Vocalizing his notions about Distal Biceps Tendon Tear Dr. Gupta says, “It is a condition that usually results out of an injury that may happen during heavy work or while lifting heavy objects. It is uncommon and contributes only three percent of the total biceps tendon tears. If you are apprehensive about how this injury takes place you just need to understand that while doing something strenuous with the arm you may suddenly feel a snap or pop in your elbow along with intense pain. The lower arm may also witness swelling and some bruising indicating the presence of distal biceps tendon tear.
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Always remember that it has no other medical cause besides a sudden injury yet men who are above 30 and involved in heavy lifting jobs, are into smoking or have been taking corticosteroid medicines for long should stay precautious as they are more prone to being affected by the condition. It is not very difficult ascertaining that there has been a biceps tendon tear. It is easily identifiable with physical and diagnostic tests. Once identified it is essential to treat it within 2 to 3 weeks else chances of complications increase”, emphasizes Dr. Gupta.
Being designated as the head of Hand and Shoulder division at Max Healthcare Dr. Gupta has clear beliefs and treatment techniques to relieve patients. Speaking further on the topic he asserts, “If the condition is left untreated or managed with non -surgical techniques, the patients should mentally prepare themselves to lose at least 40 – 50% of the power of supination. Surgical excision on the other hand does have its advantages as it helps to restore the lost power of supination and also improves the cosmesis of the upper arms. If the patient does decide to go in for an operation, the sooner it is done the better are the chances of complete recovery. The patients should also be aware that the numbness and weakness affecting their forearm after surgery is temporary and would go away gradually.
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FAQ – Distal Biceps Tendon Tear
When the tendon that attaches the biceps muscle to the elbow gets torn from the bone, it is referred to as Biceps Tendon Tear.
Biceps muscle is located in the front of the arm and enables bending of the elbow and twisting of the arm. The biceps muscle is attached to the bones of the shoulder on one end and elbow on the other by strong fibrous tissues referred to as tendons. The tendon that attaches the biceps muscle to the elbow at the radius bone, near the elbow joint is known as Distal Biceps Tendon.
Biceps Tendon Tears are caused by a sudden injury. These injuries may be sustained by the elbow by being forced against resistance. It kind of happens when the weight on the arm is so much that it forces the arm to straighten which in turn increases pressure on the biceps thus resulting in the tendon being torn from the bone. Weightlifters are more prone to this condition.
The factors that increase the chances of sustaining a biceps tendon tear are-
- Men above 30 years of age
- Excessive smoking
- Excessive intake of corticosteroid medications
The signs that indicate biceps tendon tear are- Intense pain at the elbow which gradually subsides a little
- Swelling at the elbow
- Bruise marks in the forearm and elbow
- Weakness when the elbow is bent or forearm is twisted
- A gap can be felt at the front of the elbow because the tendon is amiss
- A bulge can be seen on the upper part of the arm because the biceps muscle shortens or recoils
The presence of tendon tear is ascertained by a physical examination under which the front of the elbow is examined for a gap in the tendon. Thereafter the patient’s forearm rotation strength is tested against resistance. Besides physical examination certain diagnostic tests which help to diagnose or conclusively confirm the presence of tendon tear are X-Ray, MRI or ultrasound.
It is essential to reattach the tendon to the bone surgically to regain functionality. In cases where the patient is suffering from some prior severe medical problem and surgery cannot be performed on his tendon or the patient is aged and can do without surgery, non-surgical techniques are worked upon and the patient is provided relief with medications, splint/brace and physical therapy. Surgery is taken up within 2 to 3 weeks after the tear as prolonging it would only increase possibility of complications and less chances of success. Though there are several ways to reattach the torn tendon to the forearm bone the technique to be used depends on the severity of the tear. Surgery may be carried out by making a large incision at the front of the elbow or small incisions at both the sides of the elbow i.e. the front and the back. The surgical technique performed may attach the tendon by making holes in the radius bone and then using stitches or attaching it to the bone by small metal implants called suture anchors.
Once the biceps tendon tears it never grows back on its own to the bone. The elbow is easily bendable even without functional biceps tendon with the help of other arm muscles but the forearm fails to rotate without it. Surgical repair of the biceps tendon tear is recommended because leaving it untreated may result in the arm losing part of its strength and mobility.
Complications that may occur after a surgical intervention in the Biceps tendon tear are rare and temporary. The forearm may experience trifle numbness or weakness which usually goes away. There is always a possibility that the tendon may get ruptured again after healing. Another complication to which the tendon surgery is prone maybe the development of a new bone at the region where the tendon is attached to the forearm bone resulting in reducing its twisting ability and requiring additional surgery to be repaired.
Rehabilitation is an important protocol after surgery. Patients are gradually taken to the path of complete recovery of motion with the help of strengthening exercises in the forearm, elbow and shoulder. Exercises of the biceps muscle are introduced after four to six weeks of surgery and gradually increased in terms of pressure and is carried on for a period of two to four months and also learn ways to avoid future recurrence of the problem. By the end of therapy almost all patients regain their strength and functional ability.
The patients have to be patient regarding their strength and mobility restoration. The elbow needs to be protected for a few days after surgery which requires using a protective sling or splint over the elbow. Biceps tendon takes over 3 months to heal therefore activities that might cause any harm are avoided during that period. Activities that fall under the category of being light weight are permissible soon after surgery but heavy and strenuous activities are not allowed for several months.
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