Torn triceps tendon knocks Lewis out for the year

Christopher C. Dodson, MD October 17th, 2012

This past weekend, Hall of Fame Linebacker Ray Lewis of the Baltimore Ravens suffered a torn triceps tendon in his right arm. The triceps is a powerful muscle on the back of the upper arm that is responsible for straightening the elbow. A torn triceps tendon specifically refers to the tearing of the tendon that attaches the triceps muscle along the back of the arm to the tip of the elbow. Triceps ruptures commonly occur with falls onto an outstretched hand or during a block in football, when a sudden force causes the elbow to bend while the triceps muscle is simultaneously contracting and trying to straighten the elbow. The athlete’s body weight is resisted by the triceps contraction; however the force may be too much causing the tendon to rupture. Although triceps tendon ruptures are relatively uncommon, they are devastating injuries for athletes when they are missed and go untreated.

For this reason, the doctor and athletic trainer must maintain a high index of suspicion. An injured athlete will describe a mechanism of injury where the elbow was forcibly bent while he or she was trying to extend it. There will be tenderness to the touch and swelling where the tendon attaches to the back of the elbow. There will also be weakness when the elbow is extended against resistance. Although a physical exam is usually diagnostic, both physicians find an MRI helpful to confirm the diagnosis and specifically identify the location of the tear and degree of retraction of the tendon. Complete ruptures of the triceps tendon require surgery in athletes who wish to return to play at the prior level of competition. An incision is necessary on the back of the elbow to reattach the tendon directly to bone. If this injury is missed or neglected, the athlete will have significant weakness with elbow extension and may not be able to maintain a block in football or rugby, lift weights, or perform push-ups. If you suspect that you have a torn triceps tendon, it is critical to seek the urgent consultation of a local sports medicine doctor for appropriate care.

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