Bicep Tendon Ruptures | Proximal, Distal, Complete, Incomplete
Bicep and tricep ruptures are rare but it is interesting to dive into the research, the treatment options, and the risk factors.
It can occur when the bicep muscle contracts forcefully, as in a weightlifting accident, or when it is suddenly stretched beyond its limit.
Surgical management is the best option for a full or complete rupture, while conservative or non-surgical therapies are best for partial or incomplete tears or ruptures of the biceps tendon.
What Causes A Bicep Tendon Rupture?
Distal biceps tendon rupture is from the excessive eccentric force as the arm is brought into extension from flexion.
These activities include weightlifting, wrestling, and labor-intensive jobs. Proximal biceps tendon rupture is generally not due to a unique mechanism of injury but is highly correlated with rotator cuff disease.
What Are The Risks For Biceps Tendon Ruptures?
There are several risks for a bicep tendon rupture, such as:
- Age (35 to 54 years).
- Use of corticosteroids.
Rare risk factors include:
- Chronic kidney disease.
- The use of quinolones (antibiotics).
How Do You Know If You Can A Bicep Tendon Rupture?
People report a sudden and sharp pain in the shoulder or elbow, depending on if it is a distal or proximal rupture or tears. Usually, it happens after slowly straightening the elbow with a heavyweight. Many people report hearing a “pop” at the time of injury, followed by pain, that can last weeks to months. However, the pain may diminish if it is a complete tear.
Other signs of a biceps tendon rupture may include bruising, tenderness, and swelling around the elbow.
You may also notice a “popeye deformity” or the “Popeye sign”. This is when the bicep tendon has been completely torn and the bicep falls down the arm so there is no tendon to keep it attached to the shoulder and the ball of bicep muscle resemble that of the arm of the 1930’s character Popeye The Pirate. In the obese population, this can be hard to see this characteristic sign of a bicep tendon rupture.
Can A “Popeye Deformity” Be Fixed Without Surgery?
Treating anything with surgery or without comes down to personal factors, the age, and health of the individual, and the lifestyle factors that are influenced by the injury.
The consensus is you do not necessarily need surgery to fix a popeye deformity or popeye sign, however, if not repaired surgically you reduced strength with supination and flexion of the forearm, and reduced grip strength.
But if you do not mind how the popeye sign looks and you do not particularly need a lot of strength in that arm for work or recreational activities – then surgery may not be needed. Surgery is often not recommended to older patients with a bicep tendon rupture.
Treatment of Bicep Tendon Rupture?
Bicep tendon ruptures are treated both surgically and non-surgically.
This option is generally recommended for younger people who, for example, play a sport and need the full strength of the bicep restored. They are also otherwise healthy with no health risks that make surgery a risky option.
Ideally, surgical intervention is done as quickly as possible after the rupture occurred.
People with “low physical demands and multiple comorbidities” are better suited for nonsurgical treatments. However, this option rarely restores full function.
Treatment Of A Partial Bicep Tendon Rupture
Unlike complete or full bicep tendon tears or ruptures, partial ruptures respond a lot better to conservative or non-operative management, like physical therapy, exercise therapy, shockwave therapy, and laser therapy.
Laser Therapy For Partial Bicep Tendon Rupture
Laser therapy can help speed up recovery and reduce pain and inflammation, in turn improving function. Laser therapy works by emitting light in the visible and infrared spectrum. The laser is applied to the skin for a period of time, depending on the power and type of laser used.
The light from the laser penetrates deep into tissue and causes an increase in blood flow and lymphatic drainage, which helps remove waste products from the area. This also stimulates cellular activity, collagen production, and new tissue formation.
Shockwave Therapy For Partial Bicep Tendon Rupture
Shockwave therapy is an effective treatment tool for chronic conditions, for example, if some time has passed since a partial bicep rupture but it still does not seem right. Shockwave therapy is used to break up scar tissue and stimulate healing. It is a non-invasive treatment that uses high-energy sound waves to treat a range of conditions. Shockwaves are applied to the skin over the area of the bicep tendon rupture.
The sound waves cause an inflammatory response, which leads to the breakdown of scar tissue and the stimulation of new blood vessels. This increases blood flow and brings more nutrients and oxygen to the area, promoting healing.
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