The biceps tendon tear, medically biceps tendon rupture, is a possible consequence of physical overload, but also of wear and tear on the biceps tendon. After appropriate therapy, everyday activities are usually possible again without problems.
What is a biceps tendon tear?
A biceps tendon rupture affects the arm flexor muscle, called the biceps brachii muscle. A biceps tendon rupture occurs when at least one tendon of this muscle has a tear. A distinction can be made between distal biceps tendon rupture and proximal biceps tendon rupture: While a distal biceps tendon rupture occurs in the elbow area, a proximal biceps tendon rupture affects the shoulder area. If a biceps tendon rupture occurs, it may be manifested by a sound similar to a whip crack, among other things. This sound is usually accompanied by an immediate pain in the case of a biceps tendon rupture. In the area where a biceps tendon rupture occurs, a depression is palpable after the injury, often with a hematoma (bruise). A biceps tendon rupture usually results in functional impairment, including the inability to bend the elbow joint.
Causes
A biceps tendon rupture can initially be caused by sudden trauma resulting, for example, from acute overuse of the arm flexor muscle. Such a cause of a biceps tendon rupture can be observed, for example, in power athletes, but also in craftsmen. Also an external force impact on the elbow, for example by a blow, can cause a biceps tendon rupture. Furthermore, a biceps tendon rupture can be favored, for example, by doping; the tendon substance can be damaged by the influence of hormones, so that the risk of suffering a biceps tendon rupture increases. Signs of wear and tear on the tendon due to advanced age can also lead to a biceps tendon rupture in active golfers, for example. Finally, various underlying diseases (such as degenerative or rheumatic diseases) can also damage the tendon tissue and thus contribute to a possible biceps tendon rupture.
Symptoms, complaints and signs
Usually, a biceps tendon tear is associated with very severe pain. In this case, this pain often spreads to the neighboring regions of the body, so that severe pain can occur in the entire arm or even in the shoulders. The quality of life of the affected person is thus significantly restricted and reduced. Furthermore, muscle weakness occurs, so that the performance of ordinary activities in everyday life is usually no longer possible without further ado. The biceps itself shifts as a result of the biceps tendon rupture. There is also severe swelling and further bruising. Since there is no self-healing, the affected person is always dependent on medical treatment for this complaint. Without treatment, the tendon may fuse incorrectly, leading to further discomfort and complications. In most cases, sufferers are restricted in their movement for several months as a result of the biceps tendon rupture. Successful treatment will continue to require various therapies to fully restore arm motion. Thus, in most cases, the biceps tendon tear does not result in permanent damage or in permanent damage. In some cases, the life restrictions can also lead to psychological discomfort.
Diagnosis and course
A biceps tendon tear can be diagnosed initially on the basis of typical, visible symptoms. These symptoms of a biceps tendon rupture include, for example, impaired elbow function and/or a visible shift in muscle elevation away from the area of the biceps tendon rupture. Further details of a biceps tendon rupture can be seen using methods such as sonography (ultrasound) or MRI (magnetic resonance imaging). Both of these methods are capable of imaging tissue structures affected by a biceps tendon rupture. In most cases, a biceps tendon tear can be treated successfully, so that subsequent everyday activities can be carried out without any problems. Regardless of treatment methods, the mobility of the elbow may be limited after a cured biceps tendon tear.Surgical procedures after a biceps tendon rupture can occasionally increase the risk that a biceps tendon rupture will recur.
Complications
Usually, biceps tendon rupture is associated with severe pain. These may be acute and persistent or may occur only during movements of the arm. As a result, the patient’s daily life is severely stressed and limited. However, a high loss of strength in the upper arms also takes place. Ordinary activities or sports activities can no longer be performed without difficulty. The muscle moves upward in most cases, which the affected person can definitely feel. In most cases, a biceps tendon rupture is treated surgically. In this case, there are no further complications. The tendon can be attached to the bone. Immediately after the operation, the patient’s arm cannot be loaded. However, the load level is increased daily so that the arm gets used to a usual condition again. The treatment is also accompanied with physiotherapy. Due to the surgical procedure, the usual complications of surgery may occur. These include infections and inflammations at the wound or complications during healing. Most often, the patient can use the arm without restrictions after several weeks, but in this case the risk of a new biceps tendon tear increases.
When should you see a doctor?
