I have Tricep Tear: Surgery or no?

[BBkingpin]

I have a tricep tear to the long head (not the horse shoe but the longer rear head of tricep. The long head is now about 2 inches shorter than my other arm. I had MRI and doctor says the options are surgery or no surgery.
He said that it's torn muscle instead of torn tendon so it's like sewing together 2 pieces of steak and not assured of fixing it. There's nothing secure to anchor it aside from muscle to muscle. He said I can rehab it and see how much strength returns, maybe 75%, maybe 90% but if I opt for surgery it should be now and not after rehab attempts. It entails 6 weeks in a sling and 3-4 month recovery. Anyone ever in this situation before? I don't know what to do.

 

[617ricky]

How'd you do it?

 

[Showy0023]

If muscle heals to muscle you can't regain 100% use of that muscle again? I thought everything kind of "fused" back together nicely.....bone to bone.....skin to skin....etc.. Been wrong many times before.

 

[BBkingpin]

If muscle heals to muscle you can't regain 100% use of that muscle again? I thought everything kind of "fused" back together nicely.....bone to bone.....skin to skin....etc.. Been wrong many times before.

Don't know bro, the doc is not clearing things up in my mind.

 

[BBkingpin]

How'd you do it?

Boxing training, I think it went from minor to major when I fell on the ice and slammed onto pavement with same arm used to break my fall.

 

[Jude2]

Sewing muscle to muscle not that effective. Try other recovery or healing methods.

 

[dieselbuilder]

I have a tricep tear to the long head (not the horse shoe but the longer rear head of tricep. The long head is now about 2 inches shorter than my other arm. I had MRI and doctor says the options are surgery or no surgery.
He said that it's torn muscle instead of torn tendon so it's like sewing together 2 pieces of steak and not assured of fixing it. There's nothing secure to anchor it aside from muscle to muscle. He said I can rehab it and see how much strength returns, maybe 75%, maybe 90% but if I opt for surgery it should be now and not after rehab attempts. It entails 6 weeks in a sling and 3-4 month recovery. Anyone ever in this situation before? I don't know what to do.

I couldnt find much about it online. However, I noticed that 2 NFL players and a Pro wrestler had torn triceps (not sure whether it was pure muscle or involved the tendon) and they all opted for surgery. I understand that they are not bbers, but if thats the path they are taken, than that means it was probably recommended to them by the top of the top of sports medicine doctors...i'd opt for surgery.

My dad is a doctor, and he said it should heal itself becuase the tendon isnt ruptered.

 

[juggernaught]

over the last five years I have ruptured both the left and right arms tricep tendons. I was out of the gym 15 months for the first one and 7 months for the second one. I got about 90% of my strength back but it has been very hard. Myd Dr. said if mine had been muscle tear it would heal stronger then my repaired tendons would.

 

[muscle96ss]

I'm confused, is it a partial or a full tear? Also, are you sure that it is muscle belly and not tendon as I am not sure how you would tear a muscle belly in half? Can you possibly post a picture of you flexing it? Not positive it will help but may be able to let me see whether it really is tendon or muscle.

 

[617ricky]

Not positive it will help but may be able to let me see whether it really is tendon or muscle.

If a Dr. gave him an MRI, don't you think that's good enough evidence? Probably not the best idea to flex a torn muscle either, lol.

 

[muscle96ss]

If a Dr. gave him an MRI, don't you think that's good enough evidence? Probably not the best idea to flex a torn muscle either, lol.

Are you saying that MRI's are definitive? Are you suggesting that if you went to several doctors they would all say the same thing? Can you explain why a complete tear in the muscle belly would allow part of the muscle to flex and then stop 2 inches from the end(maybe I am just dumb but the physiology doesn't make sense and I see stuff like this on a daily basis)? Lastly, why is it whenever professional baseball pitchers have an elbow injury and the team doctors say the MRI shows MCL damage, they always send the player to Dr. Andrews for another opinion? Aren't the team doctors competent? Can't they just send the MRI to Dr. Andrews so the player doesn't have to go?

 

[BBkingpin]

I couldnt find much about it online. However, I noticed that 2 NFL players and a Pro wrestler had torn triceps (not sure whether it was pure muscle or involved the tendon) and they all opted for surgery. I understand that they are not bbers, but if thats the path they are taken, than that means it was probably recommended to them by the top of the top of sports medicine doctors...i'd opt for surgery.

