Where is the bicep muscle located; bicep muscle can be found in your upper arm’s front. Tendons are there to attach the bicep muscle with the shoulder and elbow. Tendons are the strong cord made up of fibrous tissues which help in attaching the muscles to the bones.
Tears on bicep muscles; it is very uncommon to find tears and distal bicep tendon repair. Injury or any unwanted event can cause a tear which results in weakness in the arm. The biceps tendon of the shoulder can also face a tear but the weakness at the elbow can be more dangerous than at the shoulder.
Once the torn has been done it is impossible to have a bicep tendon muscle at the elbow to grow back to normal and heal. However, even without the bicep tendon, the other muscles of the arm make the elbow to bend fairly well. Complete and proper functioning cannot be achieved like it would be difficult to rotate the forearm, the motion called supination.
How to distal bicep tendon repair; surgery is most often recommended for the distal bicep tendon repair. There are some non-surgical methods that can be used to treat the patients but full functioning with non-surgical treatment cannot be guaranteed.
Understanding the anatomy of distal biceps tendon;
There are two tendons for the bicep muscles, one of the tendons a attaches the muscle with the shoulder and the other tendon attaches the muscle to an elbow. The elbow tendon is called distal bicep tendon radial tuberosity is the radial bone on which the distal bicep tendon is attached. Radial bone is the small out-bump close to the bone on your elbow joint.
The bicep tendon tear;
The tear on the bicep tendon can either be partial or can be completely torn.
Partial tear damages only the soft tissues instead of completely splitting the tendon. Whereas in case of the complete tendon tear, the tendon will completely be detached from the bone’s attachment point.
Most commonly the tear is found as a complete distal biceps tendon. This causes the muscle from the bone to get completely detached causing it to get pulled towards the shoulder.
The injured tendon can be substituted with other arm muscles, through which a reasonable motion can be gained. If distal bicep tendon repair is not performed surgically than the arm will face 30 to 40% less strength in twisting and folding the forearm.
The main causes of distal bicep muscle tear;
The sudden and spontaneous injury is the main cause of distal bicep muscle tear. Other medical conditions have no association in causing the tear.
Biceps tendon injury; the force that takes the elbow to go against the resistance can cause injury to the bicep tendon. If the elbow is bent forcibly against the resistance then the injury can be prevented but the straight force against the resistance lead to deep injury.
Often the injury you get is much spontaneous like for example lifting a heavyweight box, when you grab it you do not realize that it weighs more than your potential to handle, this leads you to put a strain on our bicep tendon muscle which tries to bent your arm but the overweight put a force on your arm causing it to straighten and the struggle and the stress on your bicep muscle will increase injury will cause the tendon to teat causing the tendon to tear away from the bone.
Risk factors with the tendon bicep tear;
Men above the age of 30 are most likely to face the tear in their distal bicep tendon
Some other risks include;
- The nicotine intake through smoking badly affects the strength of the tendon
- Corticosteroid medication is known to cause weakness in muscle and tendons.
You can hear a popping sound when the tendon on the elbow ruptures. Severe pain and swelling is also another symptom.
Some other major symptoms include;
- Swelling around the elbow
- Bruising around the elbow and the forearm area
- Difficulty in bending the elbow
- Recoiling can cause a bulge in the arm’s upper part area
- The absence of tendon creates a gap in the elbow’s front
Once the tear has been created it is very important to consult the doctor immediately for distal bicep tendon repair. The physical examination must include;
- Examination of the elbow by a trained doctor, the examination must include the doctor to feel the front of the elbow; look for any gap created by the tear, the supination strength must be checked by checking the rotational and folding capability of the elbow. The supination strength must be matched against the strength of the uninjured elbow.
The imaging tests
- The imaging test is often ordered by the doctor for further confirmation of the diagnosis
- X-rays are one of the imaging tests that although cannot tells about the tissue condition but it does help in ruling out the problem that might have caused the rupture.
- Ultrasound is another imaging technique that shows recoiling of the free end of the tendon in the upper arm
- MRI is the scans that help to get the clear image of the tissue which explains whether the tear is partial or complete.
Treatment for distal bicep tendon repair
Surgery is considered as the top option for gaining the maximum strength and functioning of the elbow. Non-surgical treatments are considered when you do not want to have the full functioning and can carry on your life with 60% of a functioning elbow. And also when you are not too much physically active and the injury has occurred to a comparatively non-dominant arm. People with medical history also tend to go for non-surgical options to avoid higher complications and surgical risks.
Distal bicep tendon repair can be done using the non-surgical treatment which basically focuses on maintaining as much elbow functioning as possible and also to relieve pain. Non-surgical treatment includes;
- The doctor prescribes the patient to get full rest. The patient should avoid heavy lifting to prevent the arm from struggle and stress; overhead activities shall also be prohibited until or unless the doctor allows you to do.
- Painkillers are also prescribed to relieve pain and for gaining some functioning
- Physical therapy is considered as another good option for relieving pain and gaining maximum functioning. Physical therapy for distal bicep
- tendon repair helps to strengthen the muscle and also restores the movement.
The surgical option is considered best for regaining maximum functioning and it should be performed within two weeks of after the injury. Once the time goes beyond two weeks the muscle and the tissue of the bicep begins to shorten and it becomes impossible to gain full functioning after weak tissue and muscle.
The surgical treatment must be understood with three important things under consideration;
- The procedure to be performed
- The complications that can take place
- and the expected outcome
Procedure; a procedure of the surgical treatment aims to reattach the tendon with the muscle; incisions are used based on the preference of the doctor and the condition of the rupture. Incisions can be used at the front as well as at the back of the elbow. The tendon is attached to muscle and the bone using the drill, in some cases metal implants are also being done.
Complications; complications during or after the surgery are also possible. Complications can be seen in the form of
- numbness in the arm
- weakness in the arm
- limitation in the movement
- some extreme cases the tendon can re-ruptur
Rehabilitation; for the short time after the surgery your arm will be immobilized for distal bicep tendon repair. Your doctor will start having you to do some exercises and shall prescribe physiotherapy as well. Heavy lifting shall be avoided after few months of the surgery to avoid re-rupturing. The rehabilitation is the slowest of the step and requires maximum attention and care.
Outcome; the surgical outcome is expected to gain almost full functioning of the arm and the elbow. However, the outcome does depend on the condition and the type of the rupture.