Common Sports Injuries & Conditions

Hand:
Baseball Finger
Finger Sprain and Dislocation
Ulnar Collateral Ligament Injury

Wrist:
Scaphoid Fracture
Triangular Fibrocartilage Complex (TFCC) Tears
Wrist Sprain
Wrist Synovitis

Forearm:
Distal Radius Fracture

Elbow:
Contusions
Medial Collateral Ligament Injury (MCL) - Baseball Elbow
Medial Epicondylitis (Golfer's Elbow)
Tennis Elbow
Ulnar Collateral Ligament Tear

Upper Arm:
Biceps Tendonitis
Biceps Tendon Rupture
Triceps Tendon Inflammation and Rupture

Baseball Finger

Baseball Finger is often the result of damage caused to the tendons that assist in straightening out the finger - usually when the fingertip is forcefully jammed or bent downward. Also known as Mallet Finger, symptoms may include swelling and tenderness around the fingertip.

Risk Factors
Athletes involved in not only baseball, but football and basketball as well, are at risk for such an injury as a result of the force involved in these sports and the rapid motion and awkward positions in which their hands and fingers are often placed.

Diagnosis and Treatment
Not considered a serious injury, Baseball Finger generally only requires a splint that maintains the finger in a straight position. Occasionally surgery is required, if the bone sustained serious damage.

Understanding the action resulting in the injury often helps determine diagnosis. In confirming Baseball Finger, the last knuckle and extension of the finger are physically examined. An X-ray may also be indicated in order to determine if the finger bone was damaged during the force.

Finger Sprain and Dislocation

Finger sprains occur when the ligaments of the fingers or thumb are stretched and bent to an extreme such as that often experienced in sports or a fall onto the hand. And a finger dislocation occurs when the ligaments and joint capsule surrounding the joint are actually torn and forced out of alignment. The most commonly injured joint in the finger is the proximal interphalangeal (PIP) joint.

Sprain
Ligaments located within the joint capsules connect the bones of the finger joints. When the ligament is stretched beyond its capacity, it tears or sprains. In sports, this is often referred to as a jammed finger. The classification of ligament sprains includes: Grade I, which is a 25 percent tearing of the ligament; Grade II, which is a 25 to 75 percent tearing of the ligament; and a Grade III, which is a complete tearing of the ligament.

Dislocation
When the ligament pulls a small piece of bone off the finger during a strong force, it is called an avulsion fracture, or a third-degree sprain, which represents a complete ligamentous disruption. A dislocation is the most severe form of a third-degree sprain, because the ligament must be torn completely to dislocate the joint.

Those suffering from anyone of these different types of sprains will experience joint swelling, stiffness, and loss of joint motion. Bruising may also be present.

Diagnosis and Treatment
A thorough examination, patient history assessment, discussion of the manner in which the injury occurred and possibly an x-ray all help in determining the extent of the injury and appropriate treatment. For minor sprains, treatment may include a brief period of immobilization and splinting in conjunction with anti-inflammatory medication and cold compression - followed by a series of range of motion rehabilitative exercises. More serious sprains involving a dislocation or fracture may require surgery in order to properly repair and realign the joint.

Ulnar Collateral Ligament (UCL) of the Thumb Injury (Skier's Thumb/Gamekeeper's Thumb)

An Ulnar Collateral Ligament of the Thumb (UCL) Injury, which is also referred to as "Skier's Thumb" and "Gamekeeper's Thumb," weakens the UCL and its ability to secure the bones at the base of the thumb (metacarpophalangeal or MCP joint). As a result, the thumb is unable to extend out very far from the hand.

When it is defined as an acute injury, it more accurately depicts the type of injury for which it acquired the name "Skier's thumb." This type of injury is the result of stress placed on the ulnar collateral ligament from an extreme force (valgus force) - such as that which may be experienced when the thumb is caught in a ski pole during a fall. In this situation the ligament undergoes an exaggerated stretch and often tears as a result. Those suffering from an acute UCL injury will experience pain and swelling over the area of the damaged ligament at the base of the thumb. There is difficulty grasping or holding objects firmly and some instability.

