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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, especially for athletes. Nonoperative management is rarely indicated. It is 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 bunching up of the muscle from where it has detached.

Tendon tears are diagnosed by 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.

A biceps tendon tear is a tear of the tendon that attaches the biceps muscle to the shoulder. The biceps muscle is responsible for lifting the arm. A biceps tendon tear can occur at the shoulder or at the elbow. A tear at the shoulder can also damage the shoulder’s rotator cuff.

Biceps tendon tears are often causes by a fall on an outstretched arm or twisting the elbow or shoulder. Tears at the elbow are rare and are often caused by weightlifting, or heavy labor at a job. Repetitive motions such as are involved with overhead sports like tennis and swimming can cause a tear. 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 tear.

Distal triceps ruptures are uncommon usually caused by a fall on an outstretched hand or direct blow. Risk factors include steroid use, weightlifting and trauma.

Treatment options for biceps tendon tears depend on the severity of the injury. For minor tears, rest, ice, and anti-inflammatory medications may be enough to allow the tendon to heal properly. More severe tears may require surgery to repair the damage.

Surgery is typically recommended for people who have a complete tear of the biceps tendon. In some cases, people with a partial tear may also need surgery. The goal of surgery is to reattach the tendon to the bone so that you can regain strength in your arm.

There are two types of surgical procedures that can be used to repair a biceps tendon tear:

  • Tenodesis is a procedure where your orthopedic specialist reattaches the biceps tendon to the bone using screws or other devices.
  • Tenotomy is a procedure where your orthopedic surgeon cuts the biceps tendon and reattaches it with sutures (stitches).

After surgery, you’ll likely need to wear a splint or sling for several weeks. Physical therapy is also 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 usually successful. However, there’s a risk of the tendon tearing again after surgery.

The triceps tendon is the 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 surgically repaired.

Most triceps tendon tears occur from trauma during sports activities like throwing a ball, boxing, gymnastics, a direct hit or falling 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.

These injuries are easily missed. Prompt diagnosis is 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 the Center for Orthopedic Specialists to schedule a consultation at one of our locations. We have offices in Mission Hills, Tarzana, West Hills, and Westlake Village for your convenience. You will always be treated with respect and compassion.

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