The biceps brachii, or biceps, is a muscle on the front of the upper arm. It has two heads originating at the shoulder blade, converging into a single tendon that attaches near the elbow. The biceps primarily bends the elbow (flexion) and rotates the forearm outwards (supination). A tear in a biceps tendon can significantly affect these movements. This article explores the consequences of not surgically repairing such an injury.
Understanding Bicep Tears
Bicep tears can occur in different locations and vary in severity. Proximal tears happen near the shoulder, where the two heads of the biceps attach. The long head tendon, which passes through the shoulder joint, is more frequently affected by tears at this location.
Distal tears, though less common, occur near the elbow where the single biceps tendon inserts into the forearm bone (radius). These tears typically result from a forceful extension of the elbow against resistance and often involve a complete detachment. Tears can also be classified as partial, where the tendon is damaged but not fully severed, or complete, indicating a full detachment from the bone.
Immediate Consequences of Non-Surgical Care
Not surgically repairing a torn bicep leads to several immediate physical outcomes. Acute pain, often described as a “pop” or tearing sensation at the moment of injury, may persist initially, along with noticeable bruising and swelling. This initial pain may lessen over a few weeks, but discomfort can linger.
A distinct cosmetic deformity, commonly referred to as the “Popeye” muscle, frequently develops. This occurs when the detached biceps muscle retracts and bunches up towards the shoulder, creating a visible bulge in the upper arm. An immediate loss of strength also becomes noticeable, particularly in elbow flexion and forearm supination.
Long-Term Outlook Without Repair
Beyond the immediate effects, an unrepaired bicep tear can lead to permanent changes in arm function. Some individuals may experience persistent pain or discomfort, especially with continued use or certain movements, even after the acute phase resolves. Arm strength and endurance will be permanently reduced, particularly in forearm supination and elbow flexion. While other arm muscles, such as the brachialis and brachioradialis, can compensate to some degree, the bicep’s full power and efficiency will not return.
This long-term weakness can significantly impact daily activities, occupational tasks, and sports requiring lifting, pulling, or forearm rotation. For instance, tasks like turning a doorknob or using a screwdriver may become noticeably difficult. In some cases, altered biomechanics due to the unrepaired tear may lead to secondary issues or increased strain on other muscles and joints as they compensate for the bicep’s diminished role.
Adapting to an Unrepaired Bicep
Living with an unrepaired bicep tear often involves adopting strategies to manage the condition. Physical therapy plays a role in strengthening the surrounding muscles, such as the brachialis and brachioradialis, to compensate for the injured biceps’ reduced function. Therapists guide individuals through exercises to improve range of motion and build compensatory strength.
Lifestyle adjustments are often necessary, including modifying activities to avoid aggravating the injury or to perform tasks more effectively with reduced bicep strength. This might involve changing lifting techniques or avoiding certain strenuous movements. Individuals may also experience psychological effects, as a permanent change in body function or appearance can influence self-perception and body image. Adapting involves both physical rehabilitation and a mental adjustment to the arm’s new capabilities.