The name "Gamekeeper's Thumb" was acquired by the more chronic pattern, which leads to loosening of the ligament over time. Named after early European gamekeeper's, who killed their game by grasping the animal's head between their thumb and index finger to break its neck. This repeated stress results in loosening over time and more chronic patterns of the injury. Today, tennis players and baseball players are more likely to experience this type of UCL injury.

Risk Factors
Those involved in activities or sports that place the thumb in a vulnerable position or those who subject it to repeated stress are at risk for this type of injury. It is often seen in athletes.

Diagnosis and Treatment
Treatment depends on the severity of the injury, when the injury occurred and other patient factors. For a incomplete tear a thumb spica cast may be used for approximately four to six weeks in order to stabilize and encourage healing. This may be followed by range of motion exercises to improve grip strength.

In more severe cases involving a complete tear or rupture of the ligament and significant instability, surgery is considered - and generally done as an outpatient procedure several weeks following the injury. Patients usually see results within four weeks following the surgery, regaining thumb strength and function. Occasionally the MCP joint will remain unstable and causes pain during pinching or grasping activities. In order to prevent the eventual development of arthritis, which is caused by this type of chronic instability and looseness of the thumb, other procedures may be considered. Such procedures may include grafting in new tissue in order to reconstruct the ligaments, or arthrodesis in order to fuse the joint.

A thorough review of the patient's medical history and assessment of the manner in which the injury was incurred will help determine diagnosis. The symptoms experienced and the location of the pain also play a part in diagnosis. Both a physical examination and X-ray are done to confirm initial assessments and determine the extent of the injury. A valgus stress test is also performed in order to check the strength of the ligament and corresponding stability of the joint.

Scaphoid Fractures

The scaphoid bone is one of the strongest and most difficult bones to break in the wrist, yet it accounts for nearly 60 percent of all wrist fractures. Almost always the result of an extreme force, a scaphoid fracture is a break in the small scaphoid bone located in the wrist joint.

The scaphoid bone, which is shaped like a cashew and located on the thumb side of the wrist, near the lower arm bones, requires twice as much force to break than one of the larger forearm bones. Eighty percent of the surface of the scaphoid bone is covered by articular cartilage, and it functions much like a ball bearing in the wrist joint.

A scaphoid fracture requires special attention, because of the vulnerable location of its blood supply. The blood supply for a scaphoid bone enters from the top. Since most fractures occur in the middle or lower portion of the bone, the supply is interrupted and fails to reach the injury and promote adequate healing.

An undetected scaphoid fracture that results in an interrupted blood supply, can lead to avascular necrosis. Avascular necrosis can cause the bone to crumble and the wrist joint to be destroyed.

When a scaphoid fracture occurs, there may be pain and tenderness on the thumb side of the wrist. Motion is painful and swelling may be evident on the back and thumb side of the wrist. Often times injuries sustained from high speed or force, such as in football, a fall at high speed, or an auto accident will result in a complex injury. A complex injury involves companion fractures and ligament injuries as well. A thorough examination will determine whether or not the injury is complex.

Risk Factors
Generally this type of injury occurs when the wrist joint of an outstretched hand hyperextends. Men are much more likely to fracture this bone than a woman, because of the forceful activities in which they are often involved and the larger weight ultimately falling or pushing against joint.

Scaphoid fractures generally occur in men between the ages of 20 and 40 years. It is a common injury in traditional as well as extreme sports though can also occur as a result of an automobile accident.

Diagnosis and Treatment
Treatment will depend on the severity of the fracture. Incomplete and nondisplaced fractures are initially treated with compression and limb elevation in order to reduce swelling. This is then followed by a period of immobilization, with either a splint or short arm cast for six weeks to three months - depending on the severity of the break and associated injuries.

While cast treatment works best for incomplete fractures that do no extend across the entire bone, casting alone does not always promote healing and may also impede the rapid return to sports by restricting the ability to regain strength and range of motion.

Complete scaphoid fractures and those nonresponsive to casting may require arthroscopic or surgical repair, in order to stabilize the bone with a scaphoid bone screw Kirshner wire or other internal fixation. Fractures with a severe ligament injury also require surgical repair, in order to stabilize the wrist and prevent the collapse of the wrist bones - which would lead to deterioration and permanent stiffness of the wrist joint.

