Distal Biceps Tendon Rupture | Expert Physio Review
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- เผยแพร่เมื่อ 19 ม.ค. 2023
- In this tutorial, we discuss Distal Biceps Tendon Rupture, by reviewing the anatomy using our 3D anatomy model, clinical features and the role of Physiotherapy.
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I teared my distal tendon a bit over a month ago and just had the surgery 2 weeks ago. I was curling 80lb bar at the gym, go figure. One thing I do remember was that snap,pop, crunch noise when it teared, and then the sharp pain that kicked in shortly after. Orthopedic said if I wanted to return to the gym quicker with almost 100% function of the bicep, then I should do the surgery. Now I'm just recovering and waiting to get back 💪
Wishing you all the best Danny!!
How’s it going brother?? Anything that worked or didn’t work? I just ruptured mine, am 3 weeks since surgery
@Mr_Zesty damn I know the feeling. I'm doing much better, I still don't have my full strength as that takes a bit time. I'm currently still doing physical therapy to gain the strength back but everything is healed. I still get slight pain when I turn my hand palm facing upward.
@@Danny-hv9ox right on man. Keep up the good work! I’m right behind you. Any recommendations for me?
@Mr_Zesty I would definitely start taking supplements that helps with the healing process quicker such as anti-inflammation, muscle support, vitamins. I been taking a lot of collagen and greens. Once you're off the hand brace, (assuming you have one on), start minimal exercises at home on the days you don't go to therapy. That helped me gain more function of my bicep and forearm quickly. I'm already going to go back to the gym next week, but obviously going light for now and make my way back up.
I just had the surgery 4 days ago, 10 days after injury, here we go!
I had a pec tear 2 years ago, not a major one yet had to stay off for 6 months, I did slow training, and raised it back up to what i was lifting months later, now im lifting 40kg higher bench press + the appearence has gone way better tbh, the tear actually gave my pec kinda a lower pec which makes my chest more fuller 😂( i dint had a super dominant lower pack before ), the thing is, it will get better, and life is much more than just gyming, stay you, keep yourself busy, and yeah slow recovery, good luck !
Yet again, very informative! Thanks
Thank you so much Chris !
great informative video! Love the 3d model. Im currently week 9 of my rehab process. What do you think of my recovery timeline? I've uploaded it all on TH-cam.
I suffered this injury 14 weeks ago. I tore mine trying to catch a flooring roll that was falling at my storage unit. I had surgery a week later. I do Olympic weightlifting and powerlifting. I am on the road to a full recovery and have playlists on my channel with updates and the rehab I did for squat, bench, deadlift, snatch, and clean and jerk.
Great work! Wishing you all the best with your recovery!
Thank you! @@ClinicalPhysio
I've ruptured both of my distal biceps tendons. I'm 1 month post surgery right now. Strange thing. I did not feel that either time was painful. One was a sudden jolt as I caught myself from falling backwards off the side of a commercial vehicle. The second time I was picking up a large object that weighed approximately 90lbs with my arm fully extended. Both times I heard the tendon tear away from the bone through my body. The first time was painful for about 8 to 10 seconds and then just uncomfortable. The second time the tearing was slower and practically no pain at all. It was, in fact, barely uncomfortable.
The first surgery had pain involved for the first couple days. It was a miserable undertaking trying to sleep. I had to end up taking 5 or 6 of the prescribed opiod pain pills to be able to rest.
The second surgery... I was at home cooking dinner 6 hours later. There was no pain involved even though the incision over my biceps and elbow joint was almost double the size of my previous one. I had no issues with pain at all in fact. Just minor swelling and discomfort.
I was lucky. Both times I saw a surgeon who specializes in this surgery. He has a two incision technique and his results are amazing. After my first surgery and some physical therapy I was able to get back almost 100% range of motion and strength. I'm only a month post op on my latest and although I'm still in an orthopedic splint I can already touch my thumb to my shoulder. It's uncomfortable to do so but it is something I did not achieve until near the end of therapy the first time.
