This article guides on bicep tendon tears, outlining risks of continued activity and steps for management and safe return to movement.
Understanding a Bicep Tendon Tear
The biceps brachii, located in the front of the upper arm, has two heads at the shoulder and one tendon at the elbow, bending the elbow and rotating the forearm.
Biceps tendon tears can occur at the shoulder (proximal, more common) or elbow (distal, less frequent but often causing more weakness if untreated).
Bicep tendon tears are either partial, meaning the tendon is damaged but not fully severed, or complete, involving the tendon detaching entirely.
These injuries can result from a sudden, forceful event, such as a fall on an outstretched arm or lifting a heavy object. They can also develop gradually from chronic overuse, repetitive motions, or aging.
Symptoms often include sudden, sharp pain, sometimes with a popping or snapping sound. Bruising may appear from the upper arm down toward the elbow. Individuals might also experience weakness when bending the elbow or twisting the forearm, along with tenderness. In complete tears, a noticeable bulge in the upper arm, a “Popeye muscle,” may be present, indicating the retracted muscle.
The Risks of Continuing Activity
Continuing to work out with a torn bicep tendon is not advised due to potential risks that can impact recovery and long-term function.
Engaging in activities that strain the injured area can worsen the tear, potentially converting a partial tear into a complete rupture. This continued stress can also intensify pain and inflammation, making the injury more difficult to manage and prolonging healing.
Ignoring a bicep tendon tear and attempting to exercise can lead to further muscle weakness and atrophy. When the primary muscle is compromised, other muscles may overcompensate, creating imbalances and placing undue stress on surrounding joints and tissues. For instance, an untreated complete distal bicep tendon tear can result in a 30% to 40% strength loss, particularly in the ability to twist the forearm palm-up.
Persistent strain on an injured bicep tendon can lead to complex damage. Scar tissue can form, and the tendon may shorten, making future surgical repair more complicated. Avoid exercises that directly strain the biceps, such as heavy lifting, bicep curls, overhead presses, pull-ups, or chin-ups. These activities can affect the arm’s long-term strength and function.
Immediate Management Steps
Upon suspecting a bicep tendon tear, cessation of physical activity is important to prevent further damage.
Initial management focuses on reducing pain and swelling, following R.I.C.E. (Rest, Ice, Compression, Elevation). Resting the arm by avoiding heavy lifting and overhead activities is important, and a sling may be recommended to immobilize the limb and protect healing tissues.
Applying ice packs for about 20 minutes at a time, several times a day, helps manage pain and inflammation. Elevating the arm above the heart, such as on pillows, also reduces swelling. These measures provide temporary relief but are not a substitute for professional medical assessment.
Prompt medical evaluation from a healthcare professional, like an orthopedic specialist, is necessary for accurate diagnosis and a personalized treatment plan. A physical examination, including specific tests, assesses tendon integrity. Imaging tests like an MRI may confirm the diagnosis and determine the tear’s extent. Early diagnosis and intervention can improve outcomes.
Rehabilitation and Safe Return to Activity
Recovery from a bicep tendon tear involves a structured rehabilitation program, guided by medical professionals. Treatment options vary by tear severity and location, ranging from non-surgical management to surgical repair.
Non-surgical approaches include rest, anti-inflammatory medications, and physical therapy, especially for partial or proximal tears that do not significantly impact function. Complete tears, especially distal tears, often require surgical intervention to reattach the tendon to the bone to restore strength and function.
Physical therapy plays an important role in recovery, whether treatment is surgical or non-surgical. Under a physical therapist’s supervision, individuals engage in a phased progression of exercises to restore flexibility, improve range of motion, and gradually build strength. Initial stages focus on gentle mobility and protecting healing tissues, sometimes involving immobilization with a brace or sling.
As healing progresses, strengthening exercises are introduced, starting with light resistance like elastic bands or small weights. The program advances to more challenging exercises and functional activities, preparing the arm for daily tasks and specific movements. Returning to workout routines must be a slow, gradual process, strictly guided by medical clearance and therapist recommendations. Full return to strenuous activities or sports can take six to twelve months.