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Torn distal biceps tendon

mje
I am 38 years old, 150 lbs, and weight train and exercise.  I am in very good condition.  Two months ago, however, I completely tore my distal biceps tendon at my left elbow while improperly lifting some drywall at my construction job.  At the time I didn't realize the extent of the injury.  I iced it, rested it, and after a few days gradually began using my left arm again.  A few later a friend encouraged me to see an orthopoedic surgeon.  He recommended an MRI.  The MRI showed a complete tear. I decided to have surgery to repair the tear.  However, since the injury was approximately two months old, the surgeon would have to insert the biceps tendon to the same insertion as the brachialis muscle, since too much time had passed and the biceps tendon had already begun to atrophy.  The surgery was supposed to have been today (8/16/05) except when I went in for my pre-op appoinment yesterday, the surgeon, after physically examining my arm, said that my biceps tendon had scarred down and healed almost exactly where he would have inserted it surgically.  Doing the surgery, according to him, could not improve what has already been accomplished naturally.
Is that really possible?  No additional MRI was recommended to verify that the tendon has indeed healed correctly.  Should I insist for another MRI?  At mt original consultation he did mention spontaneous healing by scarring down, so the idea is not foreign to me.  But I have been using my arm extensively over the past 5 weeks since I first met with the surgeon and had my MRI.  Can it heal in that amount of time?
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Avatar universal
Hi
Has your bicept shape gone back to normal . Or is it still coiled up towards shoulder? I torn my bicept at elbow full tear . Had op and now the bicept still looks like it did when it snapped. Is this normal
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Avatar universal
Is your bicept the same in size before the injury. Or does it look coiled up towards the shoulder( Popeye arm)
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Avatar universal
I tore the tendon in March while skiing. Thought I was 100% July but in August something happened & it's back. Had the MRI done, (now October)  Dr said partial @ elbow but in all actuality he said its probably strands holding it. Reccomends surgery through the bone to reattach. I'm 45 and want to be 100% as well as afraid to have a failing limb in my elder years.  Didn't even think about shoveling till I read it above. Afraid of gaining the weight I lost over recent months... Advice?
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Avatar universal
I'm from the UK as well and I'm 99.9% sure I tore my distal bicep last Friday in the gym. I'm seeing an orthopedic doctor on Friday. If I do need surgery, who is this surgeon who is suppose to be the best in the UK? Could you please give me his name and contact details. Thanks, Julio.
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Avatar universal
Thanks for the comment. You are he first person I found that has not had the surgery done and you give me some confidence that I may have made the correct decision. I ruptured both of my distal bicep tendons at the same time and did not notice any significant loss in strength. I was told I would suffer permanent weakness during supination will occur if this tendon is not surgically repaired. I am a Tool and Die maker and have noticed very little
loss in suprination strength or loss of motion.
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Avatar universal
I tore my right distal biceps tendon 4 years ago due to improper form while bowling with my son.  Amazingly, I was on the golf course playing the next day with no impairment.  I briefly considered seeing a doctor, but when use of the arm continued without more than minor difficulties, I never saw a doctore for it.  I too have noticed a difference in the shape of the biceps.  The only problem I have with it is when bending the arm and lifting anything fairly heavy at the same time, it tends to cramp with me.  As for the golf, I am now 60 and have shot the two lowest scores of my life within the last year.  I guess that puts me on the side of those suggesting the self-repair capabilities of the body.
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5109246 tn?1363725317
I'm 45 I completely ruptrured my right distal tendon TWO YEARS AGO--I just had surgery two weeks ago---so far I am still in a half cast and a sling.
I waited so long because 2 docs told me I would still have 80% functiobality etc....they were wrong, It was not getting better, it was getting worse, it was swell and bruise if I did anything at all so I had to try surgery---we will soon see how effective it was after 2 years....
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Avatar universal
HEY I TORE MY LEFT DISTAL BICEP 8 DAYS AGO AND WAS IN THE THE OPERATING ROOM AND WALKED OUT BECAUSE THE NURSE COULDNT GET THE IV IN 2 TIMES AND WAS WALKING UP MY GOOD ARM WITH THE NEEDLE I AM 50 YEARS OLD AND AFTER A WEEK IT FEELS BETTER EXCEPT FOR A BULGE IN LEFT  LOWER BICEP AND BRUISE FROM THEIR DOWN MY FOREARM MID WAY.IAM RETIRED USARMY AND I WILL TAKE MY CHANCES AND REHAB MY SELF IT HAS TO BE BETTER THAN SURGURY AND REHAB THANKS JOHN
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2 Comments
you will lose 40-50% strength in that arm and will lose the use of your bicep. You will lose most of your rotational strength in that arm. As time goes on the scarring will begin to affect the brachialis muscle and your strength will further degrade. I honestly cant understand why anyone would not repair a total distal bicep tear. You can not rehab a total bicep tear even with Physical Therapy you cant rehab a muscle that is no longer attached to the bone.
You're not likely to ever find out if you're right, but it would be fun to know -- this post is 6 years old and it's unlikely anyone on here is still around, but it would be fun if the poster is still around to say whether you're right or not.
Avatar universal
Guys i hurt my triceps months ago im only 13 n i continued doing pull-ups it doesnt really hurt that much n i hear my muscle vein break* a few weeks back n started to get scared. do my triceps heal/scar by itself or it permanent pls reply im terrified
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Avatar universal
15 days max, then it scars in place. I had mine repiared at the 15th day. You need to have it looked at the day you hurt it, then it starts with Xrays, MRI's, Pre surgery testing, all this takes around a week to see all these docs, and flip flop paperwork around, and stuff to be aproved, exp if workmans comp like mine,lol. So ASAP is the answer your looking for, max 15 days till surgery,
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Avatar universal
Enough about life AFTER surgery!  Can anyone answer the question:

