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 trochlear. 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 people have an extra tendon from the inside or medial part 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 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. Also, the ulnar nerve is close to the snapping muscle, causing pins and needles and numbness in the outer hand.
How do you make a diagnosis of snapping elbow syndrome?
Generally, people report elbow snapping or popping, especially when bending the elbow. Often, pain is reported on the inside of the elbow. In addition, symptoms of ulnar nerve irritation, such as pins and needles and numbness in the ring and little fingers, are also present.
When examining the elbow, we often find tenderness on the inside. We try to reproduce the snapping by resisting triceps manoeuvres.
Usually, we use dynamic ultrasound to confirm a diagnosis of snapping triceps syndrome. In addition, ultrasound can show ulnar nerve damage, thickening, or dislocation.
Overall, it is essential to rule out other causes of snapping or clicking in the elbow, such as loose bodies or arthritis in the elbow joint.
Why does my elbow pop when I extend it?
Popping when you extend the elbow is not secondary to ulnar nerve dislocation or snapping triceps tendon; these conditions cause snapping when flexing the elbow. Popping secondary to extending the elbow is more likely to be a loose body, 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 those exercises that cause snapping of the tendon. For example, we recommend modifying chest and closed chain triceps exercises that are more likely to cause snapping in weightlifters. Examples of closed chain exercises include closed grip press-ups and closed grip bench presses. Alternatives include cable overhead tricep extensions and tricep kickbacks.
In addition, stretching and soft tissue techniques directed to the triceps muscle might help reduce snapping.
In cases that fail conservative treatment, we often suggest surgery. Firstly, we release the irritated ulnar nerve and move it to the front of the inside of the elbow. Secondly, we cut the tendon and reattach it to the main tendon in cases with an extra inside tendon. Generally, it takes 2-3 months to fully recover from this surgery, although most completely recover. 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 see an experienced doctor who can diagnose triceps snapping syndrome and suggest treatment options.
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