Triceps tear is caused by an injury and rapture to the muscles and tendons of the upper arm, that run from behind the elbow to behind the shoulder. This part is known as triceps brachii and consists of three muscles which are:
- THE MEDIAL HEAD which runs from the posterior part of the humerus to the far end of the radial nerve (extreme branches of the posterior cord) groove
- THE LONG HEAD which starts from the infra-glenoid tubercle of the shoulder blade (scapula)
- THE LATERAL HEAD which starts from the humerus near the radial nerve groove
These muscles connect to a tendon that is in the proximal surface of the olecranon (the part of the elbow that pokes/points out. Triceps tears occur in the tendon and can form partial or complete tears.
- Previous medical conditions or medications such as endocrine treatment, renal failure, or steroidal injection
- Overuse or stretching the muscles, lifting against obstinacy, trauma on the elbow
- Surgical procedures such as total elbow arthroplasty where the triceps have been reconnected
- Posterior elbow Pain
- Triceps weakness of the upper arm
- Swelling and tenderness at the area
- A pop sound when the tear occurs
- Inability to outstretch the arm
- A palpable tendon gap near the olecranon that may be seen via radiographs
A partial tear is identified by the weakness of the arm and inability to outstretch the elbow against gravity, while a complete tear is identified by the inability of the elbow to outstretch against or resist gravity over the head.
A test known as FALL DOWN TRICEPS TEST is done to assess the inability of the forearm to extend against gravity. This test is done by an insertion in the triceps tendon tear, whereby the patient is instructed to stand straight with the shoulders at ninety degrees and the forearm held out, then dropped again. When the triceps tendon is completely torn the forearm drops at ninety degrees while if the tear is partial the forearm can drop at forty degrees.
- TENDON AUGMENTATION where tissue is grafted to repair the damaged tendon and assist in healing
- ACHILLES TENDON ALLOGRAFT which aids in the reconstruction of the tendon. The graft is extracted from another donor.
ECM therapy involves exercises such as:
- Template splint that is used to block a portion of active flexion
- Suppression of the extension of the elbow while doing a passive rotation
- Resistance of the elbow extension
- Passive and/or active flexion of the elbow to thirty degrees
The flexion is increased with the regain of range of motion with exercises such as:
- Elevating the arm to chest level
- Compression with a wrap or glove
Progressive Motion Phase
- NEUROMUSCULAR ELECTRICAL STIMULATION (NMES) in which electrical impulses are sent to the nerves causing the muscles to contract
- PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION (PNF) whereby the muscles are activated by contraction and stretching.
- FOREARM SUPINATION whereby the forearm is rotated forward
- PRONATION whereby the forearm is directed downwards
- Controlling edema
- Isometric contraction to strengthen the muscle
- Pain relief
- Thermal agents