My dad is a doctor, and he said it should heal itself becuase the tendon isnt ruptered.

Thank you bro!

 

[BBkingpin]

I'm confused, is it a partial or a full tear? Also, are you sure that it is muscle belly and not tendon as I am not sure how you would tear a muscle belly in half? Can you possibly post a picture of you flexing it? Not positive it will help but may be able to let me see whether it really is tendon or muscle.

At first it seemed it was the elbow, that's where the pain was at. No external impact but serious bruising. So, doc took MRI of elbow region. There was no sign of tendon tear that needed surgery.

I insisted that it was obvious to me the difference in size or length of the muscle belly. My right tricep (rear long head) seems to only go down half way compared to my left tricep.

They did 2nd MRI of the tricep (above the elbow region) and he confirmed that the tricep was torn. But again it's not the tendon. He said cosmetically it would remain the same without surgery. I am not as concerned cosmetically. I doubt a surgical scar would offset any cosmetic "improvement" with the shape of my muscle.

I am more concerned with strength. The tricep feels so weak when, for example, I am doing flat bench flies with light weight (30 lbs). The closer I get to the right arm being fully extended above the center line of my torso, the more my elbow wants to give out and let the weight come crashing down. I am wondering if that is only due to atrophy. They initially tried to tell me the disparity between left and right tricep could be due to atrophy but my muscles don't atrophy that much that fast after a couple months. I've been training for 21 years. (Man I am getting old.)

As far as partial or full tear, I'm not sure what that means. Doc told me it's only one-third of tricep affected and I asked him "lower or outer" and he said outer. But then he said you have three heads, which I know, but it still confuses me too, because the visible and portion I can feel where my tricep is no longer there (seems to be no longer there) is the lower portion, not outer.

I am at one of the best hospitals for sports medicine in the region but I suspect not one of their top docs. He is younger and was easier to get an appointment with. Now my instincts are telling me to get in to see one of their "jedi masters" because I am not getting the answers I need to make an informed decision.

This medical group of sports physicians care for Chicago White Sox, Chicago Bulls, and one of their surgeons did a phenomenal job replacing my left hip. (I was only 35, 2 years ago). Minimally invasive. You'd never know I had new hip but for a 3 inch incision that has faded and is blending back with surrounding skin (they used glue, not stitches or staples).

The doc I am talking to now has good educational credentials but I suspect I have to go see one of the more experienced surgeons to get a good grasp of what's actually going on under the skin and what I can expect with and without surgery.

The only way for me to take a good picture is with my digital Nikon which is giving me problems. If I tried with camera phone it would be a blur. I wish I could.

 

[muscle96ss]

At first it seemed it was the elbow, that's where the pain was at. No external impact but serious bruising. So, doc took MRI of elbow region. There was no sign of tendon tear that needed surgery.

I insisted that it was obvious to me the difference in size or length of the muscle belly. My right tricep (rear long head) seems to only go down half way compared to my left tricep.

They did 2nd MRI of the tricep (above the elbow region) and he confirmed that the tricep was torn. But again it's not the tendon. He said cosmetically it would remain the same without surgery. I am not as concerned cosmetically. I doubt a surgical scar would offset any cosmetic "improvement" with the shape of my muscle.

I am more concerned with strength. The tricep feels so weak when, for example, I am doing flat bench flies with light weight (30 lbs). The closer I get to the right arm being fully extended above the center line of my torso, the more my elbow wants to give out and let the weight come crashing down. I am wondering if that is only due to atrophy. They initially tried to tell me the disparity between left and right tricep could be due to atrophy but my muscles don't atrophy that much that fast after a couple months. I've been training for 21 years. (Man I am getting old.)

As far as partial or full tear, I'm not sure what that means. Doc told me it's only one-third of tricep affected and I asked him "lower or outer" and he said outer. But then he said you have three heads, which I know, but it still confuses me too, because the visible and portion I can feel where my tricep is no longer there (seems to be no longer there) is the lower portion, not outer.

I am at one of the best hospitals for sports medicine in the region but I suspect not one of their top docs. He is younger and was easier to get an appointment with. Now my instincts are telling me to get in to see one of their "jedi masters" because I am not getting the answers I need to make an informed decision.

