Tendon Injuries around the Elbow
Multiple tendons cross the elbow, extending from the upper arm and inserting on the forearm. These muscles function to bend and straighten the elbow, and control the wrist and fingers. In addition, these muscles provide stability and compression across the elbow joint itself.
What are the most commonly injured tendons around the elbow?
The two most commonly injured tendons around the elbow are the biceps and triceps tendon. The biceps tendon flexes the elbow and rotates the forearm. The triceps attaches to the point of the elbow and acts to straighten the elbow. Both tendons cross the elbow and typically tear off of the bone that they attach to on the forearm.
Who typically sustains a distal biceps tear and how is it treated?
The biceps tendon crosses the elbow and attaches to the radius. This tendon is most commonly injured in middle age men (age 45-60 years of age) lifting a heavy object with the elbow bent. Patients report immediate pain around the front of the elbow, as well as heavy bruising and pain with elbow motion. Some patients report a “popping” sound. This injury is typically diagnosed in the clinic by the physician, but sometimes an MRI is required. Most of these injuries require surgery to reattach the tendon in order to prevent chronic pain with use of the biceps. This surgery is performed as an outpatient surgery and can be done with either a single incision along the front of the elbow, or through two smaller incisions in the front and back of the elbow. Most patients are allowed to start range of motion exercises immediately after surgery; however, weight bearing is limited for 2-3 months following surgery.
Who typically sustains a triceps tear and how is it treated?
Triceps tears may occur in any patient, but are less common than distal biceps injuries. Triceps tears occur when a resisted force bends a straightened elbow, causing the tendon to tear off of the point of the elbow resulting in an inability to straighten the elbow or hold the hand above the head with the arm raised. These injuries require surgery to reestablish the extensor mechanism of the elbow. Surgery is an outpatient procedure where the tendon is reattached to the bone with suture. After triceps repair, the elbow is maintained in an extended (straightened) position for a few weeks after surgery to diminish tension on the repair. Then range of motion is increased and slowly weight bearing activities are resumed.