The muscle at the front of the upper arm is called the biceps (also called musculus biceps brachii). It is a muscle that has its course from the shoulder region to the forearm region and is responsible for bending the elbow (flexion), outward rotation of the forearm (supination), forward lifting of the arm (anteflexion) and a slightly supportive function in moving the arm sideways (abduction).
Tearing of the biceps tendon usually occurs while the biceps are subjected to excessive sudden force, often in sports involving maximum force exertion. A biceps tendon tear can also occur due to gradual overuse of the muscle. This is because repeated use can reduce the load capacity of the muscle. In this form, we more often see that the attachment at the bottom is involved.
Biceps tendon rupture is frequently seen in men over the age of 50. The cause of this is generally largely due to some aging of the tendons. The biceps tendon has a less favorable location in the shoulder and for this reason is more susceptible to injury.
Because of the small space between the shoulder head (over which the biceps tendon runs) and the shoulder roof, the biceps is subject to compression resulting in minor damage in the long run. Other factors that contribute to the tearing of the biceps tendon are smoking and the use of corticosteroids(anti-inflammatory medication).
Tearing of the biceps tendon is often accompanied by an audible snap and considerable sharp pain. Physically, the immediate result is a decrease in bending strength and, when the elbow is bent, a distinct bulging of the bicep can be seen (the popeye phenomenon). Swelling and blue discoloration may also be present. It is a symptom with a fairly typical onset. Because of this, the physical therapist will be well able to diagnose a biceps tendon rupture during the intake interview and accompanying examination.
A completely torn tendon does not grow back by itself. Despite this, the recovery prognosis for a biceps tendon rupture is fortunately good. Through physical therapy, you are generally able to perform your daily activities again in a relatively short time. A slight strength difference between the left and right arm may remain. In other cases, surgery is performed. This is done in people who have to strain the arm daily, such as for work or (strength) sports. Surgery is also performed when the lower part of the biceps (distal) is torn off. If someone qualifies, the goal is to perform the surgery as soon as possible, preferably within 2 to 3 weeks at most. This is because the tendon can begin to retract fairly quickly and scar tissue can form. These factors make surgery more difficult.
Rehabilitation after surgery takes time. It starts with wearing a sling(sling) in the first four weeks. A brace can be added over time to ensure that the biceps tendon is not under too much tension/stretch in the first weeks of the healing process. Rehabilitation is built up slowly with a focus on increasing mobility and load capacity. Most patients can return to all normal activities about 20 weeks after surgery. Virtually everyone who undergoes this surgery regains full mobility and load capacity of the arm over time.