The triceps brachii is a major muscle of the upper arm in our body. The triceps run along the humerus (the main bone of the upper arm) between the shoulder and the elbow. Along with the biceps, it enables an extension and retraction of the forearm. When the triceps are contracted, the forearm extends and the elbow straightens; if the triceps are relaxed and the biceps flexed, the forearm retracts and the elbow bends. The triceps also serve to stabilize the shoulder joint at the top of the humerus. The shoulder has the greatest range of motion out of the rest joints in the human body, possessing the ability to turn and rotate in many directions.
Many people in life experience pain located at the back of their upper arms that could have resulted from a triceps strain. A triceps strain is a damage to the triceps brachii and is typically a result of the tearing of muscles anywhere in the triceps. The most common location of the tear is along the area where the triceps muscles and the tendon meet, either in the elbow joint or the shoulder joint. Usually, the management for a triceps strain is similar to the treatments of any type of muscle strain. However, the level of treatment is typically based on the grade of the triceps strain; triceps strains can be classified into three grades, as described below:
- Grade 1 triceps strain – Grade 1 triceps strain is the mildest form of a triceps injury, which only involves the over-stretching of the muscle. There can be inflammation and pain although only minimal and does not result in any loss of function or strength.
- Grade 2 triceps strain – A grade 2 triceps strain may involve some forms of tearing in the muscle fibers in the triceps brachii. The tear can be located on the junction of the muscle and tendon, which then produces some weakness on the affected arm.
- Grade 3 triceps strain – The most severe grade of a triceps strain involves the separation of the muscle fibers that can lead to a complete rupture of the triceps brachii. With a grade 3 injury, the rupture may result in the complete disconnection of the muscle and tendon from attaching to the bone leading to complete loss of function of the affected arm.
Causes & Symptoms of Triceps Strain
A triceps strain normally occurs due to a sudden, forceful contraction of the triceps muscle. This typically happens during heavy pushing or straightening of the elbow against resistance (such as performing push-ups or bench presses). At a local gym, the use of heavy weights, quick movements, and negatives may all increase the likelihood of a triceps strain. This condition may also occur in sports involving throwing (basketball or baseball) or sport involving heavy falls or blocking (football or lacrosse).
Occasionally, a triceps strain may develop gradually over time due to repetitive or prolonged activities placing stress on the triceps muscle. This can result in microscopic tearing, degeneration, and weakening of the triceps predisposing the muscle to further injury. Triceps strain may occur more commonly in older athletes, especially avoiding warm-ups before a sports match.
Patients with strained triceps typically experience sudden pain or pulling / tearing sensation in the back of the upper arm at the time of injury. In less severe cases, symptoms may be minimal, and patients may be able to continue with their activities only to experience an unexpected increase in pain, ache, and stiffness after resting (Usually during night sleep or waking the following morning). In some patients with more severe injuries, the pain may be disabling, preventing further activity. The pain associated with this condition is often experienced as an ache that increases to a sharper pain with activities involving prolonged, repetitive, or forceful contraction of the triceps muscle. These activities may include pushing activities or activities involving straightening of the elbow against resistance.
Generally, symptoms are typically located in the back of the upper arm (also known as the triceps region); in addition, pain may radiate into the shoulder, elbow, or forearm. Triceps muscle tightness, spasm, and tenderness on firmly touching the injured area are often present during the situation of a triceps strain. Bruising, swelling, and weakness may also be experienced. In some cases, patients with a minor triceps strain may experience little to no symptoms, therefore, minor discomfort or tightness may be the only complaint. In severe or chronic cases, muscle wasting and a noticeable deformity in the muscle may be detected corresponding to the location of the tear.
Who Gets Triceps Strain?
Anyone can tear their triceps, whether from sports or activities that involve heavy lifting, however, men are more prone to tearing their triceps muscle than women. But most people who injure the triceps muscle usually do not have any risk factors. Additionally, having a chronic illness increases your risk of injury. Elders who take the antibiotic ciprofloxacin are also at a higher risk for tendon ruptures.
Other risk factors for triceps strain injuries include:
- Chronic diseases, such as kidney disease and diabetes
- Rheumatoid arthritis
- Elbow arthritis
- Anabolic steroid consumption
- Steroid injections in the elbow
How Does It Affect You? How Serious Is It?
Complete ruptures of the triceps tendon typically 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 the bone. The surgery repair involves 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. As with most tendon repairs, the surgeon then has to get the tendon to heal in that position. If this injury is missed or neglected, the athlete will have a significant weakness with elbow extension and may not be able to maintain a block in certain sports like football or rugby, lift weights, or perform push-ups.
