Snapping elbow syndrome, also called triceps snapping syndrome, is a rare cause of elbow pain. As such, it is often misdiagnosed and treated incorrectly. Also, not all elbow snapping or popping is due to snapping elbow syndrome. So what is snapping elbow syndrome, and what should you do about it?
What is snapping elbow syndrome?
The elbow joint is a complex hinge joint between the upper arm or humerus and the forearm bones, or the radius and ulna. The triceps muscles are composed of the long head, lateral head, and medial head. Generally, the three muscles form one large tendon that attaches to the tip of the elbow. However, some individuals have an additional tendon from the medial aspect of the muscle.
Snapping elbow syndrome should be called the snapping triceps syndrome. Snapping of the triceps occurs when you bend the elbow. During elbow flexion, the inside part of the triceps muscle and tendon will snap against the inside of the elbow. Snapping is more likely if there is an extra tendon from the medial triceps. If this snapping occurs repeatedly, inflammation develops inside the elbow, causing pain. Additionally, the ulnar nerve is adjacent to the snapping muscle, resulting in paresthesia and numbness in the lateral hand.
How do you make a diagnosis of snapping elbow syndrome?
Generally, individuals report elbow snapping or popping, particularly during elbow bending. Pain is often reported on the inside of the elbow. In addition, symptoms of ulnar nerve irritation, such as paresthesias and numbness in the ring and little fingers, are present.
When examining the elbow, we often find tenderness on the inside. We aim to reproduce snapping by performing triceps manoeuvres.
We usually use dynamic ultrasound to confirm a diagnosis of snapping triceps syndrome. In addition, an ultrasound can show ulnar nerve damage, thickening, or dislocation.
Overall, it is essential to exclude other causes of snapping or clicking in the elbow, such as loose bodies or arthritis of the elbow joint.
Why does my elbow pop when I extend it?
Popping with elbow extension is not secondary to ulnar nerve dislocation or snapping of the triceps tendon; these conditions cause snapping during elbow flexion. Popping secondary to extending the elbow is more likely to be a loose body, OCD of the elbow, arthritis in the elbow or elbow plica syndrome.
Snapping elbow syndrome treatment: Do you always need surgery?
Generally, we recommend a trial of conservative treatment before considering surgery.
You should avoid exercises that cause tendon snapping. For example, we recommend modifying chest and closed-chain triceps exercises to reduce the risk of snapping in weightlifters. Examples of closed-chain exercises that can increase snapping include press-ups, dips and bench press. Alternatives include cable-overhead triceps extensions and triceps kickbacks.
In addition, stretching and soft-tissue techniques targeting the triceps muscle may help reduce snapping.
In cases that fail conservative treatment, we often suggest surgery. First, we release the irritated ulnar nerve and move it to the front of the inside of the elbow. Second, we reset or reposition the subluxing medial triceps muscle. Generally, it takes 2-3 months to recover from this surgery, although most patients recover completely. Risks are rare but include infection, nerve damage, and continued snapping.
Final word from Sportdoctorlondon about snapping elbow syndrome
Snapping triceps syndrome is a rare cause of elbow snapping or popping. You should consult an experienced physician who can diagnose triceps snapping syndrome and recommend treatment options.
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