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Triceps Tendinitis
August 2000

Q. My healthy 14-year-old, baseball playing son, recently began experiencing somewhat severe pain in his elbow when he fully extends his arm. Two visits to a sports medicine doctor ruled out UCL and direct joint problems primarily due to the location of the pain (above the back of the elbow, where the triceps muscle joins the triceps tendon). The current diagnosis is "triceps tendinitis." Extensive Internet searches have failed to turn up anything on "triceps tendinitis." Any suggestions on alternative diagnoses or treatment?

A. Hi there. You've found out that tendinitis is no fun for a pitcher, or any other athlete for that matter. It is referred to as an overuse injury, defined as "microtrauma due to repetition," meaning the tendon is intact, but some of the small fibers are disrupted and trying to heal.

The healing is a slow process because you still use the muscles and tendons in the triceps for daily activity. It is typical that pain occurs when the triceps muscles contract, or when they are stretched as occurs when you bend the arm. The general approach to treatment is as described, restriction from the activity that caused the trauma until some healing takes place, plus measures to relieve inflammation (ice, medication, physical therapy). In addition it is important to identify any other factors that might be contributing so as to minimize future occurrences. This means to ask the question, "Why did this injury occur now?" This might identify training errors (too much throwing, improper technique), equipment problems (the baseball is pretty standard in this case), and even anatomical factors (muscle weakness, muscle imbalance) that need further attention. For a young player in particular, best to decrease activity rather that risk a chronic problem.

For further information, please see the article "Sports and other soft tissue injuries, tendinitis, bursitis, and occupation-related syndromes." (Curr Opin Rheumatol. 2000 Mar;12(2):150-4). Or the book Sports Injuries, by Garrick and Webb. The following web site may also benefit you: http://www.rheumatology.org/patients/factsheets.html. Good luck!

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