Breaking Down John Cena's Triceps Surgery and Possible Return Date for WWE Star

Will CarrollSports Injuries Lead WriterAugust 22, 2013

Photo courtesy
Photo courtesy WWE.comAndrew Weber-USA TODAY Sports

One doesn't often see a sports injury push aside the latest antics of the Kardashians from a pop-culture site like TMZ, but John Cena managed to do it. A terrible triceps tear rolled up like a lampshade, leaving his elbow unlike many have ever seen, but not gruesome enough to scare off housewives.

In fact, Cena's SummerSlam matchup where he gave up the title to Daniel Bryan could be the last time we see Cena in the WWE ring for up to six months after surgery Wednesday to reattach the muscle. We have to give credit to Cena for going through with the match despite the condition.

Cena injured his arm in the ring in July, though many viewers did not know it had occurred. By Monday night, the arm had "rolled up" and, along with fluid, created a grotesque shape. At least one of the three muscles that make up the triceps, torn and not held in its normal place, had been pulled down into the elbow, as clearly shown in the picture.

Cena headed to Dr. James Andrews, like many top athletes. While some may be surprised that the top sports medicine doctor is dealing with a WWE "entertainer," this is increasingly common. Andrews has done multiple surgeries on wrestlers, including Paul "Triple H" Levesque. Triple H had a serious quad strain that needed to be surgically repaired. He also recently worked on CM Punk. 

Interestingly, this wasn't the first time Andrews had worked on Cena's elbow. Andrews removed bone spurs and cleaned the elbow up in 2012. This injury is clearly not related to previous surgery, though many have forgotten that Cena has had issues with the elbow in the past. 

The surgery itself is pretty straightforward, but difficult. The muscle had to be pulled from where it had seated itself and put back into the proper anatomical position. The muscle-tendon junction was then reattached with sutures and fixators. This part is the most difficult. Imagine trying to sew a raw steak back together and you'll understand why even a world-class surgeon like Andrews can't guarantee results.

The key is often where the tear occurs. If the tendon detaches, but the muscle itself is intact, it is easier. The tendon can be prepped and reanchored more easily than the muscle itself can be reattached to itself. The closer to the belly of the muscle, the more fibers are involved and the tougher the fix. 

The triceps itself is made of three muscles and there's some level of redundancy, but there is going to be some loss of strength and function. The body rebuilds itself with scar, not new muscle, so there will always be a weaker area inside the affected muscle. Cena will have to compensate for this by building up the existing, healthy muscle. He appears to have plenty to work with.

Cena's style isn't going to require a major adjustment. He's a power athlete, but has enough athleticism to not rely on pure power moves. He may not press an opponent above his head any time soon, but he still should be able to have enough strength to go through most of what he does. In fact, it's clear that Cena has been adjusting his style for some time. 

Cena will begin rehab immediately and could be back in as short a period as three months, if it's fair to compare Cena to an NFL player like Ray Lewis, who had a similar issue last season. It's more likely that he will be given longer due to his age and storylines.

Bringing Cena back ahead of the Royal Rumble would put him in his normal position and give the WWE another chance to push their star back toward the top.