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Tag Archives: humerus

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 2nd 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 wasDenver 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 14th, and had surgery the following day. He was quoted as saying that “it was like 95% 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 17th 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 ulnabone of the lower arm; the ulna and the humerus form the elbow joint. The triceps also inserts into the deep fascia of the forearm.

Recovery

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…

Follow Abby on Twitter @abcsims

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 2nd 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 wasDenver 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 14th, and had surgery the following day. He was quoted as saying that “it was like 95% 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 17th 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 ulnabone of the lower arm; the ulna and the humerus form the elbow joint. The triceps also inserts into the deep fascia of the forearm.

Recovery

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…

Follow Abby on Twitter @abcsims

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Roy Halladay’s Lat Injury

Philadelphia placed Roy Halladay on the disabled list yesterday with a Grade I strain of the latissimus Dorsi (generally referred to as the lat muscle). Though not an injury we generally hear too much about, the lat plays an integral role in the pitching motion. What is surprising is that there aren’t more diagnoses like Halladay’s.

Halladay reportedly contended with periodic shoulder stiffness all season, though complained of soreness only recently. His uncharacteristic lack of success now appears related. To be sure, as pitcher injuries go, Halladay’s could be much worse. This one requires only rest and rehab. For the record, the terms muscle strains and tears are essentially synonymous, and are graded from I – 3, with a grade one being a minor disruption of the muscle fibers and a grade three being a complete rupture.

Where is the lat and what is its role?

The latissimus dorsi is a very broad muscle that spans much of the back. It has an expansive connection to the spine (via fibrous tissue that attaches muscle to bone, much as tendons generally do) at the lower 11 vertebrae and sacrum, as well as to the posterior (rear) crest of the pelvis, the lowermost ribs and to the tip of the scapula (shoulder blade). –The

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lat reaches all the way to the front of the shoulder, inserting at a groove of the humerus (the bone of the upper arm), in the same region as the tendon of the pectoral muscle.

The primary roles of the lat are to extend the shoulder (drawing the humerus backward), to adduct the shoulder (drawing the humerus toward the body) and also to rotate the humerus inwardly (medially). Because of its attachments, the lat can also pull the lowermost point of the shoulder blade downward and backward.

Studies have shown that the latissimus dorsi acts

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primarily to extend and internally rotate the humerus in the later phases of the pitching motion. It is integrally involved in the preparation for, and execution of, the acceleration that occurs before the release of the ball. The lat’s other functions are considered to be of lesser importance to the overall pitching motion. The lat is thought to be most vulnerable to injury during the cocking phase of pitching where it is acting to extend while also lengthening, in what is termed an eccentric contraction.

Follow Abby Sims on Twitter @abcsims.

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