Everyone has tendons, the mechanical bridges that hold our bodies together and allows us to move with grace or power. With over 4,000 tendons, this fibrous tissue keeps muscles and bones connected to each other. Pain in the biceps and triceps muscles is commonly associated with the tendons that connect these muscles to the elbow and shoulder joints.

Under normal circumstances, tendons will operate to allow muscles to move bones accordingly. Unfortunately, like any other part of the body, tendons can get injured or torn. Particularly, biceps and triceps tendon injuries may occur as a result of a forceful eccentric contraction, such as lowering unexpectedly a bicep curl at the gym or a linebacker coming to a sudden stop to hurl the ball at the line of scrimmage. These rapid movements generate great force and increase tension in tendons and muscles. 

Having a good understanding of the mechanics and potential causes of biceps and triceps tendon injuries can help individuals take appropriate precautions to minimize the risk of tears or ruptures. If such injuries do occur, it is important to seek professional medical advice.

What are Biceps and Triceps?

The biceps and triceps are antagonists and the principal flexors and extensors of the elbow joint. The biceps, the muscles located on the anterior side of the arm, and the triceps, positioned on the posterior side, can work separately or in tandem. While the biceps facilitate flexion, enabling a person to curl an arm, the triceps enable extension movements, allowing you to straighten your arm. Additionally, with these muscles, the forearms can rotate.

Common Bicep and Tricep Injuries

Although the biceps and triceps are powerful muscles, they are not immune to injuries. Overuse, such as repetitive motions or excessive strain, can lead to irritation of the tendons that connect these muscles to the bones, resulting in pain and inflammation. Additionally, forceful injuries, such as lifting heavy objects or improper weightlifting techniques, can cause tearing or even complete rupture of the tendons. It is important to be mindful of proper form and technique during physical activities to minimize the risk of damage to these crucial muscles and tendons.

Some of the most common biceps and triceps injuries include:

• Tendinitis 

Also known as “inflammation of the tendon,” it occurs when a tendon becomes swollen after an injury. It can lead to joint pain, stiffness, and reduced mobility of the affected tendon. Mild tendon injuries may be managed at home with self-care measures, and most individuals experience relief within 2 to 3 weeks. However, it is crucial to seek professional advice for proper diagnosis and treatment.

• Strain

A muscle strain, also referred to as a “pulled muscle,” occurs when a muscle is stretched beyond its normal limits and tears. Accidents, overuse of muscles, or improper use of muscles can cause this painful injury.

• Rupture

It is a complete disconnection of the tendon fibers from the joints, so it can no longer perform its normal function. A torn tendon may be partially disconnected.

Symptoms of a Bicep or Tricep Rupture

The primary cause of biceps or triceps tendon ruptures or tears is typically a forceful eccentric contraction of the muscle, which occurs when the muscle lengthens while under tension. The signs and symptoms of a tendon rupture may vary, but it is often described as a tearing sensation, and people hear an unexpected pop in some cases, usually around the elbow but sometimes on the shoulder. Usually, the patient feels either weakness or pain in the arm, and sometimes there could be a palpable defect or a swelling over the posterior side of the elbow. In other cases, it may be impossible to extend the extremity.

Patients could feel pain for an extended period of time, ranging from weeks to months. In extreme cases, the pain may abate if the tendon is completely torn.

Risk Factors

It is worth noting that such injuries are relatively rare in most traumatic events. Biceps tendon rupture is more common than triceps rupture. According to the National Institutes of Health, the incidence rate of distal biceps tendon rupture is around 2.55 cases out of 100,000 patients per year. For triceps, the rate is even lower, accounting for less than one percent. Almost all patients with these rare injuries are males, usually in their middle age (i.e., 35–54 years).

Some of the most commonly cited risk factors for biceps and triceps tendon ruptures are:

• Biological sex
• Age
• Smoking
• Performance-enhancing drugs such as anabolic steroids

What Are the Available Treatments?

Biceps and triceps tendon ruptures are often clinically diagnosed. Magnetic resonance imaging can provide valuable information for differentiating between a partial tear or rupture so the doctor can properly assess any degeneration of the tendon.

Surgical Repair

Surgical anatomical repair is performed in acute complete or partial tears with significant weakness. After the surgery, the limb is immobilized, and the surgeon assesses the postoperative position and the ensuing therapy program.

Non-operative Treatment 

After the assessment, if the injury amounted to only a partial tear and the arm has movement, the clinician may opt only for immobilization followed by strengthening exercises to recoup full strength and range of motion. 

A professional diagnosis and a well-planned postoperative rehabilitation program are essential for a good outcome.

Do you have an injury that could benefit from a surgical technique? Our expert multistate practice has years of experience dealing with a wide array of injuries, including tendon ruptures. Contact the specialists at Mobility Bone & Joint Institute to learn more about treatment options.