Snapping in the elbow is an uncommon cause of pain. In certain young children, and especially in young weight lifters, a snapping triceps tendon can cause significant elbow pain. Because snapping triceps syndrome is a rare condition it is often misdiagnosed.
Our elbow is a complicated hinge joint. The power to flex or bend the elbow comes from the Biceps and Brachialis muscles. The power to extend the elbow comes from the Triceps muscle. The Triceps attaches to a bone on the back of the elbow we call the olecranon. In a certain, small group of people the inner or medial triceps has an abnormal or extra tendon. That tendon attaches along the inner side of the elbow instead of the back of the elbow.
In weight lifters, when the triceps becomes larger and stronger that extra medial band may start snapping over a bone on the inner side of the elbow. We call that bone the medial epicondyle. Initially people are concerned by snapping itself, but it doesn’t hurt so they keep working out. Eventually the inner side of the elbow will start to hurt each time the tendon snaps over the bone. This pain is caused by irritation of the snapping tendon.
The ulnar nerve (funny bone) is located right next to the snapping portion of the medial triceps. Eventually that will irritate the nerve in many of you. Signs that the ulnar nerve might be irritated begins with a shooting pain each time the snapping occurs. That shooting pain usually courses down the forearm and into your little finger. Some people with a snapping triceps syndrome also develop numbness in their hand, specifically along the little and ring fingers. The numbness is usually transient and goes away after a long workout.
Do I Have Snapping Triceps Syndrome?
If you have snapping on the inner side of the elbow which occurs as you bend the elbow, then you likely have a snapping triceps. If you feel nerve pain, numbness or shooting pain down into your hand then you may have snapping triceps syndrome with involvement of the ulnar nerve. Many if not most people with a snapping triceps have involvement of the ulnar nerve. There are many people who also have a snapping ulnar nerve. It is usually easy to determine whether you have a snapping ulnar nerve or a snapping triceps syndrome. A snapping triceps is loud, and very obvious. A snapping or unstable ulnar nerve is not loud, and not very obvious.
How Do You Treat Snapping Triceps Syndrome?
You always have the options of cutting down on your workouts which causes the snapping in your elbow. Most very active weight lifters are not willing to do that. I have seen a few athletes feel better using KT tape. I have seen a few athletes use various stretching and soft tissue techniques to try and stretch the medial triceps. In my experience, most active weight lifters usually elect to have surgery to fix a snapping triceps tendon. During the surgery we usually find an “extra” or unusual attachment of a small portion of the medial triceps. That portion is usually released from its abnormal insertion. That will cure the snapping of the elbow. If the ulnar nerve is involved, and is also unstable then we will usually perform an ulnar nerve release and transposition as well. We “transpose” or move the ulnar nerve to a new position in front of the bone it was snapping over. That takes the tension off of the nerve and allows it to heal.
What’s The Recovery From Surgery For a Snapping Triceps
The recovery from surgery is fairly quick. Most people are back in the gym within a few weeks. Some sooner, and some later. The swelling and discomfort from the surgery is usually fully resolved within a few months. A return to full activities is a very reasonable expectation from this surgery.
Of course complications can occur, no surgery is without risk. Infections are possible, but very rare in upper extremity surgery. Nerve injuries are also very rare. Another potential risk is that the snapping is not completely alleviated.
A review of the relevant research about a snapping triceps can be found here.
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Blake says
I have snapping triceps syndrome(medial tricep tendon). I already had my nerve transposed and I still have the issue. When doing the tricep surgery do you just release the medial tricep entirely ? Or do you perform a reconstruction?
Howard J. Luks, MD says
You just release the abnormal insertion medially. The rest of the triceps is left intact.
Jacob says
Hello, now invasive would a surgery be for someone who only experiences the snapping tricep portion but this is in both elbows ?
Howard J. Luks, MD says
Well… that depends on your perspective. It does involve an incision. The incision is anywhere from 2-4 inches in length. There’s an important nerve that’s right next to the portion of the triceps that snaps. We need enough of an incision to see the nerve and the snapping tendon.