Treatment of Biceps Tendon Injuries
Surgical and Nonsurgical Methods to Repair Biceps Injuries
May 19, 2009
Biceps tendon tears can cause pain limited upper arm mobility. These injuries may be treated either surgically or nonsurgically, depending on several factors.
The biceps muscle is located on the inside and front of the upper arm. There are three tendons that attach the biceps muscle to bone. The attachment near the elbow (the distal attachment), is critical to bending/flexing of the elbow joint. The upper part of the biceps muscle splits in two, creating a “short head” and a “long head” of the biceps. Each “head” of the upper portion of the muscle has its own attachment near the shoulder joint. Given its critical role in moving the two joints of the upper arm, the elbow and the shoulder, tears of the biceps tendons can be both painful and debilitating. Depending on the location of the tear, treatment may be conservative, consisting of rest and inactivity, or the injury may require surgery.
Causes of Biceps Tendon Tears
- Injury – a fall on an outstretched arm can cause tears of the tendons of the long or short heads of the biceps. Lifting a heavy object can result in tear of the distal tendon of the biceps (near the elbow).
- Overuse – tendons are generally weaker in older individuals. The degenerative process is accelerated by chronic overuse. Sports or other tasks that emphasize repetitive motion of the elbow or shoulder can result in tendon tears.
- Corticosteroid use – chronic use of this class of medication can leave tendons weakened, and vulnerable to tear.
Nonsurgical Treatment for Tears of the Biceps
- Most tears of the long head of the biceps do not require surgery. However, individuals such as athletes or laborer, who need a return to full strength, may opt for surgical repair. Tears of the short head, and tears of the distal tendon usually do require surgical repair.
- The R.I.C.E. Protocol is generally used for nonsurgical treatment of long head biceps tendon tears. The R.I.C.E. Protocol stands for “rest, ice, compression, and elevation”.
- Physical therapy is often prescribed to return the patient to optimum function.
Surgical Treatment for Tears of the Biceps
- Tears of the distal tendon, which attaches to the radius (bone of the forearm, with the tendon attaching near the elbow), almost always require surgical repair. When a tear occurs, the only anchor of the lower portion of the biceps muscle is disrupted, and the tendon retracts, or slides up, toward the shoulder. This leaves the patient unable to properly flex the elbow, hence the need for surgical repair.
- Some tears of the tendon of the long head of the biceps may also need surgical repair, as discussed earlier.
- Following surgical repair, physical therapy will be prescribed to return the patient to optimum function.
The copyright of the article Treatment of Biceps Tendon Injuries in Sports Medicine is owned by Steven M. Cohen. Permission to republish Treatment of Biceps Tendon Injuries in print or online must be granted by the author in writing.
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