A fresh fracture (a fracture that is less than two to four weeks old) that is displaced or unstable requires surgery and the use of a fixation device for stabilization. A fracture that is not first stabilized is unlikely to heal in a cast.

Because the scaphoid bone is located inside the wrist joint, rarely do scaphoid fractures result in an obvious deformity - as seen in many bone fractures - and may be mistaken for a simple wrist sprain. And while there may be swelling, it can subside after a few days. Therefore, the diagnosis of a scaphoid fracture is often delayed for weeks and sometimes months.

Triangular Fibrocartilage Complex (TFCC) Tears

Recognizing that the mild symptoms may be deceiving and understanding the severity of a severed blood supply often associated with a scaphoid fracture, a hand specialist will perform a thorough physical examination and confirm diagnosis with x-ray and magnetic resonance imaging - which will also reveal any other tissue damage. A bone scan can also help in a diagnosis days following an injury.

Nonunions and Old Fractures
If a scaphoid fractures remains undetected and untreated, the prolonged unstable joint environment it creates will ultimately lead to severe arthritis and require joint fusion or joint replacement. A nonunion, a bone that has failed to heal and old fractures require special treatment.

Sometimes a bone graft is necessary to prompt the healing of an old scaphoid bone fracture that never healed properly. This is accomplished by taking a small piece of bone from the iliac portion of the pelvic bone. A Herbert scaphoid screw is used to stabilize the bone graft and the patient is placed in a cast for approximately four weeks. Occasionally a fresh fracture will also require a bone graft when there are a number of pieces, or it is "comminuted."

Following Immobility
Following a period of casting and immobilization, range of motion exercises represent the first critical phase of rehabilitation. These exercises are very important for limbs that have been immobilized - as joints can quickly become stiff and muscles weakened. A thumb spica splint may be used for protection during this phase, until range of motion and strength of the wrist flexors and extensors improve. Supination, pronation, and grip strength exercises are progressively added.

If a long-arm cast is used and flexion contractures are evident, physical therapy is recommended and a program specific to the patient is developed.

Postoperative Care
For the first several days following surgical repair with internal fixation patients are encourage to keep the wrist elevated, in order to reduce swelling, and maintain clean, dry bandages. Swelling is further reduced with cold compressions. Analgesic medications may be prescribed to help minimize postoperative pain.

Following an arthroscopic procedure, there is a period of immobilization before range of motion exercises begin. This may vary depending on certain patient factors and the condition of the wrist following surgery. Patients are then given progressive strengthening exercises for the wrist flexors and extensors - with supination, pronation and grip strength exercises gradually added.

Once a fresh fracture is stabilized with fixation, the patient can return to sports in approximately eight weeks. Though following a nonunion and bone grafting, the recovery process may last up to three months.

The triangular fibrocartilage complex (TFCC) is a small meniscus located on the ulnar side of the wrist and serves as a connective site for ligaments, as well as a cushion between the carpal wrist bones and the end of the forearm. A strong compression or force can damage the TFCC.

TFCC tears cause minimal pain and discomfort, because the wrist is not a weight-bearing joint.

Risk Factors
While TFCC tears can occur during an accident or fall on an outstretched arm, athletes involved in activities requiring a large amount of wrist motion such as swinging a baseball bat, throwing a ball, or balancing as in gymnastics are at greatest risk.

Diagnosis and Treatment
Treatment will depend on the severity of the damage and may involve conservative treatment, arthroscopy, or surgical repair.

Conservative treatment consists of rest and change in activity in order to reduce the stress on the affected hand. It may also include casting and the use of non-steroidal anti-inflammatory medications (NSAIDs).

If pain persists following conservative treatment, or if there was a severe tear, wrist arthroscopy may be performed. Chronic tears may require an excision of the tear.

TFCC damage may cause discomfort on the ulnar side (little finger) of the wrist and increased pain when the hand is rotated away from the thumb. There may also be a popping sound during movement. Following a thorough review of patient history, physical examination and assessment of the manner in which the injury was incurred, a MRI will confirm the diagnosis.