If you live in Western Pennsylvania and have this injury do yourself a favor and look up Dr Christopher Schmidt. He will get you the very best possible outcome in your recovery. He specializes in shoulder and other elbow surgeries as well.
What are your thoughts on using KT tape after the rupture prior to surgery? Would this be beneficial in supporting the joint or not worth it? Thanks!
I ruptured my distal biceps tendon a couple of months ago, while waiting for surgery I have improved in terms of pain and range of motion. An opinion of the traumatologist has been not to operate. However, being 45 years old, I still maintain a high sporting activity, I play baseball and do brazilian jiujitsu at a competitive level. Is it possible for me to regain similar strength levels without surgery as without surgery? I could rupture the other head of the tendon (long) still not working at 100% as I did before? Thanks
Hey Khalid, I am a PT student from Greece. Can you make a video perhaps about how to browse the literature, I'd love to see that especially after your videos regarding manual and ultrasound therapy!
Efschiaristou Dennis! A great suggestion thank you!
I can do the test by folding my arm squeezing my fist, and reaching in under the tendon in the fold of my elbow but if I turn my arm up towards the ceiling, still Bent in at 90° at the elbow and still clenching a fist, a big knot that is tender pops out under my arm on the inside close to my right chest. It looks just like the one in the pic that popped up in your video in the corner, but if I had tore it loose at the bottom, how can I still clamp my fingers around the tendon when doing the test? I know of one of two times that I could have done it because both times I got knocked really hard by the outcome of the accident. It’s long in the past so the muscle I’m assuming has drawn up and made this knot, that is almost like a golf ball, but it’s usually not tender unless I mess with it or put my fingers under the bottom edge of it and irritate where I’m assuming it used to be running down to the attachment on my forearm. I’m just going to live with it, I’m 68, and it doesn’t really affect what I do. But boy I wish I had known it when I was still working because that’s where I hurt it pulling on a big cheater pipe on a 6 foot pipe wrench ,loosening a 6 inch fitting in a diesel fuel yard tank, and when it finally popped loose it knocked the wind out of me and my arm was tingly for a while and I got fired the same day! How ironic! I can almost guarantee in retrospect that the little bastards were watching me on camera and saw me get hurt and decided to boot me out before I made a claim. Plus I was just two years away from retiring and getting my $50,000 retirement insurance policy that I could use for whatever I wanted if I cashed it in.But that’s water under the bridge. Or I guess I should say knot under the arm!
Excellent video, good job! I currently have a chronic distal bicep tendon rupture, confirmed by MRI, 6 weeks after the injury! I was told multiple times that it was just tissue damage. When swelling went down, it was obviously not right. Have you any information on chronic repair with Hamstring Graft. I wish I had known about the hook test early.
i can help with this!
i am currently 8 weeks post op of a chronic distal bicep repair, the original injury was acute but my surgery got delayed by just over 3 weeks turning my case into a chronic repair.
i didn't have any graft as it wasn't needed, my bicipital aponeurosis was hanging on so my tendon didn't retract much past my elbow.
i think my surgery was 6 weeks 2 days after the injury happened and my bicep was almost non existent and my tendon was very scarred over.
i have been told graph surgeries are harder to recovery from so i hope it goes well for you!
my arm is pretty much back to normal now and have all my mobility back besides some pronation but for the next month i am only aloud to use very light weights to rebuild all the muscles in the arm.
speedy recovery!
Thanks very much for your feedback, and best of luck with future progress! Mine seems to be retraced further. The surgeon told me it does not matter when I go for the operation now. It will definitely require a hamstring graft. If I get it done, I will give some feedback! Thanks again for your time.
@@michaelmcgee2417 keep me updated! i would 100% get the surgery, it makes a world of difference.
best of luck.
I tore my distal bicep tendon last year and opted for the surgery to repair. For those saying they haven't experienced any strength loss. I was told by the doc, it would be more in torque strength than curl strength and then obviously the look of the bicep would still have that gap. But can anyone confirm their loss of torque strength vs curl?
