What is the condition?

Snapping triceps syndrome is a mechanical problem where part of the triceps tendon or muscle slips over the bony prominence on the inner side of the elbow during bending and straightening. This creates a visible or palpable 'snap'.

 

It is often associated with ulnar nerve subluxation, where the ulnar nerve itself also moves out of its groove with elbow flexion. Because of this, snapping can cause both mechanical symptoms and nerve symptoms.

 

What are the symptoms?

A snap or clunk on the inner side of the elbow during flexion and extension is typical. Some patients can reproduce this reliably.

 

Pain can occur locally on the inner elbow. If the ulnar nerve is involved, tingling in the ring and little fingers, hand weakness, or night symptoms can occur.

 

How is it diagnosed?

Diagnosis is usually clinical. The elbow is examined dynamically while bending and straightening to see what structure is snapping.

 

Dynamic ultrasound can be helpful to confirm whether the ulnar nerve, triceps, or both are moving abnormally and to assess anatomy for surgical planning.

 

Non-surgical treatment

Mild cases can be managed with activity modification and physiotherapy, particularly avoiding provocative repetitive snapping. However, if snapping is frequent and painful, or if there are significant ulnar nerve symptoms, surgery may be recommended.

 

Surgical treatment

Surgery is tailored to the cause. It may involve addressing the snapping portion of triceps and stabilising the ulnar nerve. If the ulnar nerve is unstable or symptomatic, anterior transposition may be considered.

 

Recovery and rehabilitation

Recovery depends on the exact procedure. Early motion is usually encouraged, but high-load strengthening is staged. Nerve symptoms can take time to settle, particularly if they were present for a long period.

 

Expected outcomes

Many patients experience resolution of snapping and improvement of nerve irritation when the underlying mechanical cause is corrected.

 

Risks and complications

Risks include infection, stiffness, scar sensitivity, persistent snapping, and persistent or recurrent nerve symptoms.

 

When should I seek urgent review?

Seek urgent medical review if you develop increasing redness, heat, rapidly worsening swelling, fever, increasing pain that does not settle with rest, or new weakness or numbness in the hand. If you have had a recent injury and the elbow looks deformed, feels unstable, or you cannot move it, this also requires urgent assessment.

 

Surgery, Risks and Recovery

Surgery is considered when symptoms persist despite appropriate non-operative treatment, when imaging or nerve studies confirm structural pathology, or when weakness, locking, or mechanical symptoms are present.

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Operations are usually performed as day procedures under regional or general anaesthetic. Techniques depend on the underlying condition and may involve tendon debridement or repair, arthroscopic bone spur removal, loose body excision, fracture fixation, ligament reconstruction, nerve decompression, or joint replacement.

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General risks include infection, bleeding, stiffness, scar sensitivity, nerve irritation, persistent symptoms, recurrence, and the need for further surgery. Condition-specific risks are discussed prior to surgery.

Recovery varies according to the procedure performed. Gentle motion is usually encouraged early. Wounds typically heal within two weeks. Light activities resume over two to four weeks for minor procedures, while larger reconstructions or replacements may require several months of rehabilitation.

Patients often notice improvement within six to twelve weeks, although full recovery may continue for up to a year depending on the pathology treated.

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What does the rehabilitation/recovery involve?

To find out more about rehabilitation and recovery after elbow surgery please see our Rehabilitation Protocols here.

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