Wrist Sprain

When the ligaments responsible for connecting the wrist bones and supporting the wrist are stretched or torn, it is called a wrist sprain. This often happens when an outstretched hand is used to break a fall. Individuals suffering from a wrist sprain may experience pain and swelling around the wrist and have limited range of motion. The area may also be sensitive and warm, with visible redness or bruising.

Risk Factors
Those individuals involved in sports, as well as those experiencing poor coordination, balance, flexibility and strength in muscles and ligaments, are at greater risk for wrist sprains.

Diagnosis and Treatment
Conservative treatment is generally all that is required for wrist sprains and may include a period of rest from inflammatory hand activities. Cold compression is used to reduce pain and swelling. Elevation helps drain fluid and reduce swelling as well. Medication may also be prescribed in order to reduce inflammation.

Occasionally a brace or cast may be placed on the wrist to ensure immobilization. Surgery, though rare in such cases, is sometimes necessary to repair a ligament that has completely torn - or address an associated fracture.

Generally a description of the pain followed by an x-ray to ensure that there are no broken bones will determine diagnosis. Occasionally a magnetic resonance imaging (MRI) scan may be done in order to determine if a more severe ligament injury exists.

Rehabilitation
Following a period of rest, patients then begin a series of exercises, in order to restore flexibility, range of motion and wrist strength.

Wrist Synovitis

Often coinciding with carpal tunnel syndrome, (link to Other Upper Limb Conditions/Hand/Medical Conditions/Carpal Tunnel) wrist synovitis is the inflammation of the synovial membrane lining the joints in the wrist - placing compression of the median nerve as it travels through the carpal tunnel.

Causing pain and discomfort during wrist movement, this condition may also present as a Ganglion cyst.

Risk Factors
While wrist synovitis most often affects those suffering from Rheumatoid Arthritis, it has also been diagnosed in young patients involved in sports, which are demanding on the wrist joint such as gymnastics and tennis.

Diagnosis and Treatment
The severity of the condition and other health factors will determine the treatment. Wrist synovitis may be treated with glucocorticoid injections into the joint. When a wrist ganglion and severe degenerative conditions exist despite the use of antirheumatic drugs (DMARDs) and other conservative treatment, a Synovetomy may be indicated.

A Synovetomy is done to remove the inflamed joint tissue (synovium) responsible for the pain, irritation and swelling. It may be done arthroscopically or open surgery.

Physical therapy begins one to two weeks following a procedure and focuses on restoring range of motion.

Following a thorough review of the patient's medical history, a physical examination and assessment of the type of pain experienced, magnetic resonance imaging (MRI) will help identify the areas of vulnerability and confirm wrist synovitis.

Distal Radius Fractures

Also called a Colles fracture, distal radius fractures are among the most common type of fractures, affecting the distal end of the radius bone in the forearm. It most often occurs when the arm is used to break a fall but may also occur as a result of a direct trauma or accident.

The radius, which is the forearm bone that runs between the wrist and the elbow, becomes rigid when it is extended to break a sudden fall. The extreme compression and twisting force results in a fracture at the wrist.

A fracture to the distal radius causes immediate pain, and there is an obvious deformity of the wrist. This may be followed by swelling, stiffness and loss of motion. Bruising may also be present.

Risk Factors
Distal radius fractures are most commonly seen in action sports athletes involved in such activities as motocross racing and cycling. They are also seen to a lesser extent in those involved in a trauma such as a car accident, as well as roller blade or skate boarding accidents.

Distal radius fractures are also common in patients over the age of 60, as a result of osteoporosis. The decreased bone density of patients suffering from this condition is vulnerable in even a minor fall.

Diagnosis and Treatment
A fracture may be either displaced or nondisplaced. A displaced fracture means that the two bone parts are not in proper alignment. A nondisplaced fracture means that the bone, while fractured, remains aligned.