WHEN IS IT TOO LATE TO HAVE SURGERY - Time wise in months...weeks, etc.  

Please.  Does anyone have an answer?  
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Avatar universal
Do you know how bad a partial tear has to be in order to get surgery? I have had a partially torn bicep now for literally over about 2 months, if not a couple weeks longer....i went to the doctors after 2 weeks of lifting pain and just plain pain in bicep, and he said it could STILL take up to an additional  6 weeks...it's been 6 weeks and it still hurts a TON after for example holding a 15 pound baby, hurts on its own still, and hurts to put really any pressure on it...like i def can't do pushups or leaning on my arm......do you remember anything that the doctor said about when to get a partially torn bicep repaired surgically, or when to just let it heal on its own??? Thanks!
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Avatar universal
I too had a near to complete tear of the distal bicep tendon in 2010 doing a routine judo throw.  My doctor kept telling me it was tendinitis even though I heard it snap and felt like someone jammed a knife in my arm.  Unfortunately for me it took >2months for managed care to get me into an ortho for a consult and an MRI.  I think I am lucky because I don't feel a great deal of difference except I get soreness easier and an occasional ping of pain.  I still workout but not to the extent I used too.  My doctor at the time did not recommend surgery due to time lapse and quick gains in recovery.   I'm not sure if i would have benefited from surgery or not but I guess its a mute point now.  
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Avatar universal
2 weeks ago I felt and heard the snap, and knew something serious had happened.  I had an xray the next day, hospital nurse said bone was fine and it's just a sprain.  A couple days later (after googling and forum reading) I went to the doctors.  He said a sprain too...even though my inner elbow was looking "odd" but I didn't have the popeye bulge.  He said give things a couple of weeks.  Instead, I waited out 2 days and started phoning around private surgeons/ consultants.  As anyone reading this forum knows, after a tendon rupture you have a 2 week window before tendon graphs are required for surgery.  Anyway, I finally saw someone who knew what they were talking about and had an ultrasound... Much cheaper than MRI and you can move your arm around so they can see more.  Tear confirmed.  I had a full distal tendon bicep repair 2 days ago.  I'm in a cast, but my surgeon wants that to come off after 5 days and for me to start moving my elbow.  He's recognised in the uk as one of the leaders in this area and writes medical papers on the subject... So I trust him!  It hurts, it's not fun writing this with my left hand, but I feel good that I did something about it and, with luck, on the road to a full recovery.  By the way, he said I didn't get the popeye effect because my tendon had caught on something so didn't retract fully, but it was fully detached.
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Avatar universal
I had a partial tear of my distal bicep tendon several months ago.  At the time of the injury , I went to the doctor where they took an x-ray.  They sent me home with an ice pack telling me that it was probably a muscular tear and that it would repair itself after a while.  Thinking that was the case I worked trhrough the pain and weakness.  A client of mine, a radiologist, highly sugested that I have an MRI and diagnosed the partial tear. I'm looking at having surgery but i need to find someone in the Houston area that will perform a surgery for an injury that is more than a few weeks old. My arm is very important to me (not that it wouldn't be to everyone else) but It's how I make my living.  I'm an ornamental blacksmith and I'm constantly lifting very heavy things and hammering for hours at a time.
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Avatar universal
I had a partial tear to my dominant arm distal bicep tendon.  Diagnosis was missed until the third doctor, which was three weeks post-injury.  Strength actually was pretty close to normal at that time so long as I was not doing motions that really isolate the bicep.  Things like turning a screw driver or curling a weight with the palm up had very reduced strength still after 3 or 4 weeks.  That was with the arm extended, if I had the arm bent at about 90 degrees I still had pretty good strength.  I didn't have much of a different appearance in the arm since it was partial, but I could tell that I already had some atrophy because part of the bicep couldn't really contract normally.  I could play golf near normally before surgery but I do some long drive competitions so dialing back on the power still allowed for golfing without any issues.  The day before surgery I gave it a pretty good swing and there was definitely noticeable discomfort and I wouldn't have wanted to do any kind of long driving without the repair.  Because of my job [police] I elected for the surgery since the recovery without was progressing very slowly and doctor said it wasn't going to ever be back to normal because of the injury.  A 30 -40% strength loss in supination/pronation was too much to accept.   As I write this I am 5 weeks post-op and getting brace off next week.  Never had a bit of pain from the surgery.  Had full feeling in the arm once the nerve block wore off.  I won't recommend having surgery or not having surgery.  Yes, there can be complications, but generally the surgery and recovery are very succesful, particularly if it is done soon after injury.  Mine was done 5 weeks post injury and since it was a partial tear, there was no scarring issues or need of a grafted tendon.  The physics are what they are, your arm will not have normal strength in all aspects if you have a tear, regardless of rehab and healing.  Some people can accept a certain level of disfunction, fatigue, and strength loss, but athletic types probably will be better served getting surgery.  Make your decision based on what you learn and believe is best.  The tendonsurgeryinfo.com website has lots of info on this injury, mostly people that have had the surgery, some who elected not to.  
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Avatar universal
Hawaiianhost - What age and how did you rupture your distal biceps tendon
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Avatar universal
Had the surgery and it was originally fine
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Avatar universal
I  had a complete distal bicep rupture, I had surgery. Still got a little paid in forearm area. My wrist gets sore at times since. Also my shoulder. How long before all is gone, anyone??
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1337014 tn?1275755343
Torn my biceps at the shoulder,doctor said not to bother.Oh well old age is a bummer.

