Biceps and Triceps Tendon Tears
Tears of the biceps and triceps tendons are rare and significant injuries that can lead to profound disability if left untreated, especially in the athletic community. Biceps tendon ruptures are more common than triceps ruptures. Surgical repair is required in most cases. Nonoperative management is rarely indicated and typically reserved for individuals with partial ruptures that can quickly regain strength and function.
Tendon tears are graded by severity from mild to severe. Common symptoms are pain, hearing or feeling a popping sensation, swelling, bruising and tenderness, arm weakness, and a retraction of muscle bulk from where it has detached.
Tendon tears are diagnosed through clinical assessment by your orthopedic specialist. X-rays and ultrasound are used to confirm a diagnosis. An MRI provides a clearer picture of the nature and extent of the tear.
The biceps muscle is responsible for flexing the elbow and supinating the forearm. A biceps tendon tear is an injury to the tendon attachment at either the shoulder or forearm insertion point. A tear at the shoulder can also damage the shoulder’s rotator cuff.
Proximal biceps tendon tears at the shoulder are often causes by a fall on an outstretched arm causing a twisting motion at the shoulder joint. Distal biceps tendon tears at the elbow are often caused by direct elbow contraction activities such as lifting heavy objects at the gym or during manual labor, or by catching of heavy objects. Repetitive motions such as are involved with overhead sports like tennis and swimming can cause partial tears to either end of the biceps. Aging and normal wear and tear can also cause a biceps tendon rupture. The use of steroids and smoking can increase the risk of a biceps tendon tears.
Treatment options for biceps tendon tears depend on the severity of the injury. For partial tears, rest, ice, anti-inflammatory medications, and regenerative medicine injections such as Stem-Cell or Platelet-Rich Plasma (PRP) therapy may be enough to allow the tendon to heal properly. More severe tears may require minimally invasive surgery to directly repair the ruptured tendon.
Surgery is typically recommended for people who have a complete tear of the biceps tendon. The goal of surgery is to reattach the tendon to the bone so that you can regain strength in your arm.
Surgical repair of biceps injuries varies by location:
- Proximal biceps tendon tears are either directly repaired to its anatomic insertion on the glenoid (shoulder joint socket) or reattached at the level of the humerus (upper arm bone) via suture anchors. Both procedures help alleviate pain from proximal biceps injuries.
- Distal biceps tendon tears are directly repaired to its insertion point along the radius (forearm bone) via suture anchors.
After surgery, you’ll wear a splint or sling for a few weeks. Physical therapy is an important part of your recovery. You’ll likely need to do exercises to regain strength and range of motion in your arm. Surgery for a biceps tendon tear is very successful if treated promptly by experts.
The triceps tendon is a large tendon that attaches the back of the upper arm to the elbow. A triceps tendon tear most commonly occurs near the attachment site at the elbow. Triceps tendon tears are rare and can result is substantial disability unless promptly surgically repaired.
Most triceps tendon tears occur from trauma during sports activities like throwing a ball, boxing, gymnastics, or from a direct hit or fall on the arm. Repetitive motions can place too much stress on the tendon causing it to tear during weightlifting, manual labor, and sudden lifting of large loads. Risk factors include diabetes, chronic kidney disease, heart disease, male sex, steroid use, and rheumatoid arthritis.
Prompt diagnosis of triceps tendon tears are important because delayed repair can result in inferior outcomes. Surgical repair for complete ruptures, where the tendon is torn off the bone, involves reattaching the tendon to bone with suture anchors. In some cases, tendon repairs can be augmented with the use of an artificial ligament or tendon graft when the quality of the tissue is poor due to medical disease.
Post operative protection with a splint is important to prevent failure of the repair. Rehabilitation is important to prevent stiffness and reestablish range of motion. Reconstruction of the distal triceps tendon provides good functional results.
When you or a loved one suffers a shoulder or elbow injury, it is important to see an expert. Contact LALL Orthopedics + to schedule a consultation at one of our locations. We have offices in Illinois, New Jersey and Philadelphia for your convenience.
Dr. Ajay C. Lall is a former dual sport NCAA collegiate athlete (football and track & field), American board certified, triple fellowship-trained expert orthopedic surgeon who specializes in hip arthroscopy, robotic hip replacement and cutting-edge regenerative medicine such as platelet-rich plasma (PRP) and Stem-Cell therapy. He treats non-athletes and athletes at all levels of play from collegiate to professional to the Olympic level. Dr. Lall is a world-renowned orthopedic surgeon who cares for all patients like family. Contact LALL Orthopedics + to schedule a consultation, receive the correct diagnosis, and undergo state-of-the-art treatment options.
At a Glance
Ajay C. Lall, MD, MS, FAAOS
- Board Certified – Orthopedic Surgery
- Triple Fellowship Trained
- Performs over 750 Surgeries Per Year
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