The treatment plan selected will depend on the severity of the fracture and whether it is displaced or nondisplaced. The primary goal in treating a fracture is to ensure that the bones heal in the correct alignment. Nondisplaced fractures may simply require bracing and anti-inflammatory medication. Displaced fractures may require surgery in order to ensure that the dislocated bones are replaced in their normal anatomic positions. This is called reduction. Reduction may be done either closed (no incision) or open (requiring an incision). The type of fixation used to hold the bone in the correct position is determined based on the condition of the patient, lifestyle, and severity of the injury. Fixation can be either internal or external.

A thorough examination and discussion of the manner in which the injury occurred is part of determining diagnosis. The appearance of the wrist is also a strong indicator of this type of fracture. An x-ray will confirm the diagnosis.

Contusions

Often accompanied by a fracture, contusions result when the muscles of the forearm and portion of the elbow bone sustain a force such as that in a contact sport. A common injury among athletes, contusions involve bruising and possibly bleeding, which produce stiffness during active range of motion activities.

A contusion can also produce an actute hemorrhagic bursitis or a common chronic olecranon bursitis, depending on the area sustaining the force. A contusion to the ulnar nerve (an area often referred to as the "funny bone") can be very painful and send burning sensations down the ulnar side of the forearm to the ring and little fingers.

Risk Factors
Individuals and athletes involved in full contact sports such as football, baseball and basketball are more likely to be affected by this condition. Contusions can also result from an accident or fall as well.

Treatment
A thorough examination, patient history assessment and discussion of the manner in which the injury occurred will help determine diagnosis. An X-ray may also be taken in order to determine if there is an associated fracture that must first be addressed. After first addressing any accompanying fracture, treatment generally consist of a period of rest followed by rehabilitative range of motion exercises.

Medial Collateral Ligament Injury (MCL) - Baseball Elbow

A medial collateral ligament (MCL) injury is not a common injury for most individuals, as it most often results when the elbow is subjected to the motion such as that of high velocity pitches experienced in amateur and professional baseball - with balls reaching extremely high rates of speed.

Helping to stabilize the lower and upper long arm bones is a network of ligaments and tendons, which come together at the elbow joint. A high level of continuous force, over time, can lead to irritation, inflammation, cartilage tears, formation of bone spurs and eventual tearing of the MCL.

When the MCL is torn, the stability is compromised. While those suffering from such an injury may retain full range of motion, strength is greatly reduced. While some patients report hearing a "pop" when the ligament tears, it can also occur gradually and remain undetected for a while.

Risk Factors
Those most at risk for an MCL injury are athletes involved in a throwing sport such as pitchers in Baseball. The continuous force required in pitching, particularly at the professional level, places stress on the elbow joint and increases the likelihood of an MCL tear.

Treatment
Following a thorough physical examination and assessment of patient history and manner in which the injury occurred, an x-ray or magnetic resonance imaging (MRI) may be indicated. Treatment is then determined based on the severity of the injury and may include a rest from the activity causing the injury followed by rehabilitative exercises.

More sever tears may require exploratory arthroscopy and surgical repair. Popularized by a former professional baseball player, the Tommy John surgery has proven effective in treating these types of ligament tears. Known to doctors as medial collateral ligament reconstruction the procedure is short and quickly restores strength by using a ligament-tendon exchange.

Medial Epicondylitis (Golfer's Elbow)

Medial epicondylitis, or Golfer's Elbow, affects the opposite side of the elbow as lateral epidondylitis, or Tennis Elbow. Therefore it is easy to differentiate between the two based on the location of the pain - medial identifies the inside portion of the elbow and lateral the outer portion.

While the condition is referred to as Golfer’s Elbow, any number of activities subjecting the wrist and elbow to constant and excessive force, causing damage to the tendons responsible for bending the elbow, can result in medial epicondylitis - including pitching, chopping wood, serving a tennis ball or swinging a golf club.

The symptom most commonly associated with the condition is pain that generates from the elbow to the wrist - along the palmar side of the forearm.

Risk Factors
Both athletes and average adults who apply repeated bending force to the wrist and elbow are likely to experience medial epicondylitis. It is most often seen in individuals between the ages of 20 and 40, who are involved in certain sports or forceful manual labor activities.

Treatment
A physical examination and review of the patient's history and lifestyle help determine diagnosis and the best form of treatment. While most often treated with conservative treatment, which may entail cold compression, anti-inflammatory medications, and rehabilitative exercises, surgical repair may be necessary in cases of more severe ligament damage.

