Anyone have this injury?

[Lee_48157]

This is my MRI report from the radiologist I got this week. Anyone else ever have this Injury? Happened to me back in March doing DB incline presses. Arm just gave out, and it sounded like velcro. Took this damn long to get me In for an MRI, but here we are. Just curious if anyone else has had this happen & if they had to get surgery? I am scheduled to see the orthopedic doctor for follow up.

Since this I’ve still been doing a lot of front raises, lateral raises and chest flys since I can’t press. Legs train as normal, but back is kinda tricky because after a certain load it puts a strain on my arm pulling so I just do what I can.

Using this time to clean up & drop some BF. Brought my gear down to 250 test / 200 mg primo WK & 5IU GH ED. Down about 16 lbs (247 now ) since mid March feeling a lot healthier TBH.

Findings:

No abnormal marrow edema is appreciated.

There is no evidence of fracture, healing fracture, or AVN.

There is a partial-thickness tear of the posterior component of the distal triceps tendon. This represents a partial-thickness tear of the combined tendon involving the lateral long heads. The more anterior medial head is uninvolved.Surrounding soft tissue edema is appreciated. Follow-up with orthopedics is advised.

The biceps is intact. The brachialis tendon is intact. The common flexor tendon is intact.

Mixed signal in the common extensor tendon is appreciated. This represents severe tendinopathy with some intrasubstance tearing. The collateral ligaments appear intact..

Impression:

* Partial tear of the posterior compartment of the distal triceps tendon is confirmed.

Surrounding edema is noted.

* Common extensor tendinopathy with intrasubstance tearing. Follow-up with orthopedics is advised

 

[JDLift]

Have you tried using any variant of the Slingshot type band products? Or considered just getting a Bench Shirt? These things were initially made with the sole purpose of keeping the shoulders of lifters healthy, and while modern usage sees them as overload tools or competitive powerlifting implements they still do a great job of the actual original purpose they had. Plenty of times I've had to turn a raw session on bench into a semi-equipped one with slingshot type tools or boards so I could work in the same weights but to a range that isn't making something worse, then next session just go back at it raw and continue as normal or whenever it all feels better again. Pro tip: It all increases your raw strength and builds muscle the same way, probably builds even more considering the pec, shoulder, tricep and forearm mass on the top level equipped lifter guys.


"There is a partial-thickness tear of the posterior component of the distal triceps tendon. This represents a partial-thickness tear of the combined tendon involving the lateral long heads. The more anterior medial head is uninvolved.Surrounding soft tissue edema is appreciated. Follow-up with orthopedics is advised."

So at a glance we'd just write this off as a triceps tear, while it isn't the muscle I'd just treat it the same manner and avoid all movements that strain it. Tbh I'd say if you intend to lift weights in any capacity long term or for your foreseeable future you should STOP LIFTING ALTOGETHER with that arm. The spot you tore is going to be either a primary, secondary, or uhhh antagonizing/stabilizing? mover in basically everything that involves your arm. If you continue to try working through it as you are then it's not going to heal any faster and you likely will further damage it and reach the point of surgery being 100% necessary. I'm not a doctor, but.

"The biceps is intact. The brachialis tendon is intact. The common flexor tendon is intact."

All good on the anterior chain basically. The biceps brings the arm into flexion (wrist toward shoulder), the triceps brings the arm into extension (Wrist away from shoulder). This just says you didn't fuck up anything else basically. Good job!

"Mixed signal in the common extensor tendon is appreciated. This represents severe tendinopathy with some intrasubstance tearing. The collateral ligaments appear intact.."

In layman terms you've got a pretty rough tear in the tendon. Not exactly FUBAR yet but you really should follow the previous advice and stop using the arm, and that includes doing shit like attempting to strap or tether weights to your arm to do makeshift versions of pulling movements because the triceps activates in a way every time your lat is working.

"Follow-up with orthopedics is advised"

This part gets me. What were the doctor's thoughts after reading your MRI findings to you? Because this signals to me that they think you're going to need surgery to reattach the thing already. If they thought it was fixable through PT they would refer you to PCP and PT, but they suggest Ortho which highly suggests they're seeing the surgical route as absolutely necessary.

