Tricep tendon rupture

[DR.BB]

My MRI revealed a ruptured tricep tendon in my right arm. I will go for surgery, need to set a date w/doc. (I am 40 years old, and have trained seriously since high school, now I am experencing endless muscle/tendon injuries but this is bby far the worst.) I know Esplendido had tricep tendon surgery, and it would also be helpful to hear from anyone who experienced it. So, Esplendido and others...

How long before I can return to the gym after surgery?

Can I train w/machines (like pec dec) with arm in cast or is this just plain stupid? Are there excercises I can do that will not hit tris or modify the range of motion to avoid the tri/elbow area? I need to figure out a way to train. Some say doing one side of the body can still help the opposite side that's injured? Could this be true?

Will the tricep look normal or distorted after the operation?

Should I continue TRT during and immediately after surgery? Should I drop TRT and try growth? Is it better to do nothing? (Before the doc cuts me open, I'll reveal my TRT--just don't want any lectures for now).

[esplendido]

I used 3IU GH/day while recovering, along with 400mg test/wk. I was cleared to use the arm lightly after 90 days and was benching at full stength 90 days later.

While recovering (and I was never in a permanent cast, I had a removable sling), I trained the opposite side, and pretty much maintained unilateral size and strength.

Yes, my left triceps (the reattached one) is a little shorter than the right one, but looks pretty good considering. It actually looks better in a side triceps shot than the uninjured arm.

[DR.BB]

Thanks Esplendido for the helpful response. Are there lifts that you did with the opposite (uninjured) side that are especially good for this situation? Did you rely on machines? Did your opposite side really maintain its size and strength? Did you ever push it and do lats or pec deck w/both sides as I can do these movements w/o pain in the tricep? This is all encouraging.

[esplendido]

Thanks Esplendido for the helpful response. Are there lifts that you did with the opposite (uninjured) side that are especially good for this situation? Did you rely on machines? Did your opposite side really maintain its size and strength? Did you ever push it and do lats or pec deck w/both sides as I can do these movements w/o pain in the tricep? This is all encouraging.

I "listened" to my triceps when I was given the green light to use it again. It had some pain in it when I did anything requiring it to flex, but it was not injury pain, but the kind that comes with using a muscle not used to lifting. It was in the area of the injury. So I did light moves for a few weeks, then slowly pushed it, using the pain as the stopping point. But I was able to get to full strength in 3 months....very cautiously, because a retear would've been disaterous.

I used dumbells and cables to work the opposite side....pec deck, one armed pushdowns, lateral raises....that kind of thing. And yes, I did not lose any appreciable size on the injured side. The reattached triceps has about a 1/2" higher insertion than the good side, but it's hard to tell, even in the front double biceps pose.

I did NOT do heavy leg presses during the 3 months I wasn't allowed to use the arm because it had to remain in a 30 degree angle in the hard sling so I couldn't grab the leg press handles with my left hand, preventing me from doing anything heavier than 500lbs.

Just take it easy during recovery and don't push it too fast. Better to be cautious than tear it loose from its new mooring. Remember, I used GH to speed recovery, but even then, I only pushed when I could do it painlessly.

[vboissiere]

I ruptured both tricep tendons towards the end of November last year. I had surgery on my right arm because of a total detachment of the medial head. The left arm was a 60% detachment (which I foolishly allowed the surgeon to talk me out of repairing).

I wish I had followed a protacal such as described above. My right arm has regained 75% of its former strength. The left 65%. I base these numbers on performance on unilateral isolation movements. This makes it very difficult to perform free weight pressing movements. The pain in my right elbow is constant, with the exception of when warmed up during training.

Once your rehab training starts, look into band training to promote a faster recovery with less joint trauma.

Good luck.

[esplendido]

I ruptured both tricep tendons towards the end of November last year. I had surgery on my right arm because of a total detachment of the medial head. The left arm was a 60% detachment (which I foolishly allowed the surgeon to talk me out of repairing).

