Bicep Tendon Tear
A bicep tendon tear at the shoulder occurs due to either abrupt injury or overuse over time. The tendon itself can either tear partially or entirely. Most people will be able to continue living their lives without ever having to get surgery. A biceps tendon tear will cause you to lose some strength and mobility in your shoulder, but not enough to make a difference in your daily activities. But people who need to regain full mobility and strength of the shoulder will need to get surgery. Recovery is often a lengthy process, but most people are able to return to their daily activities.
Your shoulder is a ball-and-socket joint that consists of 3 bones: your collarbone (clavicle), your shoulder blade (scapula), and your upper arm bone (humerus). The head of your upper arm bone fits into a rounded socket (known as the glenoid) in your shoulder blade. A combination of tendons and muscles (known as the rotator cuff) help keep your arm bone centered in your shoulder socket. The upper end of the biceps muscle has two tendons that attach it to the bones in the shoulder. The long head connects to the top of the shoulder socket (glenoid). The short head attaches to a bump on the shoulder blade called the coracoid process.
Your biceps tendon attaches the biceps muscle to bones in the shoulder and elbow. If you tear the biceps tendon at the shoulder, you run the risk of losing some strength in your arm and may have pain when forcefully turning your arm from palm down to palm up. Most people can still function with a biceps tendon tear, and only need simple treatments to relieve symptoms.
There are two different types of biceps tendon tears: partial tears and complete tears. Partial tears do not completely sever the tendon, while complete tears completely sever the tendon. In most cases, torn tendons start off by fraying. As the damage progresses, the tendon can completely tear, sometimes triggered by lifting heavy objects.
When you tear your biceps tendon, you can also damage other parts of your shoulder, such as the rotator cuff tendons.
There are two leading causes of biceps tendon tears: injury and overuse. If you fall on an outstretched arm or lift something too heavy, you can tear your biceps tendon. Also, if you over time wear down the tendon, it can tear.
There are several risk factors associated with biceps tendon tears, including:
- Age. Older people will have put more years of wear and tear on their tendons, making their tendons more susceptible to ripping.
- Smoking. Smoking can affect nutrition in the tendon, making it weak and easier to tear.
- Heavy overhead activities. Too much load during weightlifting, for example, can cause the tendon to rip.
- Shoulder overuse. Sports like tennis or swimming that have repetitive overhead movements can cause tendon wear and tear.
- Corticosteroid medications. These medications are linked to increased muscle and tendon weakness.
The symptoms associated with a biceps tendon tear include:
- Pain or tenderness at the shoulder and the elbow.
- Cramping of the biceps muscle with strenuous use of the arm.
- Bruising from the middle of the upper arm down toward the elbow.
- Sudden, sharp pain in the upper arm.
- Weakness in the shoulder and the elbow.
- Difficulty turning the arm palm up or palm down.
- An audible pop or snap in the shoulder.
Since a torn tendon loses the ability to keep the biceps muscle tight, a bulge in the upper arm above the elbow may appear, with a dent near the shoulder.
Your Florida Orthopaedic Institute physician will take a look at your symptoms and medical history, and then examine your shoulder. In most cases, the determination of a complete tear is obvious since it causes a deformity in the arm muscle. Partial ruptures are less obvious. Your physician may ask you to bend your arm and tighten the biceps muscle. If you feel pain during these movements, then you may have a biceps tendon tear.
Your physician may also order several tests to confirm that you have a biceps tendon tear and not another condition or injury. These tests include:
- X-rays. This test will rule out other problems that can cause shoulder and elbow pain.
- Magnetic resonance imaging (MRI). These scans create better images of soft tissues and can show both partial and complete tears.
Since many people are usually able to function with a biceps tendon tear, usually only non-surgical, simple treatments are needed to relieve symptoms. If symptoms do not improve, or if you need a complete recovery of strength, surgery to repair the torn tendon may be necessary.
For many people, pain from a biceps tendon tear goes away over time. There are some things you can do to help lessen the time it takes for the pain to lessen, including:
- Rest. Avoid heavy lifting and overhead activities to limit swelling and relieve pain. Your Florida Orthopaedic Institute physician may recommend using a sling for a short period to prevent the shoulder from moving.
- Ice. Applying ice packs for 20 minutes at a time, several times a day, will help control the swelling. Never apply ice directly to the skin.
- Nonsteroidal Anti-Inflammatory Medications. Medications like Advil and Motrin (ibuprofen) and aspirin reduce pain and swelling.
- Physical Therapy. Flexibility and strengthening exercises help restore movement while strengthening your shoulder.
Surgical treatment is rarely ever needed to heal a biceps tendon tear. Some people who develop cramping of the muscle, or who need complete recover of strength, like athletes or manual laborers, may require surgery.
Several new procedures can repair the tendon with minimal incisions. In general, the procedures consist of re-anchoring the torn tendon to the bone. Your Florida Orthopaedic Institute physician will discuss with you your options.
After the procedure, your shoulder may be immobilized with a sling for a brief period. Afterward, your physician will soon start you on therapeutic exercises. Exercises that improve flexibility will improve your range of motion of your shoulder. Recovery will be slow, but eventually you will regain full movement of your shoulder.
Regardless of which treatment plan you pursue; it is important to follow your physicians plan to make a full recovery. Although it can be a slow process, your commitment to your treatment plan is the most crucial factor in returning to all the activities you enjoy.
Contact your Florida Orthopaedic Institute physician today for more information.
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