If I was coaching you I would take all your upper body days either completely out or insist you train only the healthy arm. Studies have proven that training the healthy side in these cases can get the body to promote quicker healing of the injured side, so I would recommend you doing strictly single arm isolations and keep the fucked up arm in a sling or have someone run ace bandages around from armpit to elbow and force it to stay straightened, whichever is more comfortable. Increase your cardio, add more leg days, blah blah or just lay on your ass because it doesn't take 1-2 months to ruin what you built over years of time.

Beyond this, a personal suggestion on things going forward since you are never going to have the same strength in that tendon as you did pre-tear is to invest in either a slingshot type product or a full on Bench Shirt for your pressing. These were both designed as aid devices to protect the lifter's shoulders and while they certainly can be used to overload and move retarded weights that is not their immediate function. I've had plenty of days where I warm up and realize shit is not feeling good, throw on a slinger and use my same weights/sets/rep scheme and call it a day. Still get the work done, still get the pump, much better than just scrapping the session. Also recommend looking at pin press and board press variations on your pressing movements post-recovery as you may find the arm is okay to a certain point then it hurts to go lower, well these alternatives will help you work just in the comfortable and safe range so you still induce growth and build the body back up. All of these are also quite fun, too.

 

[Lee_48157]

Hey man I really appreciate you taking the time to respond to this. Definitely made some good points, and brought up some interesting things that haven’t crossed my mind.

I have never used the sling shot, I actually just seen a good buddy in the gym using one last week. Perhaps I might ask him to give it a try when I can actually do any kind of pressing again sounds promising. As for the peg lifts that had not crossed my mind, but the floor presses were definitely going to be in rotation once I able to. Learned that from watching some of the mountain dog videos a long time ago.

I am going to take your suggestion to not use that arm and only train my good side. I have seen that study that says training the non injured side led to better muscle retention than not training at all even on the non trained side.

I have an appointment Wednesday with the surgeon, but like you said if they didn’t think I’d need surgery then why aren’t they just sending me to PT.

TBH though my strength in that arm hasn’t improved not even 5% & it’s been over a month so I’m not sure if PT would help or not. I’ve been doing little PT movements myself on a daily basis just to keep some mobility. However im definitely afraid of what might happen if I let them re attach it by surgery. I always fear the worst on stuff like this & often just deal with the pain like I did with my meniscus tear 6 years ago. They wanted to do surgery but I just did PT exercises myself and after a long time I am back to normal with that leg being even stronger for some odd reason now.

That is why I came on here asking for advice & if anyone has had this injury, the surgery or didn’t get surgery. I like to hear from people who do what we do not joe schmo who lives a sedentary lifestyle.

Thank your again for your insight on the lifting aids and training movements to invest in for my future lifting.

Have you tried using any variant of the Slingshot type band products? Or considered just getting a Bench Shirt? These things were initially made with the sole purpose of keeping the shoulders of lifters healthy, and while modern usage sees them as overload tools or competitive powerlifting implements they still do a great job of the actual original purpose they had. Plenty of times I've had to turn a raw session on bench into a semi-equipped one with slingshot type tools or boards so I could work in the same weights but to a range that isn't making something worse, then next session just go back at it raw and continue as normal or whenever it all feels better again. Pro tip: It all increases your raw strength and builds muscle the same way, probably builds even more considering the pec, shoulder, tricep and forearm mass on the top level equipped lifter guys.


"There is a partial-thickness tear of the posterior component of the distal triceps tendon. This represents a partial-thickness tear of the combined tendon involving the lateral long heads. The more anterior medial head is uninvolved.Surrounding soft tissue edema is appreciated. Follow-up with orthopedics is advised."

So at a glance we'd just write this off as a triceps tear, while it isn't the muscle I'd just treat it the same manner and avoid all movements that strain it. Tbh I'd say if you intend to lift weights in any capacity long term or for your foreseeable future you should STOP LIFTING ALTOGETHER with that arm. The spot you tore is going to be either a primary, secondary, or uhhh antagonizing/stabilizing? mover in basically everything that involves your arm. If you continue to try working through it as you are then it's not going to heal any faster and you likely will further damage it and reach the point of surgery being 100% necessary. I'm not a doctor, but.

"The biceps is intact. The brachialis tendon is intact. The common flexor tendon is intact."

All good on the anterior chain basically. The biceps brings the arm into flexion (wrist toward shoulder), the triceps brings the arm into extension (Wrist away from shoulder). This just says you didn't fuck up anything else basically. Good job!