Tennis Elbow

Tennis Elbow is an overstress or overuse condition affecting the tendon around the lateral epicondyle, or bony bump, located at the back or outside of the elbow.

Referred to medically as lateral epicondylitis, the condition is the irritation and subsequent inflammation of the tendon resultant of a potentially degenerative environment within the tendon.

Those suffering from Tennis Elbow may experience moderate pain at the outer portion of the elbow that over time increases and spreads down the forearm and to the back of the middle and ring fingers. If left untreated, the pain will eventually become debilitating, causing progressive weakening and reduction in arm function. Reaching and grasping activities may become painful, and persistent discomfort may be present while at rest following activities.

Risk Factors
Though most commonly known as Tennis Elbow, most individuals diagnosed with the condition are not tennis players. Those most affected are average adults between the ages of 40 and 60, who are involved in everyday activities - gardening, picking up children, storing luggage in an overhead compartment, painting with a brush or roller, using a chain saw or hand tools.

Any activity resulting in the overuse of the muscles and tendons of the forearm and elbow is likely to prompt the condition.

Treatment
Following a thorough examination, assessment of the patient's history and lifestyle, and imaging scans, treatment is determined based on the severity of the condition. Generally beginning with conservative treatments that work to prevent further degeneration of the tissue and reduce inflammation, other minimally invasive procedures are indicated if symptoms persist. Other nonsurgical treatments may include ultrasound therapy or electrohydraulic shockwave energy treatment, which is performed as an outpatient procedure in less than 20 minutes.

Chronic conditions failing to respond to nonsurgical treatment may require a lateral epicondyle release, which is also performed as an outpatient procedure.

Ulnar Collateral Ligament Tear

Serving as the primary stabilizer for the elbow joint, the Ulnar Collateral Ligament (UCL) consists of anterior, posterior and transverse bands. When the anterior band - which most prominently impacts valgus stability - is stressed, it can tear or rupture.

The type of force required to damage the UCL in this way generally comes from overhead and throwing sports such as competitive volleyball, swimming, and baseball. During the acceleration of an overhead throw of movement, the largest amount of valgus force is placed on the elbow - while the forearm disproportionately lags behind the upper arm causing valgus stress. The elbow becomes dependent on the anterior band of the UCL for stability. The extreme acceleration can cause the valgus force to overcome the tensile strength of the UCL and result in either chronic microscopic tears or an acute rupture.

When a tear occurs, patients generally report feeling a "pop." There may also be weakness and poor arm function.

Once career-ending injuries for athletes, today better diagnostic techniques and treatment makes it no more than a minor set back.

Risk Factors
Those at greatest risk for UCL injuries are competitive athletes involved in overhead sports - continuously subjecting their elbow to high acceleration flexion and extension activities.

Treatment
Following a thorough examination and assessment of patient history and manner in which the injury occurred, an imaging scan is performed.

Depending on the severity of the injury, treatment may require only a change in activity for a period of time, followed by rehabilitative exercises. More severe tears and injuries nonresponsive to conservative treatment may require exploratory arthroscopy to identify the severity of the damage and surgical repair.

An effective procedure used to repair such ligament injuries and popularized by former major league pitcher, Tommy John, is the Tommy John surgery - also known as ulnar collateral ligament reconstruction. During this procedure the damaged ligament is replaced with tendon from another part of the body, in order to restore strength to the elbow and forearm.

Biceps Tendonitis

Often secondary to rotator cuff instability, biceps tendonitis occurs when the tendons attaching the biceps muscle to the shoulder and lower arm bone become overused or stressed. The corresponding irritation and inflammation results in tendonitis.

The biceps tendon is vulnerable to such conditions, because it helps control lower arm movement and is subjected to extreme force in such throwing sports as competitive baseball or football.

Symptoms associated with biceps tendonitis include, pain along the front of the shoulder during arm and shoulder movement - particularly forward and upward movements - which intensifies at night and becomes increasingly prevalent during daily activity.

