Triceps Tendon Rupture in the Elbow

The triceps tendon is a crucial part of the powerful muscle-tendon complex located at the back of the upper arm. It connects the triceps muscle—composed of three distinct heads—to the elbow, enabling extension of the elbow joint.

Triceps tendon ruptures may be partial (incomplete) or complete. They typically occur due to a sudden, forceful contraction of the triceps muscle. These injuries are more commonly seen in weightlifters and men with systemic diseases such as chronic kidney failure.

Complete triceps tendon ruptures cause significant functional loss, especially the inability to extend the elbow against resistance. Diagnosis is usually based on physical examination, but advanced imaging such as MRI may be needed to confirm the extent of the rupture.

Treatment depends on the patient’s age, general health condition, chronicity of the tear, and level of physical activity. While partial tears are often treated with immobilization and physical therapy, complete ruptures usually require surgical repair.

Who Is at Risk for a Triceps Tendon Tear?

Although rare, triceps tendon injuries can occur more frequently in individuals with certain risk factors:

1. Systemic Conditions:

• Hyperparathyroidism – Excess parathyroid hormone weakens bones and tendons.

• Renal Osteodystrophy – Bone and tendon quality deteriorates in chronic kidney disease.

• Osteogenesis Imperfecta (OI) – A genetic disorder affecting connective tissue and tendon strength.

• Rheumatoid Arthritis (RA) – Chronic joint inflammation contributes to tendon degeneration.

• Type 1 Diabetes (DM) – Diabetes weakens soft tissue structures, increasing rupture risk.

2. Medication Use:

• Anabolic Steroids – May boost muscle strength but weaken tendons.

• Local Corticosteroid Injections – Long-term use can compromise tendon integrity.

• Fluoroquinolone Antibiotics – Associated with increased risk of tendon rupture.

3. Chronic Conditions or Prior Surgeries:

• Chronic Olecranon Bursitis – Repeated inflammation weakens tendon insertion.

• Previous Triceps Surgery – Past interventions may impair tendon strength.

4. Genetic Disorders:

• Marfan Syndrome – A connective tissue disorder that may reduce tendon durability.

Patients with these risk factors should avoid high-strain physical activities and take preventive measures to protect tendon health.

Symptoms of a Triceps Tendon Tear

Symptoms vary based on whether the rupture is partial or complete, and whether the injury is acute or chronic. Common symptoms include:

1. Pain and Tenderness:

• Localized pain at the back of the elbow.

• Increased sensitivity to touch.

2. Limited Motion:

• Inability to fully extend the elbow.

• Difficulty extending the elbow against resistance.

3. Visual Changes:

• A visible gap or depression where the tendon is normally located.

• Swelling or bulging of the upper arm muscle.

4. Audible Signs and Sensation:

• A "popping" sound at the time of injury.

• A sudden feeling of something tearing.

5. Loss of Strength:

• Significant weakness during pushing or pressing movements.

• Difficulty performing tasks like push-ups or pressing objects.

6. Swelling and Bruising:

• Acute swelling and subcutaneous bruising at the back of the elbow.

Differences Between Partial and Complete Tears

• Partial Tear: Milder pain and strength loss; some extension is preserved.

• Complete Tear: Severe pain with total loss of elbow extension.

If symptoms of a triceps tendon tear are suspected, timely evaluation by an orthopedic specialist is critical. Early diagnosis and appropriate treatment can prevent long-term complications.

How Is a Triceps Tendon Rupture Diagnosed?

Diagnosis of a triceps tendon rupture is based on the patient's history, physical examination, and imaging studies. A popping sound at the moment of injury, pain in the back of the elbow, and significant weakness when trying to extend the arm are classic signs.

Physical Examination:During the examination, the doctor checks for a gap or indentation in the area where the tendon attaches to the elbow. The patient is asked to actively extend the elbow against resistance. In complete tears, this motion is usually impossible, a condition referred to as extension loss.

Imaging Techniques:

• X-ray: Helps assess bone structures and potential fractures or avulsions.

• Ultrasound: Provides a quick and dynamic view of the tendon.

• MRI (Magnetic Resonance Imaging): Offers detailed visualization of the extent of the tear and the condition of surrounding tissues.

Once the diagnosis is confirmed, treatment is planned according to the patient’s general health and the severity of the injury.

How Is a Triceps Tendon Rupture Treated?

Treatment of a triceps tendon rupture depends on the type of tear (partial or complete), the patient's age, overall health, and activity level. Management options are broadly classified into non-surgical (conservative) and surgical methods.

1. Non-Surgical Treatment for Triceps Tendon Tear:This approach may be suitable for partial tears or in patients with lower physical demands.

• Rest and Immobilization: The elbow is stabilized using a splint or a special brace.

• Pain Management: Anti-inflammatory medications help reduce pain and swelling.

• Physical Therapy: After the initial healing phase, physical therapy helps restore range of motion and muscle strength.

Partial tears generally heal within 8–12 weeks with conservative treatment.

2. Surgical Treatment for Triceps Tendon Rupture:Surgery is often necessary for complete tears or in physically active individuals.

• Tendon Repair: The torn triceps tendon is reattached to the ulna bone using special anchors or sutures.

• Recovery Timeline: The elbow is immobilized for the first 1–2 weeks post-surgery. Gradual, controlled movements are then introduced with physical therapy.

• Full Recovery: Most patients regain full function within 3–4 months.

Recovery After Triceps Tendon Surgery or Conservative Treatment

Regardless of the treatment type, rehabilitation plays a critical role in regaining elbow motion and strength. A customized physical therapy program ensures optimal functional recovery.

Conclusion

Triceps tendon ruptures are rare but serious injuries. Early diagnosis and appropriate treatment are essential for a full recovery. While partial tears are often managed without surgery, complete ruptures typically require surgical repair.

In both cases, structured physical therapy and rehabilitation are crucial for restoring range of motion and strength. Identifying risk factors and taking preventive measures in high-risk activities can help avoid such injuries. Maintaining triceps tendon health is key to living an active, pain-free life.

For professional evaluation and treatment of elbow injuries, including triceps tendon ruptures, you can contact Op. Dr. Utku Erdem Özer. To schedule an appointment or learn more, please visit our Contact Page.