"Mixed signal in the common extensor tendon is appreciated. This represents severe tendinopathy with some intrasubstance tearing. The collateral ligaments appear intact.."

In layman terms you've got a pretty rough tear in the tendon. Not exactly FUBAR yet but you really should follow the previous advice and stop using the arm, and that includes doing shit like attempting to strap or tether weights to your arm to do makeshift versions of pulling movements because the triceps activates in a way every time your lat is working.

"Follow-up with orthopedics is advised"

This part gets me. What were the doctor's thoughts after reading your MRI findings to you? Because this signals to me that they think you're going to need surgery to reattach the thing already. If they thought it was fixable through PT they would refer you to PCP and PT, but they suggest Ortho which highly suggests they're seeing the surgical route as absolutely necessary.

If I was coaching you I would take all your upper body days either completely out or insist you train only the healthy arm. Studies have proven that training the healthy side in these cases can get the body to promote quicker healing of the injured side, so I would recommend you doing strictly single arm isolations and keep the fucked up arm in a sling or have someone run ace bandages around from armpit to elbow and force it to stay straightened, whichever is more comfortable. Increase your cardio, add more leg days, blah blah or just lay on your ass because it doesn't take 1-2 months to ruin what you built over years of time.

Beyond this, a personal suggestion on things going forward since you are never going to have the same strength in that tendon as you did pre-tear is to invest in either a slingshot type product or a full on Bench Shirt for your pressing. These were both designed as aid devices to protect the lifter's shoulders and while they certainly can be used to overload and move retarded weights that is not their immediate function. I've had plenty of days where I warm up and realize shit is not feeling good, throw on a slinger and use my same weights/sets/rep scheme and call it a day. Still get the work done, still get the pump, much better than just scrapping the session. Also recommend looking at pin press and board press variations on your pressing movements post-recovery as you may find the arm is okay to a certain point then it hurts to go lower, well these alternatives will help you work just in the comfortable and safe range so you still induce growth and build the body back up. All of these are also quite fun, too.

 

[JDLift]

Yep, no problem. I'm still working back up after breaking my forearm and it took a loooooooong time now and not lifting with that arm or doing main (fun) lifts sucked ass but if I did it any differently I don't think I'd be where I'm at right now and might have just fucked it up even more. Patience is your best friend in these times!

 

[Lee_48157]

If anyone cares I’m just reporting back after my tricep tendon surgery. 2 weeks today I had the surgery & my ROM is about 10-100 degrees ( can’t fully straighten it yet and can’t bring it much past 90) Here’s how they did it and the full report of my procedure. SORRY ITS LONG.

General

Operative Technique: Patient was seen in the preoperative holding suite informed consent reviewed. Patient was then taken from the preoperative holding area to the operative suite and transferred from the gurney to the table. All bony prominences were padded. General anesthesia was administered. Patient was then transferred from supine the lateral position with the affected upper extremity draped over an arm holder. Preoperative antibiotics were administered. Sterile standard prep and drape were then performed. Operative time-out was performed identifying patient and correct left upper extremity. Esmarch used to exsanguinate the arm and the Tourniquet inflated 250 mm Hg. An 8 cm curvilinear incision coursing lateral to the tip of the olecranon was performed with a 10 blade. Retractors were placed. Triceps tendon was completely avulsed, all 3 heads, from the olecranon process with retraction. We utilized a Cobb elevator to develop planes both superficial and deep to all 3 heads and allow for better excursion of the tendon. The tendon ends were freshened with a 15 blade as well as rongeur. Allis clamp was placed on the tendon heads and adequate excursion confirmed. We then began preparation for a triceps repair. We used a rongeur to debride the stump and freshen the bone for adequate healing surface on the olecranon process. Following this, we then placed 2 475 double loaded SwiveLock Arthrex anchors with preloaded tape as well with excellent purchase in the olecranon process and no penetration of the intra-articular area. These FiberWire sutures were then passed sequentially in a horizontal mattress fashion in both the medial head as well as the long and lateral heads of the tendon. The fiber tapes were also passed in horizontal mattress fashion just proximal to previous past fiber wires. The arm was brought into near full extension for repair. We then sequentially tied all 4 knots for the horizontal mattress repair with the FiberWire sutures noting excellent compression at the anatomic insertion site of the triceps on the olecranon process. We cut 2 of these sets of sutures and left the other 2 for our speed bridge construct. We then drilled and tapped 2 more pilot holes for lateral row of our speed bridge construct. We then incorporated our FiberTape as well as the remaining 4 strands of suture in a speed bridge construct, noting excellent tension and compression of the repair at its anatomic insertion site and dunked these into 2 475 swivel lock anchors and our lateral row along the ulnar shaft, approximately 3 to 4 cm distal to the initial set of anchors placed. Our construct was then complete. We had excellent restoration of the triceps insertion site and excellent compression with our speed bridge construct. Flexed and extended the elbow from 0-100 with no undue tension and no undue stress on the repair. Content with our construct, we then turned our attention to closure. Copious irrigation was then carried out. Deep fascia was closed with 2 O Vicryl as well as deep dermal layer closed with 2 O Vicryl. This was followed by Monocryl for 0 subcuticular layer runner. Dermabond and Steri-Strips were then placed. Soft dressing and Ace bandage were then placed as well. Patient is then placed in a sling. All sponge and needle counts were correct at the end the procedure. Patient 1 or go passive range of motion from 0-110 as tolerated. We will begin physical therapy after his 1st postoperative visit.