This medical group of sports physicians care for Chicago White Sox, Chicago Bulls, and one of their surgeons did a phenomenal job replacing my left hip. (I was only 35, 2 years ago). Minimally invasive. You'd never know I had new hip but for a 3 inch incision that has faded and is blending back with surrounding skin (they used glue, not stitches or staples).

The doc I am talking to now has good educational credentials but I suspect I have to go see one of the more experienced surgeons to get a good grasp of what's actually going on under the skin and what I can expect with and without surgery.

The only way for me to take a good picture is with my digital Nikon which is giving me problems. If I tried with camera phone it would be a blur. I wish I could.

First let me clarify what I mean between a partial tear and a full tear. With a full tear the muscle belly would be completely torn in half. With a partial tear you would either have part of the muscle belly cut compeltely in half or only part of the thickness of the muscle belly torn; so there are really 3 possible scenarios. Based on what you are saying we can probably rule out a complete full thickness tear as you would not be able to elicit any contraction of that head whatsoever. From everything that you have said it sounds as if it is a partial thickness tear with the superficial layers being torn away. However, here is the reason why I was requesting a picture. The part of the muscle that has torn away is going to retract. If the belly of the muscle tore then it would retract towards the elbow and you would have a slight lump/balling of tissue close to the elbow. If instead it broke away from the tendonious attatchment then you would have that lump/balling occur in the muscle so it would actually look a little bigger and disfigured in the middle of the muscle. In either of those 2 scenarios it would be a very difficult surgery with a very low chance of success, and thats if the surgery is performed within a couple weeks of injury. I am guessing from what you are saying that this happened a couple months ago which makes it almost impossible at this point to correct if this is the actual problem. My advice would be to pursue things further with one of the top surgeons in the group to get an second opinion so you can get a better idea of what actually has transpired and what options if any you have at this point. Lastly, your timeline of what would happen if you did have a surgical repair of a normal triceps tear is correct; however this does not sound like a normal situation so things obviously could vary. Also, just so you know where I am coming from, I am a physical therapist as well as I had a surgery this past August where they had to actually create a tear in my triceps tendon to remove a huge bone spur that had broken off while benching and was tangled up in the tendon after breaking off.

 

[Deadin]

A guy on BB.com called Layne Norton had a tear like that, in the actual muscle. He went for surgery.

 

[juggernaught]

First let me clarify what I mean between a partial tear and a full tear. With a full tear the muscle belly would be completely torn in half. With a partial tear you would either have part of the muscle belly cut compeltely in half or only part of the thickness of the muscle belly torn; so there are really 3 possible scenarios. Based on what you are saying we can probably rule out a complete full thickness tear as you would not be able to elicit any contraction of that head whatsoever. From everything that you have said it sounds as if it is a partial thickness tear with the superficial layers being torn away. However, here is the reason why I was requesting a picture. The part of the muscle that has torn away is going to retract. If the belly of the muscle tore then it would retract towards the elbow and you would have a slight lump/balling of tissue close to the elbow. If instead it broke away from the tendonious attatchment then you would have that lump/balling occur in the muscle so it would actually look a little bigger and disfigured in the middle of the muscle. In either of those 2 scenarios it would be a very difficult surgery with a very low chance of success, and thats if the surgery is performed within a couple weeks of injury. I am guessing from what you are saying that this happened a couple months ago which makes it almost impossible at this point to correct if this is the actual problem. My advice would be to pursue things further with one of the top surgeons in the group to get an second opinion so you can get a better idea of what actually has transpired and what options if any you have at this point. Lastly, your timeline of what would happen if you did have a surgical repair of a normal triceps tear is correct; however this does not sound like a normal situation so things obviously could vary. Also, just so you know where I am coming from, I am a physical therapist as well as I had a surgery this past August where they had to actually create a tear in my triceps tendon to remove a huge bone spur that had broken off while benching and was tangled up in the tendon after breaking off.

Interesting! Whats the likelyhood of forming another?
BBkingpin can you feel any hollow spots in your arm where there is an absence of muscle?When my injuries occured I could feel my bone right beneath my skin in my elbow joint.

