Question
Hi there,
I am currently recovering from a broken ankle, and did not lift weights during the first four weeks of my recovery.  However, about a week ago, I decided to do a bicep workout.  About an hour after the workout, I tried to bend my left arm back and scratch my back with my left hand, and I felt a sharp, intense pain in the area of my lower tricep near the elbow.  Since then, I have felt a tingling sensation in my left triceps when I am on my crutches, and tonight I moved my arm backwards and suddenly felt a sharp, burning pain in my lower left triceps. The tingling is not constant, but when I first get out of bed or off the couch and get on my crutches, I feel the odd tingling sensation.    
I was just curious what might be causing this? I hypothesized that it might be a partial tear of my triceps or triceps tendon, but this is just a guess.  I was also wondering what you think the healing time for an injury such as mine might be?  Thanks a lot for the help.

Answer
Dear Kirk,

It is not likely that your tore your tricep without an injury mechanism such as  a trauma or a pop while working on the tricep musculature.  What is more likely is a strain of the tendinous attachment to the bone which can easily cause the symptoms you have described. Either way, bit injuries will need some rest to allow the acute inflammation phase to pass so that scar tissue can start to repair the area.  

If tendinitis is the main issue, then this is due to overuse type activities...if there is a small tear the result is the same...you need to limit full motion initially while working up to full motion gradually over a two week period, without strain.  After that time, active muscular contractions are  needed to start regaining strength and stressing the scar tissue so that it will become stronger.  A graduated return to full activity and weight lifting will take time and should be accomplished with care...do not over do it, and progress in a pain free range of motion.

Concerning the tingling in your arms when you are on crutches, this is probably due to the brachial plexus nerve being encroached or compressed while the crutches are under the arms applying pressure. This is usually compression of the axillary or radial nerve.  The first thing you need to do is make sure that the crutches are sized properly...you should not be leaning into the armpit.  The pressure should be in your hands, and the crutch should be two inches below the armpit when in use.  You may further wish to add padding to the top of the crutch to minimize pressure on the armpit.  You should see the tingling symptoms improve immediately.

Hope this helps Kirk.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net