Baltimore Ravens
The Baltimore Ravens were a popular pick to make the Super Bowl. Can they overcome the lost of their longtime leader Ray Lewis?
The Baltimore Ravens have been many experts’ Super Bowl Pick even before the NFL season started. Considering their AFC leading 5 – 1 record, these predictions don’t seem far-fetched. However, their latest victory, a 31-29 defeat of the Dallas Cowboys, might have hurt those chances.

Head coach John Harbaugh informed the media on Monday that linebacker Ray Lewis suffered a triceps tear. Jay Glazer of Fox Sports added that an MRI revealed the injury to be “a complete tear”.

With about two minutes left in the fourth quarter and the Cowboys driving for a potential game-tying drive, Lewis appeared to make a routine tackle on running back Phillip Tanner. After he wrapped up the ball carrier, Lewis walked to the sidelines. He missed the ensuing two defensive drives, while the Ravens medical staff evaluated his arm.

Watching the replay, it is difficult to tell exactly what caused the triceps injury. Typically an athlete tears the triceps tendon off the olecranon (tip of the elbow) with a sudden movement. He often goes to straighten his elbow against resistance. If the triceps contracts but the elbow can’t extend, that eccentric force could injure the muscle or tendon. Alternatively, a sudden force, such as another player, could bend the elbow quickly while the player is trying to extend it.

Triceps tendon
The triceps tendon (orange arrow) inserts into the olecranon, or the tip of the elbow. Injuries to the triceps tendon typically involve the tendon pulling off the bone.
It is difficult to know what the Ravens mean exactly by complete tear. Either the MRI has shown a complete tear of the triceps muscle fibers in the back of his arm or, more likely, the team doctors found that the tendon that attaches the muscle to the bone at the tip of the elbow has pulled off.

Where the injury occurred specifically does play a huge role in treatment. Muscle belly injuries often heal on their own, while avulsions of the triceps tendon almost always require surgery to reattach the tendon. The surgeon makes an incision over the tip of the olecranon, exposes the tendon end, and reattaches it to the bone with stitches and anchors or tunnels in the bone.

Despite these surgeries being outpatient procedures, recovery is lengthy. The surgeon has to protect the elbow and limit motion as the repaired tendon heals. As the repair gets stronger, motion of the elbow can be increased. Then strengthening of the triceps and return to functional activities can be progressed. The overall rehab process to return to lifting weights and playing football can take 3-6 months.

Recovery from these triceps injuries and surgeries is usually likely, but it is a long, difficult recovery. Working for months to regain strength and the ability to play at a high level can be difficult for younger athletes. It would seem to be even more daunting for a player who is 38 years old.

The Dr. David Geier ShowRay Lewis’s triceps rupture: That’s Gotta Hurt segment from Episode 61 of The Dr. David Geier Show.

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It’s unclear what the future holds for Lewis, who was competing in his 17th NFL season. Questions undoubtedly will arise about whether Lewis should or will retire. As intense a competitor as Lewis has been his entire career, he might push through the lengthy rehab to play again and retire on his own terms.

The Ravens must also decide how to adjust to Lewis’s loss. Despite perennial Pro Bowl appearances by Lewis, the once vaunted Baltimore’s defense ranks 23rd against the pass and has allowed 200+ yards on the ground for consecutive two weeks. Perhaps more important from a football standpoint, the Ravens also lost their best cornerback, Ladarius Webb, to a torn ACL Sunday as well. It will be up to Dean Pees and the rest of the defensive coaching staff to become more creative with their personnel and play calling after injuries to their marquee defensive players.