Two weeks ago I was going through a turnstile with my elbow bent at 90 degrees and felt a sharp pain but not really a pop in my elbow area. The pain quickly went away and I was fine for the rest of the day. I had no bruising and barely any swelling but I still have some pain and discomfort in the medial side of my bicep/elbow/forearm. And occasionally I can feel like my bicep muscle will cramp up some. I tried the hook test on myself and I can feel the tendon is in tact. So I’m not sure if I just pulled a muscle or what I did but if anyone thinks they know what I might’ve done then I’d greatly appreciate it! Also I don’t really see any deformity in the muscle or anything just the pain and discomfort.
my injury happened like 2 years ago and have been able to do hiit , pushups, and pullups, but I def have the reversed popeye. But the thing is I can feel the hook at the elbow still. so I dont if it's partial tear? but the bicep belly definitely moved up. def stresing me out looking at it, I was able to go hard on my workouts and do warehouse work and even bicep curls but aesthetically the bicep belly has shifted up.. i never got an xray or mri but went to orthopedic and someone did a hook test and Im not sure he knew what he was doing but he said i was fine, but i can clearly see the bicep belly shifted up, I just wasn't sure if it's possible to have a partial tear and still get surgery
I imagine in most cases that a surgeon would not want to operate just on the look alone. If you are managing to do your normal activities as you said, then you potentially have more to lose than to gain from having the surgery… wish you all the best
@@ClinicalPhysio I appreciate the reply, and your take- thank you, you as well ✌
Thanks for the excellent explanation Khalid. The older I get the more I have to refer to your channel 😭
🙏🏼🙏🏼🙏🏼 wishing you all the best!
I was put on 40MG of crestor. I’ve been lifting weights regularly for over 30 years. I ruptured my bicep and torn my rotator cuff within 6 weeks of each other.
on my god!, sorry that just sucks.
So sorry to hear this 🙏🏼
I have a bicep distal tendon tear, it was made in a judo movement 5weeks ago, the last 2 days ago i was at the hospital and before i went to the surgery block the doctor saw me and canceled my procedure...as i gained all the movement, wich i never had lost, and retracted about 3/4 cms of my elbow, but i had no other issues, my streght is a lttle down in suppination, but better than last week..(just moving my arm gaining slowly resistance in a full range of motion), i had seen in a long term that the strenght is going to be back as the tissue will with time fuse with the lost tendon of the bicep, causing a "bridge" . The only thing i see will be different is the format. I think we need to see that everyone is diferent...regeneration, metabolism, etc. Thanks for your information!👌😉
Wishing you all the best Miguel!
How is you bicep now? I am 5 weeks out this week and I have been gaining strength everyday.. have not done surgery
@@MIGGS32100hello, I did my MRI and it showed 2 different thorns of tendons in my left arm-i am trying to see asap one ostheopath to see if operation is needed.
You didnt get your operation, you think it can heal on ots own?
I am very scared
@@evelinayounan8090 hi Evelina. Mine happened 3 months ago. The tendon went up 9cm. I have an obvious gap. But it very functional. Strength is weaker but I have never stopped working out. Kept at it. Within a week of I gained all range of motion. I actually never lost it. It was just really tight. I was very nervous about the surgery and having nerve damage and range of motion issues as I read that some people don’t always get it back right away. People that I have talked to who never had surgery are doing just fine and I am starting to realize it. These guys I talk to are huge power lifters and they are doing fine. I don’t do any of that but have still been gaining strength getting stronger. It’s a tough call to make since there is a short period to make a decision. I took how I was feeling and who I have talked to and decided not to have surgery. I’m here if you have any questions.