I wish I had followed a protacal such as described above. My right arm has regained 75% of its former strength. The left 65%. I base these numbers on performance on unilateral isolation movements. This makes it very difficult to perform free weight pressing movements. The pain in my right elbow is constant, with the exception of when warmed up during training.

Once your rehab training starts, look into band training to promote a faster recovery with less joint trauma.

Good luck.

How did you rupture both triceps?

[MrAust92]

I am currently 8 weeks post-surgery from a supraspinatus tendon repair.

Believe it or not I was stretching (sucks I know). I had just completed training bicep and tricep in superset fashion and was stretching my biceps in the power-rack when I felt a sickening snap and an audible popping noise. At first I thought I had torn the upper insertion of the bicep but an MRI scan revealed it was the supraspinatus tendon that was torn.

Extent of damage:

I knew straight away what had happened (there is no sensation quite like snapping a tendon) and I iced it repeatedly that day and throughout the night. The next day I tracked down a Dr and politely demanded a referral for an MRI scan. The results of this indicated a tear of close to 100% of the supraspinatus tendon.

Surgery or not?

Always a big call. I took my scans straight to a sports physician and asked firmly but politely for a referral to an expert sports orthopaedic surgeon to have it repaired. Some sports Drs will recommend against surgery depending on your age, activity level etc but if you want to continue to train at pre-injury levels then surgery is the only solution. Takes longer to rehab but repaired tendons are as good as new ones, they heal 100%.

I was lucky to get a slot with a reknowned ortho who specialises is shoulder repair, he repaired my left pec 15 years ago and my faith in his ability is 110%.

Post op care:

Post surgery arm is immobilised in a sling and you are pumped full of pain meds and anti inflammatory meds. This sucks but its important as minimising pain in the first 72 hrs will speed up rehab considerably. I hate taking morphine based pain meds as they make me feel like shit (fuck knows why junkies like the stuff) but taking these and naproxen 4 times per day kept the pain manageable. Icing the wound every 2 hrs is also recommended for the first 48 hrs and then at least 4 times per day after that. (yes this means getting up in the night to get a fresh icepack from the freezer)

Exercise/ regaining range of movement:

Rehab methods seem to be more aggressive these days, the pyhsio had me out of bed the morning after the op, removed the sling and started to get me moving the arm through a limited range of motion. After 24 hrs I started undertaking the following 4 times per day.

• L arm bicep curl (no weight just curl the arm up and down)
• L forearm supination (activates the shoulder joint)
• Shoulder shrugs (just up and down with you arms by your sides)
• Shoulder blade shrugs (just squeezing/shrugging your shoulders backwards like the completion of a pully row)
• Hanging arm rotation (just bend forward, hang the arm down and rotate clockwise and then anti-clockwise)
• Hanging arm "swings" (similar to rotations but just swing the arm front to back and then side to side)

I do this 4 times per day for 50 reps and try and increase the ROM each time (its easy to do in the shower). Use pain as a guide and dont extend further than is comfortable. I usually follow this up with paracetamol and naproxen to settle any inflammation it may cause.

After 2 weeks the sling came off and I graduated to using elastic band resistance work as well.

Nutritional supplmentation:

I take all my usual supps, vitamins etc and on top of this I take the following cocktail 4 times per day.

Magnesium
Calcium
Zinc
5 grams Vitamin C
Fish oil
Evening Primrose oil
Glucosamine, Chondroitin and MSM formula

Gets a bit tedious but Im sticking to it like glue as I intend to set a record for injury recovery.

Super supps??

Super supps are an individual choice, they arent for everyone and I understand that but they can have a role to play here.

If someone had access to these items legally via a medical practitioner the following protocol would contribute to an effective recovery.

Test at a standard HRT dosage (for the average 40-something male this is around 200 mg every 10 days)
Nandrolone decanoate 100 mg every 10 days
hGH at 1-3 iu per day

These dosages present little health risks (very close to just replacement therapy) yet promote healing and recovery. (remember no real weight training is being undertaken).

