belly or musculotendinous junction tears–these typically will heal without much functional deficit, however on occasion will leave a cosmetic deformity. 

Muscle Size of an athlete ex. Bodybuilder vs. fighter or football player affect the type of surgery performed or amount of anchors used?

No

Is the tricep post surgery able to regain 100% strength?

In the acute repair setting with good mobile tendon tissue and strong repair construct, full return of strength can be attained.  

So post op the Physician places the patient in an elbow brace “locked” in various degrees that are adjusted each week during the rehab.  Beginning Physical Therapy varies among Doctors.  Some Doctors like to have their patients begin therapy right away, while others are more conservative and do not want the patient to begin for 4-6 weeks post op.

Dr. Brian Neri practices at ProHealthCare, for an appointment please call (516) 622-6040.