What is Biceps Tendon Rupture?
First of all, a rupture is simply a tear.
Second, a tendon is connective tissue that connect muscle-to-bone. (As opposed to a ligament that connects bone-to-bone.)
The Biceps is the muscle at front, closest area of the arm. A Bicep tendon is both at the top connecting to the shoulder area or the bottom at the elbow area.
Most patients will have a bicep tear after lifting a heavy object quickly or jerking (pulling) their arm. The pain is usually not that bad. Patients will notice a weakness in their arm and what looks like a ball at their bicep area
Putting this all together, this is a bicep tendon tear or torn bicep.
Quickcare or ER?
As bad as the tendon tear looks, this can easily be seen in a clinic. That is, it is not an emergency where time is of the essence. Edna ( see story below) waited 2 weeks just to get the orthopaedic appointment.
Conditions that will send you to the ER:
- Severe pain
- An open wound
- Loss of pulse
What will your doctor ask?
Your doctor will want to here your symptoms. Remember, a symptom is your description of your condition to your doctor. It is your story.
Answering the following questions will help your doctor understand.
- When did it happen?
- How did it happen?
- Is it painful? Do you have bicep pain?
- Do you have weakness of the arm?
What will your doctor look for?
Your doctor will look for signs. Remember, signs are objective findings that a doctor discovers on examination.
The bicep muscle is kind of interesting The best way to look at the function is this: Think of opening up a corked bottle of wine. To pull out the cork, you have to grab the cork, turn your palm up an then flex at the elbow.
So your good doctor will test your strength as you bring your hand to a “palm up” position and when you bend the elbow
What is your doctor thinking?
Your doctor will create a mental list of possible reasons for your signs and symptoms. This list is called the differential diagnosis.
As mentioned above, the tear can be at the tendon closest to the shoulder or closest to the elbow
If the tear is closest to the elbow, marked weakness occurs.
If the tear is closest to the shoulder, much of the strength is preserved because other muscles ( brachialis and supinators) pick up the slack
Surprisingly, most patients are not in severe pain. There is pain at the site of the tear
Without a clear-cut tear, bicep tendonitis could be the cause of pain.
What is the treatment of bicep tendon rupture?
The only way to treat this is via surgery. I have only referred patients to orthopaedic doctors for the surgery.
Physical therapy is not going to resolve this injury
There are no shots or pills that will heal it up
How long will you have a bicep tendon rupture?
I have seen some persons with this ailment and never get it fixed. They cannot function as well, of course. Usually they have a “I don’t bother it. It don’t bother me”
Let me tell you a story
It seems like in medicine, everything comes in 3’s. When I just started my medical career, I thought this was just an old cliche.
In the ER, this trend happened all the time
I can’t count how many times, after pushing back in a dislocated shoulder, there were two more to follow.
The same was true for a family stories…
During a very quiet shift, I had the luxury to just sit and talk to my patients. No rushing in and out. I was able to listen. The first couple was retirement age. Right away they started off talking about their recent trip to Puerto Rico. They brought their entire family except their son who unfortunately died in a motor vehicle accident. 17 years old. Drinking and driving mixed with raging hormones are a bad combination.
A few hours later, I walked in to a treatment room, where a older man with a hair dyed jet black paced the room. His shirt was wrinkled, his pants were dirty. Shoes were untied. “Look at me, doc. Look at me!…I was never like this. I used to be ‘styling’. You know? But once they killed my son three years ago, they tore out my heart.” He was clutching his chest. His eyes welled up. His wife with matching jet black hair was in the exam. She kept her head down. The pain of loss was palpable. It bounced off the walls.
Everything comes is 3s. For a slow night, this shift was heavy
My very last patient, Edna, was a clean, pleasant local federal worker. Edna looked like she had never done a hard day’s work in life. Just looking at her pleasant soft feature, you never know the heavy tragedy that her heart carried. Less than a year had passed when her only son was hit by a car while he was riding his bike. “Doctor Reyes, you just cannot believe the shock.” She continued: ” As part of my therapy, I started to go back the gym and now look.” She stuck out her arm. It looked like she had a tennis ball at her bicep muscle.
With the bicep tendon next to the shoulder ruptured, Edna was able to just carry on with her daily activities until surgery followed two weeks later.
I hope this helps