I was pulling on a large cable underhanded and actually heard a 'pop' sound in my arm. I immediately dropped the cable and the pain extended from my wrist to my shoulder. My bicep seems to have moved upward and inward a little. There is a large bruising on the inside of my forearm. I went to the emergency room and was told a tendon was pulled. "Ice it down a couple times a day and take some inflammatories." I recently made an appointment with an orthopedic surgeon but it has been almost a week since the injury. Have any input on what I have done and what can be done about it?
Repetetive lifting and overhead reaching can lead to biceps tendonitis, which causes inflammation and partial tears of the upper biceps tendon.
Patients with biceps tendonitis typically complain of pain that is limited to the front of the shoulder. Pain may be worsened by lifting, overhead reaching, or both. Inflammation that persists chronically increases the risk of rupturing (tearing) of a biceps tendon. This may occur in up to 10 percent of patients with biceps tendonitis.
In people whose biceps tendon rupture, a lump can be seen and felt in the lower biceps muscle. Because the biceps attaches in two places in the upper portion of the muscle, a rupture usually causes only a slight decrease in muscle strength, and does not usually require surgery to repair the tear. Shoulder pain due to bicipital tendonitis is sometimes completely relieved after the rupture occurs.
Treatment of biceps tendonitis focuses on reducing tendon inflammation and swelling, strengthening the biceps muscle and tendon, and preventing rupture.
Initial treatment — Initial treatment includes:
• Apply ice for 15 to 20 minutes each day to reduce inflammation.
• If needed, a pain medication such as acetaminophen can be taken; the usual dose of acetaminophen is two 375 mg tablets every four to six hours as needed. No more than 4000 mg of acetaminophen is recommended per day, and anyone with liver disease or who drinks alcohol regularly should speak with their healthcare provider before using acetaminophen.
A nonsteroidal antiinflammatory drugs such as ibuprofen may relieve the pain.
Eliminate lifting and restrict over-the-shoulder positions and reaching until your symptoms have resolved. It is safest to keep the arm down and in front of and close to the body:
Stretching exercise — The weighted pendulum stretching exercise should be performed for five to ten minutes a day during the first few weeks of recovery. These exercises are intended to help maintain joint mobility and flexibility of the muscles and tendons in the shoulder.
Range of motion,flexibility exercises should not cause more than a mild level of pain; patients who feel sharp or tearing pain while stretching should stop exercising immediately and consult with their healthcare provider.
This exercise should be performed after heating the shoulder for five minutes, once or twice per day.
Toning exercises should begin three to four weeks after the initial pain has resolved. Daily toning exercises are particularly important for patients who have had a tendon rupture.
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