08/21/2012 08:41 pm ET Updated Oct 21, 2012

A Triangle of Triceps Tears

One of the significant NFL injuries this month is a torn triceps. Eugene Amano of the Tennessee Titans had the unfortunate distinction of giving Levi Brown and Jason Hunter a preview by tearing his right triceps in practice on August 2 when he was hit by a helmet while blocking on a pass attempt. Brown, a starting center for the last two seasons, had been fighting to hold off competition for his starting job. Amano had surgery and, though estimates vary, is likely out for the season.

Next in line for a triceps tear this preseason was Denver Broncos' Jason Hunter. Hunter, who had only recently joined the first team at defensive end, suffered his injury during a training camp drill on the 14, and had surgery the following day. He was quoted as saying that "it was like 95 percent torn... They told me mine was hanging on like a piece of rope." This significant loss for Denver's defensive line follows two previous seasons in which they lost key linemen to torn muscles in the preseason -- in 2010 Elvis Dumervil tore his pectoral, while in 2011 Ty Warren also suffered the now popular torn triceps. Like his colleague from Tennessee, Hunter is likely to miss the season in spite of some reports otherwise.

Levi Brown, starting left tackle for the Arizona Cardinals, tore his triceps in an August 17 preseason game versus the Raiders. Initially expected to be out for 3 months, Brown will, like his colleagues, require surgery and will likely warm the bench throughout the season.

The Triceps

The triceps, as its name implies, is a three-headed muscle whose primary role is to exert a force to extend (straighten) the elbow. We rely on our triceps to push open a revolving door, to perform push-ups and to use crutches. A secondary role of the long head of the triceps is to assist with movement of the arm toward the body/midline (adduction) and assist with shoulder extension (movement of the arm toward or into the plane behind the body).

Located in the back of the upper arm, the longest head of the triceps originates on the scapula (shoulder blade) at a point below just below the socket for the humerus bone. The lateral and medial heads of the triceps originate at points on the surface of the humerus itself. The medial head has an intimate relationship with the radial nerve, which innervates the entire muscle.

At its lower attachment, the triceps inserts at the uppermost rear surface of the ulna bone of the lower arm; the ulna and the humerus form the elbow joint. The triceps also inserts into the of the forearm.


Surgery to repair the triceps is likely to shorten the muscle-tendon unit. In addition, the immobilization required in the early stages of recovery contributes to this problem while also resulting in loss of motion at the elbow joint, particularly restricting the amount of flexion (bending). Bending the elbow puts the triceps muscle on stretch. Disuse in the early phase of recovery leads to muscle atrophy and weakness, not only of the triceps, but also of the other muscles of the shoulder girdle and upper extremity. Rehab addresses all these issues as well as focusing on controlling inflammation and swelling (particularly early on) and working to enhance soft tissue mobility. Once strength, mobility and flexibility are sufficiently restored, an athlete will get into sports specific training before returning to competition.

Wishing a full and straightforward recovery to Amano, Hunter and Brown...