@@MIGGS32100 Thank you for this feedback - it is very hard to find individuals who haven't had the surgery as everyone posting seems to have had it. I need to make a decision myself in the next two weeks as I ruptured my distal bicep tendon 7 days ago. I'm in my 60's and my PT friend tells me he wouldn't do it based on where I am currently at. I have full range of motion and very little pain if any. He says that the rest of my arm will compensate. I'm just concerned if I don't have the surgery, what does things look like in 6 months? Do you start to have chronic pain as the tendon retracts and atrophies? Cannot find much info on these questions at all out there. Glad to hear you are doing great - gives me hope that a non-operative approach might be good.
As a 2nd year physiotherapy student who's teachers don't care at all , thank you.
Thank you so much for your message and wishing you all the very best with your studies!
Can you have a partial tear of this tendon? ty
Yes you can.
I partially tore mine last August. I get sharp pain every now and then.
Sir I have a pain in wrist when I hold weight horijontally any thing like dumble and a tendon beside my wrist bone fall down when I rotate and it is also making noise during rotation
Hi! I would definitely suggest seeing a physiotherapist so that you can be formally and properly assessed!
@@ClinicalPhysio ok
Do you have experience with PARTIAL ruptures? Its unclear how much of my tendon is left but there's definitely a 3 finger gap between the elbow and biceps.
Consulted 4 specialists and half of them want surgery, the other half no. So frustrating
Hello, I am seeing an osteopath for thorn tendon of the arm - I am scared if he will siggest operation.
Did you get your intervention or left it to heal on its own?
@@evelinayounan8090 it was a very frustrating process as there were different opinions and I generally believe in natural ways of healing...but I ended up taking the surgery because:
1. More than 50% of the tendon was ruptured and therefore a full recovery wouldn't be possible.
2. I'm young and very active and the endobottom surgery is the one which has the highest probability to get you back to
100%
3. The success rate of this intervention is very high
4. I couldn't waste more time cause it should be done within the first 2-3 weeks
Good luck with your process
I did somthing to my distal tendon about 5 months ago whilst curling 70kg on a barbell kept training for 3 months but it started getting worse my whole forearem would lock up n spasm so i stopped training for two months it seems better but i still dont know what was wrong because ive not been to the doctors any suggestions on what it could be ?
I would absolutely recommend that you visit someone who can analyse things for you properly like Dr or Physio 🙏🏼
Should one expect any long term pain due to [complete] ruptured distal biceps tendon if left unrepaired surgically? Any quick insight would be appreciated. Thank you!
The main concern will be the reduction in strength, naturally for elbow flexion but also supination
Pain: totally dependent individual to individual, for example, might other muscles have to work harder in place of biceps? And naturally this will be different person to person
Yes, you can expect to feel some discomfort. I know a man that did not have his repaired. Imagine that every time you go to lift something your body is trying to still engage your biceps to assist you in lifting. But, instead of flexing your elbow, it just tightens and balls up more as it isn't attached. The man I know said it is like a muscle cramp.
@@brob-zy8zi mines like someone twisting a screwdriver into my lower portion of my bicep. Dreading getting it fixed.
@@wolverinebear5357plz help me what should I do in my case so I will tell you a story of mine. In April after 8 month of no gym I curl 45 lbs dumbell for 35 reps ( poor form) but I didn't hear pop sound and all that but my bicep become sore and after 2 days it starts to get swollen and then I was not able to straighten my hand after that and after i consult to normal doctor and he gave me some medicine for swelling and for pain and then after 1 week my hand becomes normal I was able to straigthen my arm but now after 7 months I am doing workout and my bicep curl strength has been reduced and I don't feel that power in my bicep and tendon i used to before that incident now i have lost some strength of my right hand during curls and I can shoulder same weight as before but cannot curl that much weight I used to can you tell me some solution
@@brob-zy8ziwhat is this condition called? As I never had my surgically repaired, and now anytime i do something with my distal it feels like a massive muscle cramp
I tore my bicep back in 2010. Is it possible it can still gain size from working out? Never got the surgery.
It will only be short head of biceps which is intact, and so I would imagine it would be naturally challenging
Sir I'm 18 years old Boy Me and My Friend playing Arm Wrestling so suddenly my hand slipped and i realize i can't move my biceps arm but Elbow i can move So after that I'm going to hospital and Doctor suggest me Plaster for some month it can help the Fracture So Sir can you tell me what can i do for my Recovery?
