Triceps tendonitis is inflammation of the triceps tendon, the tissue that connects the triceps muscle on the back of the upper arm to the back of the elbow joint, allowing you to straighten your arm back after you have bent it.
Triceps tendonitis is characterized by a pain or aches in the triceps area, elbow or shoulder, swelling, weakness, reduced arm movement and a bulge near the elbow.
Triceps tendonitis can occur due to an acute injury or repetitive overuse. Activities that can lead to triceps tendonitis include:
- Throwing a baseball
- Using a hammer
- Performing bench presses
- Falling onto your outstretched arm
Risk factors for developing triceps tendonitis include using anabolic steroids, medical conditions such as rheumatoid arthritis or diabetes, not warming up properly before exercise and not using proper technique while performing a repetitive movement.
Your doctor will conduct a thorough examination of your shoulder, arm, triceps and elbow to identify the site of inflammation and the movements that cause pain. X-rays, ultrasound and MRI scans may be suggested to confirm the diagnosis.
First-line treatment options include rest, ice, compression and elevation (RICE protocol).
- Rest: Restrict all activities that irritate or overuse the triceps tendon.
- Ice: Apply ice packs wrapped in a towel over the affected area for 15-20 minutes at a time to help alleviate pain and swelling.
- Compression: An elastic compression bandage is used to wrap and support the area to reduce swelling. Take care not to wrap too tightly which could constrict the blood vessels.
- Elevation: Keep the affected area elevated as much as possible.
- Non-steroidal anti-inflammatory drugs (NSAIDs) may also be recommended to reduce inflammation and pain. If first-line treatment does not work, your doctor may inject a corticosteroid directly into the affected arm or may recommend a platelet-rich plasma (PRP) injection and physical therapy.
If conservative treatment does not provide relief, surgery is performed. Through surgery the tendon can be cut and reattached to an area of the elbow called the olecranon (tendon repair) or may require grafting. With grafting, a bone graft (transplanted bone tissue) is placed on the damaged site to fill the gap after removal of the damaged tendon.
Avulsion Fractures of the Pelvis
What are Avulsion fractures of the Pelvis?
Avulsion fractures of the pelvis is an injury that occurs when a tendon or ligament pulls off a piece of bone from the hip. This results in a part of the pelvic (hip) bone breaking away from the main part of the bone.
Avulsion fractures of the pelvis are seen more in people who:
- Play sports or practice too hard too often
- Use the wrong technique during training or sports
- Are adolescents whose bones are still growing
Common Sites of Avulsion Fractures in the Pelvis
The pelvis is a ring of several bones located at the lower end of the trunk, between the spine and the legs.
The three most common sites for avulsion fractures in the pelvis are:
- Anterior Superior Iliac Spine: The large broad bone (ilium) forming the top of the pelvis
- Anterior Inferior Iliac Spine: The bony wing of the ilium (upper lateral part of the pelvis)
- Ischial Tuberosity: The V-shaped bone at the bottom of the pelvis
Although rare, avulsion fractures also occur at other parts of the hip such as:
- Lesser Trochanter: The bony projection from the lower or back part of the femur neck base
Causes of Avulsion Fractures in the Pelvis
Major causes of avulsion fractures can be:
- Sports or activities that involve speed and sudden stops
- Sudden and/or forceful contraction of the pelvic muscle
- A car accident or any accident that puts sudden stress on the hip
Signs and Symptoms of the Condition
The possible symptoms are any or all of the following depending on the severity:
- Swelling, redness and/or severe pain in your hip
- Limited movement and pain when you try to move the pelvis
- Popping or sudden pain in your hip or groin during an activity
- Trouble moving the upper leg, both back and forth
What if Avulsion Fractures of the Pelvis are Left Untreated?
If untreated, avulsion fractures of the pelvis could lead to:
- Instability of the pelvis
- Impaired mobility of the hip
- Loss of function in severe cases
- Sexual dysfunction due to nerve damage
How is the Condition Diagnosed?
Your doctor is likely to begin the diagnosis with the evaluation of your medical history and a physical examination of the pelvis. This may be followed by a standard anteroposterior (AP) pelvis radiography.
An X-ray or a CT scan to check for broken bones and a bone scan to determine the site of the fracture may be taken to conclude the diagnosis.
Treatment of Avulsion Fractures of the Pelvis
The condition is treated both conservatively or surgically depending on the degree of the fracture. The conventional treatments of an avulsion fracture typically include but are not limited to:
- Resting and icing the pelvis
- Controlled exercises (physiotherapy)
- Use of crutches or walker
- Prescription of medications
Most avulsion fractures are known to heal well without surgical intervention. However, you might require surgery if you are faced with situations such as:
- Unstable pelvic fractures
- Bone fragment far away from the main bone
- Dislocation greater than 2 cm
- Non-union of the bones
- Painful exostosis (bone spur)
- Failure of conventional treatments
Your doctor will choose the best possible surgery and may include:
- External fixation
- Skeletal traction
- Open reduction and internal fixation (ORIF)
The doctor will explain to you the details of each treatment depending on the requirement.
Prevention of Avulsion Fractures of the Pelvis
You can prevent avulsion fractures of the pelvis if you:
- Warm up and stretch before playing any sport
- Do not push yourself too hard during any sport
- Avoid making sudden movements (twisting or direction change)
- Do exercises that strengthen and improve pelvic muscles