What is a distal biceps rupture?
The biceps is a strong muscle at the front of your arm that attaches to the radius bone just beyond your elbow. It has two main functions: Firstly, it is one of two major muscles to bend your elbow. Secondly, with your elbow partially bent, it twists your forearm for example when tightening a screw using a screwdriver.
A distal biceps rupture occurs when the biceps tendon detaches from the bone. When it happens, people describe a sudden pain and after that, they will notice that their arm is weaker when bending their elbow or some twisting movements. Over time, the biceps muscle may bunch up towards the shoulder because it loses its attachment to the bone at the far end that would otherwise hold it in place.
Who gets a distal biceps rupture?
People who work out at the gym classically have thie injury. It happens when lifting something very heavy, such as doing arm curls. It is seen particularly in people who increase their exercise quickly and often happens to people who take anabolic steroids to help strengthen their muscles. By quickly making muscles stronger, they overcome the attachment of the muscle’s tendon to the bone, causing it to pull off.
Some people who do a lot of heavy lifting experience a dull ache near their elbow when using their biceps. This can be a sign of biceps tendonitis and may be a warning that the biceps is partially torn or weakened, and could tear completely. If you experience this pain during workouts, it is important to rest the arm until the pain subsides, rather than ignoring it.
It is very important to see your doctor as soon as possible after your biceps has torn because you may get a better result if it is repaired as early as possible. However, Mr. Davies is experienced in performing repairs even after many months or more than a year.
How is a distal biceps rupture diagnosed?
This starts with a conversation with your doctor to describe the problems you are experiencing with your elbow. People often describe a suddent tearing sensation and pain and bruising in the arm. You will then be examined, with some specialised tests to feel for the biceps tendon. The diagnosis is usually clear by this point. If there is any uncertainty, you may be sent for an ultrasound or MRI scan.
Can distal biceps rupture be prevented?
By taking good care of your muscles, such as doing stretches, a good warm-up and warm-down, you can reduce the chance of rupturing your biceps. Also, you should avoid taking anabolic steroids which can lead to a biceps rupture and has other very serious complications too.
What are the treatment options?
Distal biceps ruptures can be treated in several ways:
- Take simple painkillers and change of activity level
- Physiotherapy
- Surgery
Simple painkillers
For some people, just knowing what the problem is can be enough. You will still be able to move your elbow and if you do not have a heavy job, you may not have any problems in the future. The pain subsides after several weeks can be controlled with simple painkillers, such as paracetamol and anti-inflammatories (if you can take them). This may be coupled with simple changes to your lifestyle to avoid heavy activities.
Initially, people lose around one third of their bending and twisting strength in their elbow. Over time, other muscles around the elbow strengthen naturally so you may regain some of the lost strength.
Physiotherapy
A course of physiotherapy can be helpful to maintain the movement in your elbow and strengthen the other muscles that move your elbow. The main exercises for distal biceps rupture early on are stretching exercises. After the initial recovery, you are given strengthening exercises using elastic bands and weights. It can take several months to get the full benefit of physiotherapy, so it is important to work hard early on, even if you do not feel an immediate benefit.
Surgery
Depending on your usual activity level, you may be offered surgery to repair the torn tendon. This is usually performed through a cut down the front of your elbow to reattach the torn tendon to the bone. This operation is often called a distal biceps repair. The timing of surgery for a distal biceps tear is important. It is a simpler operation to perform if caught within the first two weeks. However, Mr. Davies uses a special technique and can often successfully repair a torn biceps tendon after months or even more than a year. A direct repair can usually be achieved even without needing to use a graft to bridge the gap. So don’t worry if you come late with a tear – there is usually something that can be done to repair the tendon, however late it is.