In case of urgent suspicion of a biceps tendon rupture, the early visit to the doctor is just as sensible as in case of symptoms that indicate a strong overuse of the tendon of the biceps. There are several reasons for this. On the one hand, it is usually impossible for those affected to distinguish whether the biceps tendon has only become inflamed due to a constriction in the shoulder area or has already ruptured. For a possible operation, however, this is quite decisive, since the surgical therapy often succeeds better if it has not yet come to a complete biceps tendon tear. In addition, the timely visit to the doctor is also useful in view of the fact that with a conservative therapy, an operative intervention can perhaps even be avoided. Another reason for visiting the doctor as early as possible is the often very unpleasant symptoms of an inflamed or (partially) torn tendon of the biceps, which are manifested primarily in sometimes severe pain and significant movement restrictions. This can often only improve as part of a well-founded therapy, so that if left untreated, overuse or irritation of the tendon due to constricted anatomical conditions can also lead to tearing of the biceps tendon in many cases. If the patient feels a tear, seeing a doctor promptly is also important. This is not only a matter of providing adequate therapy for the tendon, but also of preserving the important function of the biceps.
Treatment and therapy
Which medical measures are used to treat a biceps tendon rupture depends, among other things, on the symptoms of the affected person and also on his physical requirements. Basically, a biceps tendon rupture can be treated in two different ways: Within the framework of the so-called conservative therapy of a biceps tendon rupture, surgical measures are dispensed with. The conservative therapy of a biceps tendon rupture is based, for example, on the consistent implementation of targeted physiotherapeutic measures. If conservative treatment of a biceps tendon rupture does not lead to the desired success, surgical measures can be used to treat a biceps tendon rupture. If a biceps tendon rupture is present in the shoulder area of an affected person, there is a tendency in medicine to perform a corresponding operation with the help of arthroscopic procedures (with the help of instruments that are also used for joint endoscopy). In surgical procedures, the tendon can be reattached to the bone in the case of a biceps tendon rupture; for example, by suturing or attaching it to the bone. If older people are affected by a biceps tendon rupture, medical professionals often lean toward the gentler procedure of conservative therapy. However, if the lower biceps tendon is affected by a biceps tendon rupture, surgery is usually performed immediately.
Outlook and prognosis
Biceps tendon rupture is generally associated with a good prognosis. However, the completeness and rate of recovery depend on several factors.These include the chosen form of therapy (surgical or conservative treatment), the extent of the lesion (partial or complete rupture of the biceps tendon), and cooperation of the patient during regeneration. In many cases, special stability can be achieved by surgery. In the vast majority of cases, it restores the normal extent of mobility in the shoulder and arm. Even patients who put permanent strain on the arm due to a special profession or hobby often no longer complain of any functional limitations after the operation. Only a slight loss of strength in contrast to the other arm is sometimes noted. However, this is usually so slight that it does not noticeably restrict the patient in everyday life or at work. If the biceps tendon rupture is due to a mechanical irritation such as constant friction against a bony structure and is associated with an inflammatory process, it is important that the cause is also treated. Only then can a flare-up of the inflammatory reaction be avoided and the operated tear on the biceps tendon be given a good prognosis. In rather rare cases, surgical complications such as hemorrhage or infection, as well as premature weight-bearing on the arm, complicate the healing process in the patient.
Prevention
To prevent a biceps tendon rupture, for example, it can be helpful to warm up sufficiently before exercising. Also, if possible, avoid overloading the arms because this increases the risk of biceps tendon rupture. Injuries to the biceps tendon should be cured before re-exertion to prevent a biceps tendon rupture.
Here’s what you can do yourself
A biceps tendon tear must always be treated by a doctor. Medical treatment can subsequently be supported by some measures and preparations. First, it is important to take it easy on the affected body part. In the first few days, the affected person is advised above all to rest in bed and to avoid stressful or jerky movements. After that, physiotherapy and alternative measures such as yoga or Pilates can support the healing process. However, depending on the severity of the tendon rupture, some time should be waited before starting to train again. Especially professional athletes and people who have to exercise a lot for physical or psychological reasons should therefore also consider therapeutic measures. This can effectively combat depressive moods and lack of motivation. Various medicinal plants also contribute to healing. Effective, for example, is the pain-relieving and anti-inflammatory arnica or the antibacterial calendula ointment. The use of medicinal herbs and plants should be clarified with the responsible physician in order to avoid interactions. Finally, the injury must be adequately cared for to prevent inflammation and other complications. Again, all steps are best taken in consultation with the physician.