Recommended Treatment, Rehabilitation & Supporting Equipment
To diagnose triceps strain, your doctor will first perform a physical examination. During this examination, your doctor may press on the area where the tendons attach to the elbow or triceps to see if they can feel any hardness or swelling. Your doctor may also ask you to move your arm or elbow to assess your range of motion. You may also be asked to perform simple shoulder or elbow exercises that will help your doctor figure out how strong your triceps, shoulder, and elbow are. Afterward, your doctor will ask you a few additional questions about your symptoms, such as when the symptoms began, if they are worsening, is the pain accompanied by swelling or snapping, if your symptoms have been getting in the way during any activities, or if you have tried any self-care, or home treatments. If your doctor finds that you have the symptoms of triceps strain, they may perform an X-ray, ultrasound, or MRI to confirm the diagnosis.
Following the acute stage of triceps strain, and with the approval of your doctor or physiotherapist, you should begin a graduate program of exercises designed to stretch and strengthen the triceps muscle. Other physiotherapy includes ultrasound, massage, and the application of ice and heat. You may be advised to wear a strap over the lower part of the triceps if you have to do particular activities that aggravate your symptoms. In some cases of triceps strain, conservative treatment fails to resolve the problems linked to this condition. A corticosteroid injection can be used into the affected tendon and further diagnostic tests can be performed. Surgical repair or reconstruction of the tendon is only performed for complete ruptures of the tendon.
As for exercises to help reduce symptoms of triceps strain, here are some exercise examples to restore full movement in your elbow. These methods include:
Triceps stretch
While standing, raise your bent elbow so that your palm gradually slides down your back as far as it can without causing any pain. You can use your other hand to gently assist the stretch. Finally, hold this position for 15 seconds before repeating 5 times a day.
French stretch
While standing, with your hands clasped together, raise your arms above your head. Keep your elbows close to your ears as you reach back with your arms, as though trying to touch your upper back. Hold for 15 seconds, then repeat 5 times a day.
Triceps contraction
Begin by standing with your bent elbow at your side and your palm facing inwards, make a fist with that hand. Next, place your other hand under the fist. By tightening the triceps muscle, push your fist down onto your other hand. Lastly, hold this position for 5 seconds, then repeat 10 times a day.
Triceps lift
Supporting yourself with one hand on a table, lean forward and hold a small weight in the hand of the affected arm. Bend the elbow to a 90-degree angle and draw the upper arm back and up until it is parallel with the floor. Keeping the upper arm still, raise the forearm until the entire arm is straight. Repeat this exercise 10 times a day.
Alternative & Homeopathic Treatment
There are a wide variety of homeopathic treatments anyone can try to help reduce symptoms due to a mild triceps strain, including the following:
Ice application
When you strain a muscle, the fibers in the tissue are damaged. This may cause immediate pain, inflammation in the muscle tissue, and swelling in the affected area. You can help combat these symptoms by applying cold to the injury, ideally as quickly as possible after it occurs. Continue applying cold several times a day for 20-30 minutes at a time. In most cases, an ice pack is a most readily available solution immediately after an injury. However, using a cold therapy system for the duration of your recovery may help with your recovery process because a cold therapy system applies continuous, uniform cold to help treat both pain and inflammation.
Compression
Another way to help treat muscle strains is by applying pressure to the affected area. Compression helps reduce swelling and inflammation, which may intensify pain and slow healing. You can use static compression with an elastic bandage to apply consistent pressure and help prevent additional swelling. Active compression that creates a pumping action may provide additional benefits by helping your body remove excess fluid in the injured area and increasing the flow of freshly oxygenated blood, which is needed for tissue repair and healing.
Massage
Therapeutic massage helps loosen tight muscles and increase blood flow to help heal damaged tissues. Applying pressure to the injured muscle tissue also helps remove excess fluid and cellular waste products. Some studies have shown that massage immediately following an injury may even speed strained muscle healing.
Heat application
Heat therapy may help relieve pain after the initial swelling has subsided. You can apply heat with electric heating pads, warm baths, and hot cloths. Heat also increases blood flow, which may promote healing. You can alternate hot and cold therapy to help reduce the pain and swelling caused by a triceps strain.
Pain relievers
Triceps strain can be painful, and if you have injured your triceps tendon, it may impact your ability to perform certain daily activities. Fortunately, you can relieve pain with over-the-counter medications such as aspirin or NSAIDs, which may also help reduce swelling.