The physician's assistant was 1st assistant during this case, was present for the entirety of the case and assisted with all critical portions of the case. Prior to the procedure he was involved with room setup, patient positioning, prepping and draping. Intraoperatively he assisted with retraction and manipulation of the extremity, tendon reduction, reaming, anchor placement. Post-procedure he assisted with subcutaneous wound closure. He directly performed skin closure and dressing application. He also was involved with transferring the patient from the OR bed to the hospital bed.

Complications: None

Additions (Drains, Specimens, Implants):
Implants:
Implant Name
Type
Inv. Item
Serial No.
Manufacturer
Lot No.
LRB
No. Used
Action
ANCHOR SUT 4.75MM 2 SWIVELOCK TIGERWIRE ARTHX 2 LD 2 TIP EA=BILL-ONLY - LOG4823077
Anchor
ANCHOR SUT 4.75MM 2 SWIVELOCK TIGERWIRE ARTHX 2 LD 2 TIP EA=BILL-ONLY

Arthrex
14921228
Left
1
Implanted
ANCHOR SUT 4.75MM 2 SWIVELOCK TIGERWIRE ARTHX 2 LD 2 TIP EA=BILL-ONLY - LOG4823077
Anchor
ANCHOR SUT 4.75MM 2 SWIVELOCK TIGERWIRE ARTHX 2 LD 2 TIP EA=BILL-ONLY

Arthrex
14962105
Left
3
Implanted


Estimated Blood Loss: * No values recorded between 5/6/2024 12:03 PM and 5/6/2024 1:03 PM *

Total IV Fluids:
Intravenous fluids were administered See Anesthesia Record

Tourniquet Time: See OR Record

Condition: good


Findings: As dictated

 

[zebradelt]

If anyone cares I’m just reporting back after my tricep tendon surgery. 2 weeks today I had the surgery & my ROM is about 10-100 degrees ( can’t fully straighten it yet and can’t bring it much past 90) Here’s how they did it and the full report of my procedure. SORRY ITS LONG.