 

[BBkingpin]

First let me clarify what I mean between a partial tear and a full tear. With a full tear the muscle belly would be completely torn in half. With a partial tear you would either have part of the muscle belly cut compeltely in half or only part of the thickness of the muscle belly torn; so there are really 3 possible scenarios. Based on what you are saying we can probably rule out a complete full thickness tear as you would not be able to elicit any contraction of that head whatsoever. From everything that you have said it sounds as if it is a partial thickness tear with the superficial layers being torn away. However, here is the reason why I was requesting a picture. The part of the muscle that has torn away is going to retract. If the belly of the muscle tore then it would retract towards the elbow and you would have a slight lump/balling of tissue close to the elbow. If instead it broke away from the tendonious attatchment then you would have that lump/balling occur in the muscle so it would actually look a little bigger and disfigured in the middle of the muscle. In either of those 2 scenarios it would be a very difficult surgery with a very low chance of success, and thats if the surgery is performed within a couple weeks of injury. I am guessing from what you are saying that this happened a couple months ago which makes it almost impossible at this point to correct if this is the actual problem. My advice would be to pursue things further with one of the top surgeons in the group to get an second opinion so you can get a better idea of what actually has transpired and what options if any you have at this point. Lastly, your timeline of what would happen if you did have a surgical repair of a normal triceps tear is correct; however this does not sound like a normal situation so things obviously could vary. Also, just so you know where I am coming from, I am a physical therapist as well as I had a surgery this past August where they had to actually create a tear in my triceps tendon to remove a huge bone spur that had broken off while benching and was tangled up in the tendon after breaking off.

I have appt with top surgeon Apr 15th. He has amazing cv. If I get camera fixed I'll post pic. But it retracted up or toward the shoulder.
BTW, your answer sounds like a surgeon or doctor and has given me much more clarity and certainty.
Let me ask you this: I think you're right that surgery would most likely not be beneficial. How much strength will I regain? Is the weakness now attributable mostly to the injury or atrophy, or both?

 

[BBkingpin]

Interesting! Whats the likelyhood of forming another?
BBkingpin can you feel any hollow spots in your arm where there is an absence of muscle?When my injuries occured I could feel my bone right beneath my skin in my elbow joint.

Now that you mention it, hollow spots, yes. If I lift arms over head, straight up, and then bend elbow, looking in mirror you can see the elbow looks "bony" compared to the other. And it feels like I am missing muscle where it used to be (on bad arm) and where it still is in the other (good arm). Picture the lateral head on good arm rounding out at the elbow but the lateral head on bad arm curving in (less gradual rounding out but more abrupt curve higher up, at least 2 inches higher and, as a result, looking more bulbous in shape) (instead of long and more gradual curve lower at the elbow). And yes it does feel harder in there, like bone. This sucks. Will I lose function? Aside from regaining strength, it there something worse, like actual loss of function? Like a tendon?

I guess I'll know more on Apr 15th after appt with surgeon. I'll let you guys know in case you're still interested.

Thanks so much, bros!!

 

[Bigbubz]

I had a buddy that partially tore a pec. The doctor told him there really wasn't a good surgery for it and to rehab it. He said the hollow spot should fill back in with muscle over time.

 

[muscle96ss]

I have appt with top surgeon Apr 15th. He has amazing cv. If I get camera fixed I'll post pic. But it retracted up or toward the shoulder.
BTW, your answer sounds like a surgeon or doctor and has given me much more clarity and certainty.
Let me ask you this: I think you're right that surgery would most likely not be beneficial. How much strength will I regain? Is the weakness now attributable mostly to the injury or atrophy, or both?

Obviously some of your weakness is due to not lifting for the last couple of months; but most of it is due to the actual injury. When you use the muscle for lifting your brain sends a signal to different parts of the muscle telling them to contract in a specific pattern. Now that part of the muscle is not connected, the brains signal to the torn muscle fibers is no longer able to cause a contraction. Not sure if that makes any sense, but the bottom line is that the amount of strength lost is going to be dependent on how much of the actual muscle is disconnected. You will be able to improve your strength but it is going to take time and how strong you are able to get it is really going to depend on how much muscle you have left. Even if you had a minor tear that was surgically repairable you would still lose a fair amount of strength and it would take a long, long time to get back to the size and strength it was before the tear. In terms of function, it should not have any effect on a normal persons ability to function. Obviously if you plan on stepping on stage or doing serious lifting it will have an impact, but in terms of living a normal life it should have no effect.