Triceps tendonitis is a term used to describe inflammation, damage or rupture of the triceps tendon. The triceps muscle runs down the back of the upper arm and is responsible for straightening the elbow. At its proximal (upper) end it is attached to the shoulder blade and humerus (the bone in the upper arm) and at its distal (lower) end it inserts into the ulna (one of the two forearm bones) by means of the triceps tendon. Like all tendons, the triceps tendon is a very strong, dense sheath formed by strands of connective tissue. When the triceps muscle is contracted, the tendon pulls on the ulna and causes the arm to straighten.
Damage to the triceps tendon can cause inflammation and progressive degeneration of the tendon fibers. Such damage and its symptoms are known as triceps tendonitis, triceps tendinopathy, triceps tendinitis, or triceps tendonosis.
Triceps tendonitis occurs when some or all of the fibers that make up the tendon become frayed or broken. This leads to pain, weakness, and impaired function of the triceps muscle. Tendon strands can heal themselves with time, but if the muscle is not rested the tendon fiber cells do not have adequate time to regenerate and tendonitis can develop.
Tendonitis usually arises as a consequence of wear and tear through repeated overuse of the tendon. A sudden increase in the amount of use can overstress the tendon and cause damage. Sometimes the tendon is injured as a result of sudden trauma, but normally the damage accrues over time. In extremely severe cases the tendon may completely rupture (break into two pieces). This injury would require prompt surgical repair.
Exercising without properly warming up the arm muscles will increase the risk of injuring the tendon.
Typical symptoms of triceps tendonitis may include:
- Pain felt at the back of the elbow
- Stiffness in the elbow joint, particularly after a period of rest following intense or repetitive elbow straightening
- Tenderness when touching the area over the tendon
- Aching pain made worse with movement
- Possible swelling near the tip of the elbow
- Possible weakness when straightening the elbow against resistance
Your doctor will ask for your medical history and the details of any previous injury to your elbow. You will be asked about the circumstances of your current injury and the onset, duration, and severity of your symptoms. Your lifestyle, occupation, and recreational activities will be discussed and then your elbow and arm will be physically examined. Areas of tenderness or swelling will be noted and your elbow flexed and extended in order to assess the level of pain or weakness.
Occasionally an X-ray or MRI (magnetic resonance imaging) scan may be taken to better view the structures within the elbow. X-rays can reveal a displaced bone chip or fracture, while an MRI will clearly show any damage to the triceps tendon.
In order to achieve the best possible outcome, you must be prepared to completely rest your elbow until healing of the tendon fibers is complete. Failing to do so can result in the tendonitis becoming a chronic condition, which takes much longer to heal, and you would be left with an increased risk of developing tendonitis again.
During the initial, acute stage of the injury, which is normally the first two or three days, you should try the following techniques:
Rest: This is crucial to a good recovery. Avoid any and all activities that put stress on the triceps tendon.
Ice: Apply ice, crushed in a bag and wrapped in a towel, to the damaged area for as long as is comfortable, several times a day. This will help to reduce swelling and inflammation.
Compression: Wear a compression bandage on the elbow. This will direct force away from the tendon and make you feel more comfortable.
Elevation: Raise your elbow above the level of your heart to reduce swelling. This can be achieved by resting the elbow on a pile of cushions.
NSAIDs: Non-steroidal anti-inflammatory drugs such as ibuprofen (Advil), naproxen (Aleve), or aspirin can be taken to relieve pain and inflammation.
Following the acute stage, and with the approval of your doctor or physical therapist, you should begin a graduated program of exercises designed to stretch and strengthen the triceps muscle. Other physical therapy may include ultrasound, massage, and the application of heat. You may be advised to wear a strap over the lower part of the triceps if you have to do particular activities that aggravate your symptoms.
In some cases of triceps tendonitis, conservative treatment fails to resolve the problem. A corticosteroid injection can be administered into the tendon and further diagnostic tests can be performed. Surgical repair or reconstruction of the tendon is only performed for complete ruptures of the tendon.
These should only be performed with medical approval. Stop immediately if you feel any pain when performing them. Try to do them twice a day.
Standing, raise your bent elbow so that your palm gradually slides down your back as far as it can without causing any pain. You can use your other hand to gently assist the stretch. Hold for 15 seconds. Repeat 5 times.
Standing, with your hands clasped together, raise your arms above your head. Keep your elbows close to your ears as you reach back with your arms, as though trying to touch your upper back. Hold for 15 seconds. Repeat 5 times.
Standing, with your bent elbow at your side and your palm facing inwards, make a fist with that hand. Place your other hand under the fist. By tightening the triceps muscle push your fist down onto your other hand. Hold for 5 seconds. Repeat 10 times.
Supporting yourself with one hand on a table, lean forward and hold a small weight in the hand of the affected arm. Bend the elbow to a 90 degree angle and draw the upper arm back and up until it is parallel with the floor. Keeping the upper arm still, raise the forearm until the entire arm is straight. Repeat 10 times.