We are pleased to welcome a new member to our team, Dr. Collin Messerly, a foot and ankle specialist. He will be seeing patients in all four of our Town Center Orthopaedic offices.
Your muscle connects to your shoulder at one end and to one of your forearm bones near your elbow at the other. Like all other muscles, your biceps is attached to these bones by tendons, thick, strong tissue bands. There are two tendons proximally at the shoulder and only one at the far end near the elbow. This tendon near your elbow is called the distal biceps tendon.
A distal biceps tear is, as it sounds, when the distal biceps tendon tears at its bony attachment. The tendon may either entirely or partially tear from its bone insertion. When it completely rips, there is no longer any connection of your biceps muscle to your forearm. A partial tear can be any degree of tendon tearing short of complete.
There are both traumatic and degenerative tears. Tendons have a limited amount of force that they can withstand. If the force is greater than the tendon’s capability, the tendon will tear. This mechanism is what happens during a traumatic tear. The common causes of traumatic distal biceps tears are carrying or catching a heavy object in your hands with your elbow bent at around 90 degrees.
Degenerative tears can occur with only minimal trauma or without any trauma at all. These occur due to the slow degradation of the tendon that can arise over time from use and age. Degenerative tears are almost always partial tendon tears.
When a traumatic distal biceps tear occurs, there is nearly always an acute painful “pop” in the front of your elbow. Often there is a deformity in the appearance of the biceps muscle either initially or over time. This deformity occurs since there is no distal attachment of the biceps muscle. As a result, there is nothing to hold the muscle out to length. So, it often shortens.
In addition to these more immediate symptoms, there is often elbow and proximal forearm bruising and perhaps some mild swelling.
Degenerative tears do not have these acute symptoms. The common symptoms for degenerative tears are typically forearm pain at rest and while bending your elbow or rotating your forearm.
The surgeons at Town Center Orthopaedics are very familiar with this injury. As a result, they can often make an accurate diagnosis in the office after discussing your symptoms and examining your elbow. Frequently they will obtain X-Rays to make sure that there is no other source for your pain. Occasionally, the diagnosis may be unclear. In these cases, an MRI can often be diagnostic. This study is particularly beneficial for diagnosing partial and degenerative tears.
Traumatic distal biceps tears are best treated soon after the injury. Therefore if you believe that you may have injured your distal biceps, you should be evaluated promptly. Most often, you will need surgery to restore all your function and strength. The surgery reconnects your distal biceps tendon to its prior insertion site on your forearm bone.
A degenerative tear is a less urgent issue than a traumatic one. Depending on one’s activity level and general health, nonoperative treatment, including rest, anti-inflammatory medications, and physical therapy, can be tried. Often, however, you will need surgery to resolve the symptoms.
No matter the type of tear, surgery is usually followed by bracing to protect the repair and limit your elbow motion. Once the tendon repair has healed some, your surgeon will often suggest physical therapy to help regain your movement and strength. At Town Center Orthopaedics, the surgeons and physical therapists work together to ensure each patient receives a tailored treatment plan specific to their surgery and needs. The complete healing and recovery process takes several months.
If you believe that you may have sustained a distal biceps tear and would like to discuss treatment options, please book your appointment by phone or online today with Town Center Orthopaedics.
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