A triceps tendon rupture is a tear of the tendon that connects the triceps muscle to the back of the elbow. It is an uncommon injury, most often occurring from a fall on an outstretched arm, a forceful eccentric contraction during weightlifting, or a direct blow to the back of the elbow. Loss of active elbow extension is the hallmark finding, and complete tears typically require surgical repair to restore function.
What Is a Triceps Tendon Rupture?
The triceps muscle has three heads (long, lateral, medial) that converge into a single tendon attaching to the olecranon, the bony point at the back of the elbow. The triceps extends the elbow and stabilizes the forearm during pushing activities. When the tendon ruptures, the active extension function is lost.
Most ruptures occur at the tendon-bone insertion, often with a small avulsion of bone. Partial tears preserve some active extension. Complete tears produce loss of active extension against gravity.
Causes and Risk Factors
- Falls on an outstretched arm with a forceful eccentric load on the triceps
- Heavy weightlifting, especially bench press and overhead pressing
- Direct blow to the back of the elbow
- Anabolic steroid use, which is associated with higher tendon rupture rates
- Local corticosteroid injection into the tendon
- Systemic factors: chronic kidney disease, hyperparathyroidism, diabetes
- Olecranon bursitis or prior elbow surgery
Symptoms
- Sudden pain at the back of the elbow during the injury
- A pop or tearing sensation in some cases
- Bruising and swelling over the back of the elbow
- Inability to fully extend the elbow against gravity
- Palpable defect at the back of the elbow at the tendon insertion
- Weakness with pushing activities
Diagnosis
Dr. Chudik’s evaluation includes the mechanism, timing, and a focused examination assessing active extension against gravity and against resistance. The hallmark finding is loss of active extension with a palpable gap at the olecranon. X-rays may show a small avulsion fragment. MRI confirms the diagnosis, characterizes partial versus complete tears, and documents tendon retraction. The Westmont office has on-site high-field MRI and X-ray.
Treatment
Non-surgical treatment is appropriate for partial tears with preserved active extension and for complete tears in lower-demand patients who accept some weakness. It involves bracing in extension for several weeks, progressive range of motion, and triceps strengthening.
For complete tears in active patients, Dr. Chudik performs triceps tendon repair, reattaching the torn tendon to the olecranon with suture anchors or bone tunnels. Acute repair within three to four weeks of injury produces the most reliable outcomes.
Recovery and Outcomes
Recovery after acute repair typically includes four to six weeks of brace protection in extension with limited flexion, progressive active extension from six weeks, strengthening at three months, and return to most activity at four to six months. Return to heavy lifting and contact sport is typically six months.
Outcomes after acute repair are very good. Chronic tears with significant retraction have less predictable outcomes.
When to See Dr. Chudik
Schedule an evaluation after any injury that produces sudden pain at the back of the elbow with weakness extending the elbow, particularly if a pop was felt. Call 630-324-0402 or request an appointment online.