Could the other tendon left torn as well on the same arm ?
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Avatar universal
If you can see deformation and bruising in the area of your biceps, then you probably have fully ruptured the distal biceps tendon.  If this is the case, then your biceps WILL NOT RECOVER, as it is no longer attached to anything at its distal end.  You NEED to talk to an orthopedic surgeon ASAP if you want to regain full strength in your arm.  Supination strength in particular can be severely affected by this injury.  It is not uncommon to feel little pain within a few days of injury.

In the case of a full rupture, surgery typically is done within a few weeks of injury.  Otherwise the tendon eventually retracts, which can make reattachment at the radial tuberosity impossible without use of a graft.

I'm two years post-op and have no regrets about the surgery.

Brian
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Avatar universal
MEDICAL PROFESSIONAL
Hello!

You have no pain and movement issues after 2 weeks of rest; now with physiotherapy the strength of the biceps muscle should return.

Take an opinion near an orthopedician if you have any complications and keep surgery as the last option.

Take care!
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Avatar universal
On 4/24/2010 after doing 50 pullups over a period of 30 mins I was removing a pole from a ski boat pulling with my right arm. I heard a pop @ my distal bicep. The pain was very mild and did not last more that a day. Ihad swelling and brusing on my right arm but full rotational use altho I was limited with what I could lift. I had a self imposed rehab where I lifting nothing for two weeks.
Now I am back doing pull ups and curls to build strengh in the right arm.
The bicep is somewhat distored in the under tension location. I have no pain or movement issues.
1. Will the strg in the bicep return as before ?
2. Is surgury an option.
Doug  in Mullins SC
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Avatar universal
MEDICAL PROFESSIONAL
Hello!
You should go for conservative approach and try to heal the partial tear with physiotherapy.
If conservative approach fails:  then surgery is an option, always take a second opinion before surgery. Always ask the surgeon to explain the pros and cons in detail before going ahead.
Take care!
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