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Although a triceps tendon rupture is an uncommon injury, the Baltimore Ravens’ Ray Lewis and, more recently, the Cleveland Browns’ Joe Thomas have suffered such tears.
The triceps tendon, in the back of the upper arm, serves to straighten the elbow, attaching the triceps muscle to the bony tip of the elbow, which is called the olecranon. An injury to the triceps tendon is almost always traumatic, and the mechanism usually involves a force that suddenly bends the elbow while the muscle is trying to straighten it. Often the athlete will describe feeling or hearing a pop in the elbow. It can occur in weightlifting or in contact sports such as football.
There is typically swelling and often bruising at the back of the elbow and upper arm almost immediately. Usually, a defect can be felt just above the olecranon where the tendon inserts. The athlete will usually have weakness trying to straighten the elbow against resistance. The diagnosis is confirmed by an MRI.
Unfortunately, once the tendon tears away from the bone, no conservative treatment will get it to magically reattach ― surgery is required. The procedure involves an incision over the back of the elbow to expose the ruptured tendon and repair it to the bone, placing stitches in the tendon and anchoring them to the tip of the elbow either with suture anchors or through tunnels drilled in the bone. The operation is relatively easy; the hard part is the recovery.
The athlete is placed in a splint, with the arm extended for about a week and then switched to a hinged-elbow brace, which allows elbow motion. By six weeks, the athlete has typically regained full range of motion. Then strengthening begins. It is typically about a six-month recovery before the athlete can return to full, unrestricted activity.
While the injury ended Thomas’s consecutive snap streak, the good news for him and the Browns is that he should be able to return to his previous level of play next season.