The triceps tendon is a broad three-sectioned muscle that comes down along the back of the upper arm from the shoulder and inserts into the back of the elbow. The place where these three sections meet into one tendon and attaches to the bone is called the triceps footprint.
When the muscle is completely torn, the tendon usually pulls away from its footprint. Sometimes the traumatic event is so powerful that the tendon pulls away still attached to the footprint, taking a piece of the underlying bone with it. Because the muscle functions to straighten the elbow, when it is ruptured, arm extension is compromised.
The triceps muscle doesn’t tear or rupture very often. In fact, of all the tendons in the body that do get injured, injuries affecting this one are reported the least often. When it does happen, it’s usually in a professional-level football player or weight lifter. Of course, the nature of these sports with potentially violent contact or powerful lifts increases the risk of this type of injury.
Current treatment guidelines for triceps tears include: conservative care for anyone with less than half the tendon torn and for older adults with more than half the tendon thickness torn who are inactive. Surgery is always advised when the triceps has ruptured completely away from the tendon footprint. When surgery is indicated, it should be done as soon as possible (within the first two weeks of injury). A delay in diagnosis and/or in treatment can result in significant loss of muscle strength and other complications.
When surgery is not the first-line of treatment, the patient is instructed to keep the arm in a splint (or cast) for 30-days. The arm will be immobilized in a position of 30 degrees of elbow flexion. This position helps protect the triceps tendon from tearing more by avoiding muscle contraction needed to get the last bit of elbow extension. If the conservative (nonoperative) approach doesn’t work, then surgery is the next option considered.
Recovery time depends on whether you are treated with a conservative (nonoperative) or surgical approach. Either way, you are looking at at least a four to six week period of time while the soft tissues knit back together — possibly longer with surgery. You will want to follow your doctor’s directions carefully to avoid reinjury, microtears, or even rerupture.
Returning to a training regimen will require some time and patience as you gradually build up the muscle to its former tensile strength and ability to handle repetitive loads. A sports physical therapist can help guide you through this process in the most safe and efficient way.