Risk Factors
Those most often affected by biceps tendonitis are competitive athletes involved in throwing positions in a sport. It equally impacts active men and women, who repeatedly subject their arm to such force. Though less common, a direct trauma or calcification in the tendon may also prompt the condition.

Treatment
Following a thorough examination and assessment of the patient’s history and lifestyle, radiographic testing may be indicated in order to determine the severity of the problem and select the best treatment option.

Conservative treatment has proven effective in the treatment of biceps tendonitis and generally involves anti-inflammatory medication and cold compression. A rehabilitative exercise program designed to strengthen and promote flexibility and balanced conditioning of opposing muscles is established. Corticosteroid injections may also be indicated in order to reduce the inflammation and pain.

Biceps Tendon Rupture

Bicep tendon ruptures generally occur as a result of ongoing shoulder instability problems - though may sometimes occur as a result of a single forceful impact and in conjunction with rotator cuff tears. The injury results in a tear of the biceps tendon, either complete or partial. This most often occurs at the long head of the biceps tendon, which travels through the shoulder joint to its area of attachment.

Separating near the shoulder into a long head and a short head - both of which attach to the shoulder in different places - the biceps muscle is attached by the biceps tendon to the scapula, or shoulder blade, and the radius bone. This muscle allows the arm to bend at the elbow and the forearm to rotate.

As a result of the shoulder joint's large range of motion, the proximal biceps tendon is more frequently injured than the distal biceps tendon, because of its close proximity to the shoulder.

Those suffering from a biceps tendon rupture may experience sharp and sudden pain that may or may not precede a loud snap or pop. A large bulge in the upper arm above the elbow may also appear, along with an indention near the shoulder - possibly accompanied by bruising, pain or tenderness.

Risk Factors
Since a biceps tendon rupture most often occurs as a result of chronic tendonitis or long-time shoulder instability problems, they most often affect athletes and active individuals continuously exposing their shoulder to extreme force, such as throwing and other overhead activities that over time weaken the shoulder joint and increase the vulnerability of the biceps tendon.

Ongoing shoulder impingement and other shoulder instability problems left untreated or causing gradual degeneration within the shoulder joint will increase the likelihood of a biceps tendon rupture.

Treatment
Following a thorough examination of the arm and shoulder in motion and assessment of patient history and lifestyle, a treatment plan is selected. Patients with a history of shoulder pain and instability may require magnetic resonance imaging (MRI) in order to assess the condition of the rotator cuff muscles and shoulder joint.

Conservative treatment has proven successful in treating biceps tendon ruptures and may entail cold compression in order to reduce swelling, nonsteroidal anti-inflammatory drugs (NSAIDs), and a period of rest followed by a rehabilitative strengthening and flexibility program specific to the injury and lifestyle of the patient.

Patients nonresponsive to conservative treatment may require surgical repair.

Triceps Tendon Inflammation and Rupture

While less common than a biceps tendon rupture, the triceps tendon - located at the back of the upper arm and inserting into the back of the elbow - can become inflamed and rupture when subjected to severe stress such as that experienced while lifting heavy weights or pushing a very heavy object. It can also rupture when arms are used to break a fall.

Symptoms of triceps tendon inflammation or a rupture may include elbow pain at rest or during activity, painful swelling at the back of the elbow, and a reduction in elbow function.

Risk Factors
This type of injury is most likely to occur when an exercise or endeavor is approached overzealously, or without proper conditioning. Opposing muscles should retain the same amount of strength. If the biceps muscles are much larger and worked for strenuously than the triceps muscles, the triceps muscles and surrounding tissue become increasingly vulnerable.

Treatment
A thorough examination of the triceps muscle and arm in motion will help confirm diagnosis and determine the best treatment option. Those patients with a history of elbow pain may require imaging scans, in order to assess the condition of the elbow joint and surrounding tissue.

Conservative treatment has proven successful in treating triceps tendon inflammation or ruptures and may entail cold compression to reduce swelling, nonsteroidal anti-inflammatory drugs (NSAIDs), and a period of rest. A rehabilitative program specific to the injury will also be indicated a play a large role in recovery.

Those cases nonresponsive to conservative treatment may require surgical repair.