Inflammation of the triceps tendon is an injury that most often occurs with excessive use and repetitive movements, resulting in inflammation (or degeneration) of the triceps tendon at the point where it connects to the back of the elbow. This injury is very similar to biceps tendonitis, with the exception that in this case it is another muscle – triceps brachii. However, the causes, symptoms, and treatments are almost identical.
Located along the backs of your upper arms, your triceps are composed of three separate muscles, or heads: the lateral head, the medial head, and the long head. The three heads each start at one of two locations—your upper arm bone or your shoulder blade – then come together at your forearm, attaching to a tendon that connects to your elbow bone.
The term tendonitis refers to an acute inflammatory process of the triceps tendon that occurs shortly after the injury itself. But if the injury is recurring, the inflammatory process slowly turns into degenerative processes on the tendon, which is called tendinopathy.
Symptoms of triceps tendonitis
Symptoms of triceps tendonitis include severe pain on the back of your elbow, right above the elbow joint, where the triceps tendon hooks to the back of the elbow. Pain is likely to worsen when you perform activities that involve loaded elbow extension such as push-ups, bench presses, or triceps extensions. However, you can feel the pain even at rest when you’re not performing any activity. The back of the elbow is painful to the touch. This pain tends to be particularly severe in baseball pitchers. You may also feel a snapping sensation in your elbow. Even stretching the arm at the elbow without load causes pain and discomfort.
What are the most common causes of triceps tendonitis?
Triceps tendon injury can result from a sudden blow or fall causing strain (tearing) of the tendon. Also, pain can develop gradually through repetitive exertion or improper performance of an exercise. For example, performing an overweight triceps extension over the head is a common cause of this injury. Also, with the same movement, bending the elbow at an angle of less than 90 degrees can cause injury because the forces through the muscle increase (due to the system of levers created in the elbow joint).
Often a tendon injury is not even noticed during the onset (during the performance of the exercise). It’s more likely that you will start developing pain over a couple of days. However, the injury needs to be repaired and approached according to the tips we will list below.
Other common causes include:
- Tense triceps muscle (inelastic);
- Training errors;
- Improper warm-up;
- Muscle weakness;
- Insufficient recovery between exercises/training;
- Incomplete recovery from a previous injury;
How is triceps tendinitis diagnosed?
The diagnosis is made on the basis of the difficulties that the athlete feels and by examining the athlete. Physical examination in most cases indicates the diagnosis of the problem. In unclear cases, an ultrasound examination of the tendon or, in the last resort, magnetic resonance imaging of the elbow is performed. Sometimes, there is a need for an X-ray of the elbow.
How is triceps tendonitis treated?
In case of symptoms and diagnosed inflammation of the triceps tendon, the following is highly advised:
- Avoid movements or activities that could further irritate or damage your triceps tendon.
- Apply ice to the affected area for up to 10 minutes every hour, and then 2-3 times a day, or until symptoms subside. Never put ice directly on the skin to avoid frostbite. Instead, wrap the ice in a towel or cloth and place it on the sore spot. This should help with the pain and swelling.
- Use bandages or wraps to compress and provide support to the area until swelling has gone down.
- Later in the treatment process, after the acute inflammatory process has passed, apply warm compresses to the site of the injury.
Your doctor will probably advise you (if necessary):
- Ultrasound or laser therapy to reduce inflammation and pain.
- Anti-inflammatory drugs like ibuprofen, which will help in case of acute disease.
- A sports massage that will help heal damaged tissue.
If first-line treatments don’t work, your doctor may recommend some additional medications to treat your triceps tendonitis. For example, corticosteroid injections or even platelet-rich plasma (PRP) injection.
Physical therapy: stretches & exercises
Physical therapy may also be an option to help treat your triceps tendonitis. It focuses on using a program of carefully selected exercises to help strengthen and stretch your triceps tendon.
Below are a few examples of simple exercises that you can do. It’s very important to remember to talk with your doctor before doing any of these exercises, as doing certain motions too quickly after injury may worsen your condition.
It is important that performing the exercises does not cause pain, or that there is a worsening of the discomfort after the exercises.
1. Triceps stretch
Bend your left elbow behind the head and with the opposite hand grab the elbow and slowly push down stretching the triceps muscles. Hold in the lower stretched position for 10-15 seconds, then relax. Repeat 3 times and repeat this stretch several times a day.
The goal of strengthening exercises is to gradually increase the load through the tendon to the point where normal training can continue. It is important to be patient and not overdo it or rush to return to training.
If the exercises are painful during, after the performance, or the next day, slow down and rest for a while before you start doing the exercises again.
2. Triceps extension using elastic band
Take the elastic band and stand with your foot in the middle of the band. Stretching the strap behind your back, grasp the end of the strap with each palm. Bring your hands over your head.
Keeping your elbows close to your head and fully directed above your head, begin to bend your elbows until you feel a stretch in your triceps. From this position, extend your arms up again. Be sure to stop at about 90 degrees at the elbows, and then, as the injury heals, slowly reduce the angle at the elbow.
3. Triceps dips
Sit on a bench with your palms resting on the edge of the bench, right next to your body. The legs are outstretched in front of you. Pushing your palms away from the bench slowly lower yourself to the ground by bending your elbows, so that you are as close to the bench as possible.
When you reach the arm position at 90-degrees, slowly rise to the starting position. For greater resistance, lift your feet to another bench or Swiss ball.
Summing up
Distal triceps tendonitis presents as pain at the back of the elbow with extension activities. Throwing, weight lifting and using a hammer can lead to inflammation of the tendon due to overuse. Falling onto an outstretched hand or receiving a direct blow to the distal triceps brachii tendon can lead to a rupture or avulsion from the olecranon attachment site.
Triceps tendonitis is not common. Conservative treatment is recommended; local steroid injection should be avoided. Rupture of the triceps tendon is the least common of all tendon ruptures, but it can occur with an excessive counterforce during active extension of the elbow. This requires immediate surgical repair.