Is their any scientific evidence or studies on what weights they start to occur in cases more commonly? Like what weight range for biceps is safest
I’m not sure of that I’m afraid
I have been searching for a while and i can’t quite seem to find an answer for how to avoid such injury i hope that someone would help
Hi Nick - how do you mean how to avoid? Are you doing a job or activity that you worry about this happening?
I need to do chargery
🙏🏼
Strange ,i passed the 2 tests, but not the third (popey), not ruptured then, or just stretched but not enough to tear ??? strength loss is minimal.
Me too
I am 59 and have the same thing. My first orthopedic surgeon who saw me only looked at me with my arms in certain positions and told me I tore my muscle, and basically didn't want to do anything except check back in six weeks. I was unhappy six weeks later and he recommended I see a different doctor in the same office, who had more of a specialty in this.
I had to wait a couple of weeks I think to see this new doctor. When I saw him he said that this was fairly extreme, and the tendon had retracted quite a bit. In fact, when I had my surgery, an Achilles tendon allograft was needed.
I feel that the first doctor should have recognized the severity of my issue. He had said something like, "surgery isn't very successful with this, typically." The Doctor Who did my surgery said nothing like this.
It was over 14 weeks between the time my accident happened and my surgery.
Was the first doctor incompetent? Did waiting longer necessitate the Achilles tendon allograft? I believe it did. How might this have been better had I not waited so long for the surgery? Any advice, suggestions, or thoughts are appreciated.
Hi Aaron, so sorry to hear of your troubles. You can always request copies of your medical notes if you wish to see what the thought process was from your first consultation if it is something you are concerned about
. @ClinicalPhysio Thank you. I do have his notes. Because I cannot interpret them 100%, I'm going to run them by a legal pro in the medical field. I do believe that he misdiagnosed me, though
Brachialis is not as strong as biceps? (7:50) Brachialis is the strongest elbow flexor without supination, a lot of the bulk of the biceps actually comes from the brachialis underneath.
So the other day I badly hyperextended my left elbow and it hurts. My orthopedist told me nothing was ruptured.
But here's what confuses me:
Although I can hook my biceps tendon just fine in both arms, in my healthy elbow I can clearly feel two smaller side strands next to the main biceps tendon, but I can feel only one of these side strands in my injured elbow.
The inside strand (the one close to my body) appears to be missing, yet of course I have no idea if it was there BEFORE my injury, because I'd never palpated my elbow tendons before.
How many distinctly palpable strands does a healthy biceps tendon have?
I have the same, but have both structures missing either side of the main tendon.
Also I have no idea if it was always like that.
Been a couple of months and no improvement so I’m going to have to get a scan I think.
Just happened to me tge 26th
Hook test is great and devastating for me... I went to the doc today and he didn't know about the hook test. I go Thursday to the ortho
Wishing you all the best Jeff
ruptured my biceps 2 days ago. Surgery tomorrow. I am 50 and was lifting a heavy object. Incorrect. :-(
So sorry to hear this, wishing you all the best 🙏🏼
Hi. How did it go? I just had surgery and they had to use a forearm tendon.
Went very well I think... Past op 1 month almost now and I am pretty much using my arm as before but with the exeption that I am not lifting anything. @@gregdonald9506
I am not using any tendon anymore
I have biceps tendon
🙏🏼
i was lying shirtless in the morning, jerked my hand right, the chest skin rubed in and i felt a pain, no pop or anything, no ansymetricity, some very very minor pain ocasionally, i have no idea what happened 😂 could be the skin, what do you think
Squeeze test doesn't work on neither of my arms.... hook test does.
👍🏼
Bruh my bicep starts screamin if i lift with it. I dont know how it even happened
Sorry to hear that! Get well soon!
@@ClinicalPhysio will it heal on its own overtime? Its been about 1.5 months