Diet

Again, very individual thing but I dont think it helps to be carting a big bodyweight around when rehabbing a serious injury and all meaningful weight training is out so no point blowing out and being a fat fuck.

I am maintained about 108-110 kg (about 240 lbs) and just eating 5 meals per day of around 50 gm protein, 20 gm healthy fats and fibrous carbs (no starches or sugars). This cahanged once I could train a bit more and I added carbs to some meals.

Training?

I had grand designs of training legs flat out while this healed but was advised not to. I couldnt squat or load the leg press anyway so I just followed Drs orders and channelled all my recuperative powers into my shoulder and getting it well again.

How long till its healed?

The surgeon advises 6 months to achieve full tendon strength but to be careful up until 12 months. I am lucky my tear was mid-way down the tendon and has been stitched back together to heal. When the tendon has to be re-attached to the bone it takes longer as the bone has to heal around the new attachment.

8 weeks later I am doing light upper body workouts 2 x per week and legs twice per week. I squatted 2 plates for 20 reps the other day without aggravating the shoulder and can manage light pulldowns, dumbells presses etc, I even deadlifted 2 plates for 20 reps today without discomfort.

The trick is to follow the medical advice but try and improve incrementally each week, its frustrating at first but small gains add up over the weeks and you will surprised at your progress.

People tell me I look healthier than I have in years (mainly because I am lighter) but the truth is I feel great. In 4 weeks time I will be 12 weeks post-op and I hope to get the all clear to start slowly ramping up the resistance.

[DR.BB]

Thanks again to Esplendido and MrAust92 for this helpful info. My orthodpedic barely seemed concerned and I pushed for an MRI, which revealed a rupture and surgery was an option w/ a dco who didn't seem to worried in the first palce. I am now going to a top orthopedic (he is legitimatelly listed on an NFL website as the team doc and has done tendon suregry on pros).

MrAust, do you think I will need to plead for surgery with this doc? I have copies of the MRI showing what I am told is a "sugnificant rupture"? Any advice on making sure you get the surgey. I already have a torn bicep tendon on the arm from 5 yrs ago, and I regret that I never had surgery.

[MrAust92]

MrAust, do you think I will need to plead for surgery with this doc? I have copies of the MRI showing what I am told is a "sugnificant rupture"? Any advice on making sure you get the surgey. I already have a torn bicep tendon on the arm from 5 yrs ago, and I regret that I never had surgery.

I dont think you will have any trouble, any decent ortho who works with athletes will recommend surgical repair if you want to return to performing at your pre-injury state.

They often recommend against surgery for older sedentary individuals as the surgery and subsequent rehab is more trouble for someone who isnt going to reap the benefits of a full repair.

[vboissiere]

How did you rupture both triceps?

I was doing seated overhead dumbbell extensions...

[DR.BB]

Had the tricep suergery today on what the Doc called 90% rupture. He has me in a cast for 10 days, no movement of arm, but light rehab can begin in 10 days. I will then wear an adjustable brace, with degrees of motion increased weekly. He'll remove after 6 weeks and says I can then do bilateral LIGHT training. Does this sound reasonable? I can get no more than 2iu gh a day. Esplendido mentioned 3 and MrAust a range. Would it be worth the cost for healing, and maybe keep my bf in check?

[MrAust92]

I think 2 iu per day would be very helpful for your healing, of course its a cost/benefit thing.

[esplendido]

2IU will go a long way to speed healing.

[vboissiere]

The time table sounds about right with others (as well as what my doctor told me). As to the GH usage, you have some very well versed guys on the topic advising you. Good luck!

[DR.BB]

Thanks again for the info. So, 2iu/day of GH will help with recovery. Given the cost, I am wondering if I can get any benefit for healing and maybe body fat on 1iu/day?