Sports Rehabilitation for Biceps Ruptures

ruptured biceps

Long Head Biceps TendonSports Rehabilitation for biceps ruptures is becoming more common today than ever before. If you look over the NFL injury reports on a weekly basis this injury is starting to be seen more often.

By definition a biceps rupture involves a complete tear of the main tendon that attaches the muscle to the shoulder.

Anatomically the biceps muscle goes from the shoulder to the elbow. It consists of a long head tendon (proximal) which attaches to the shoulder and a short head tendon (distal) which attaches into the forearm. The majority of biceps ruptures occurs in the long head and many times surgical intervention is required.

In this article I am going to discuss the causes, signs, surgery and sports rehabilitation for the rupture of the long head biceps tendon.

Causes of Biceps Rupture

The causes of this type of injury are categorized into traumatic and non traumatic. Traumatic ruptures usually happen in an athlete when there is a sudden forceful load placed on the muscle as in overloading the muscle during weight lifting or falling on an outstretched arm when tackled in football.

Non traumatic ruptures occur after the tendon begins to fray from shoulder ailments ( rotator cuff tears, shoulder impingement, shoulder bursitis, shoulder instability). This type of rupture is seen in people between the ages of 40-60 who had shoulder problems for years. The rupture can occur from a minor injury because of the degeneration of the tendon. A sports rehabilitation specialist can help in educating you on conditions that can cause these ruptures.

Symptoms of Biceps Ruptures

With the initial onset there is a sharp pain within the muscle coinciding with a snapping sensation. This pain quickly subsides because tension is immediately taken off the pain sensors in the tendon from the rupture. There is marked bruising throughout the muscle coinciding with hematoma. On palpation of the muscle there is increased tenderness and sensitivity. The muscle has a tendency to ball up  and make take on the look of the “popeye” character. Muscle weakness throughout the upper extremity is quite evident.

Surgery for Biceps Ruptures

Specialty Arm Sling_2For athletes who are dependent on upper arm strength and whose pain won’t go away surgical intervention is recommended. The procedure performed is to anchor the ruptured end of the tendon into the upper bony humerus (keyhole technique).

Sports Rehabilitation following Surgery

PT bicepsFollowing surgery the shoulder is immobilized in a sling for about 4 weeks. Many surgeons like to start sports rehabilitation immediately on gentle range of motion exercises. Sports rehabilitation can now include ice, electrical stimulation and cold laser to help control the pain and swelling. Gentle sports massage and hands on treatment should be utilized to ease the muscle spasm and discomfort.

With the reduction of acute pain, swelling and bruising gentle exercises for the forearm, elbow and shoulder should start but slowly. In about 4-6 weeks post surgery light strengthening can begin with isometrics so as not to strain the healing tendon. Sports rehabilitation after 6 weeks gets into heavier active strengthening using light weights and resistive bands.

arm_rehabAs you progress the sports rehabilitation specialist will teach you the specific exercises to strengthen and stabilize the muscles and joints of the elbow and shoulder. Building endurance back into the involved upper extremity is accomplished with an upper body ergometer (bicycle for arms). Treatment usually goes for 8 weeks but do begin forceful biceps activity the athlete must give it 3-4 months.

Before you are discharged the sports rehabilitation expert will teach you a number of ways to avoid future problems.