General

Operative Technique: Patient was seen in the preoperative holding suite informed consent reviewed. Patient was then taken from the preoperative holding area to the operative suite and transferred from the gurney to the table. All bony prominences were padded. General anesthesia was administered. Patient was then transferred from supine the lateral position with the affected upper extremity draped over an arm holder. Preoperative antibiotics were administered. Sterile standard prep and drape were then performed. Operative time-out was performed identifying patient and correct left upper extremity. Esmarch used to exsanguinate the arm and the Tourniquet inflated 250 mm Hg. An 8 cm curvilinear incision coursing lateral to the tip of the olecranon was performed with a 10 blade. Retractors were placed. Triceps tendon was completely avulsed, all 3 heads, from the olecranon process with retraction. We utilized a Cobb elevator to develop planes both superficial and deep to all 3 heads and allow for better excursion of the tendon. The tendon ends were freshened with a 15 blade as well as rongeur. Allis clamp was placed on the tendon heads and adequate excursion confirmed. We then began preparation for a triceps repair. We used a rongeur to debride the stump and freshen the bone for adequate healing surface on the olecranon process. Following this, we then placed 2 475 double loaded SwiveLock Arthrex anchors with preloaded tape as well with excellent purchase in the olecranon process and no penetration of the intra-articular area. These FiberWire sutures were then passed sequentially in a horizontal mattress fashion in both the medial head as well as the long and lateral heads of the tendon. The fiber tapes were also passed in horizontal mattress fashion just proximal to previous past fiber wires. The arm was brought into near full extension for repair. We then sequentially tied all 4 knots for the horizontal mattress repair with the FiberWire sutures noting excellent compression at the anatomic insertion site of the triceps on the olecranon process. We cut 2 of these sets of sutures and left the other 2 for our speed bridge construct. We then drilled and tapped 2 more pilot holes for lateral row of our speed bridge construct. We then incorporated our FiberTape as well as the remaining 4 strands of suture in a speed bridge construct, noting excellent tension and compression of the repair at its anatomic insertion site and dunked these into 2 475 swivel lock anchors and our lateral row along the ulnar shaft, approximately 3 to 4 cm distal to the initial set of anchors placed. Our construct was then complete. We had excellent restoration of the triceps insertion site and excellent compression with our speed bridge construct. Flexed and extended the elbow from 0-100 with no undue tension and no undue stress on the repair. Content with our construct, we then turned our attention to closure. Copious irrigation was then carried out. Deep fascia was closed with 2 O Vicryl as well as deep dermal layer closed with 2 O Vicryl. This was followed by Monocryl for 0 subcuticular layer runner. Dermabond and Steri-Strips were then placed. Soft dressing and Ace bandage were then placed as well. Patient is then placed in a sling. All sponge and needle counts were correct at the end the procedure. Patient 1 or go passive range of motion from 0-110 as tolerated. We will begin physical therapy after his 1st postoperative visit.

The physician's assistant was 1st assistant during this case, was present for the entirety of the case and assisted with all critical portions of the case. Prior to the procedure he was involved with room setup, patient positioning, prepping and draping. Intraoperatively he assisted with retraction and manipulation of the extremity, tendon reduction, reaming, anchor placement. Post-procedure he assisted with subcutaneous wound closure. He directly performed skin closure and dressing application. He also was involved with transferring the patient from the OR bed to the hospital bed.

Complications: None

Additions (Drains, Specimens, Implants):
Implants:
Implant Name
Type
Inv. Item
Serial No.
Manufacturer
Lot No.
LRB
No. Used
Action
ANCHOR SUT 4.75MM 2 SWIVELOCK TIGERWIRE ARTHX 2 LD 2 TIP EA=BILL-ONLY - LOG4823077
Anchor
ANCHOR SUT 4.75MM 2 SWIVELOCK TIGERWIRE ARTHX 2 LD 2 TIP EA=BILL-ONLY

Arthrex
14921228
Left
1
Implanted
ANCHOR SUT 4.75MM 2 SWIVELOCK TIGERWIRE ARTHX 2 LD 2 TIP EA=BILL-ONLY - LOG4823077
Anchor
ANCHOR SUT 4.75MM 2 SWIVELOCK TIGERWIRE ARTHX 2 LD 2 TIP EA=BILL-ONLY

Arthrex
14962105
Left
3
Implanted


Estimated Blood Loss: * No values recorded between 5/6/2024 12:03 PM and 5/6/2024 1:03 PM *

Total IV Fluids:
Intravenous fluids were administered See Anesthesia Record

Tourniquet Time: See OR Record

Condition: good


Findings: As dictated

Glad to hear your surgery went well. Hoping recovery goes good too. Did the ortho tell you what to expect as far as the amount of PT you'll need to do?

 

[Lee_48157]

Glad to hear your surgery went well. Hoping recovery goes good too. Did the ortho tell you what to expect as far as the amount of PT you'll need to do?

Not yet tomorrow is my first appointment.

 

[zebradelt]

Not yet tomorrow is my first appointment.

Best of luck with recovery. I haven't experienced your injury, but i know how annoying it is not being able to train after injuries & surgeries. Be patient and you'll eventually be back to normal

 

[Lee_48157]

Best of luck with recovery. I haven't experienced your injury, but i know how annoying it is not being able to train after injuries & surgeries. Be patient and you'll eventually be back to normal

That’s the plan. Doing what I can until then. Appreciate the words of encouragement!