According to Orthogate, biceps tendons torn at the elbow account for 3 percent of biceps tendons ruptures. The injury usual occurs in middle-aged men who perform heavy lifting. For instance, an individual can lift a heavy item like a box with elbows bent. When the load shifts unexpectedly during the lift or is heavier than expected, the elbows are forced to straighten. Yet, the biceps muscle works extremely hard to keep the elbow bent. So when the muscle contracts the tension in the tendons and muscles increase. This tension causes the biceps tendon to tear or snap. There are nonsurgical and surgical procedures to correct the tear.
With a distal biceps rupture, or torn elbow tendon, the tendon that attaches the bicep muscle to the radius bone is torn completely off. The biceps run from the shoulder to the forearm bones. Two tendons connect the muscle to the shoulder.
A nonsurgical option is to place the elbow in a sling to rest it. To ease the pain and swelling, the doctor will prescribe over-the-counter inflammatory medicine like ibuprofen. In addition, you’ll have to work with a physical therapist. The therapist can show you exercises to strengthen your muscles, show how to rest the elbow and how to lift boxes without placing strain on the tendon. Keep in mind that this option is usually for an individual who is not very active. Also, not having surgery can result in loss of arm strength and the ability to supinate by 50 percent. The supination is the twisting motion of the forearm turning the palm up.
With a direct repair surgery, a small incision is made above the elbow. Then forceps are inserted into the incision and the tendon pulled back down tot he radius attachment point. Direct repair surgery is usually performed shortly after the tear. This way there is less risk of tendon retraction. If the tendon recoils up the arm, the surgery becomes harder to perform. After the surgery you will wear a range-of-motion brace or cast.
The surgeon will perform a graft repair surgery if the tendon has been torn for more than three weeks. With this surgery, a larger incision will be made. Graft tissue will be used to reconnect the biceps to its original location because the ruptured tendon has recoiled. The surgeon will elect to use a piece of a cadaver’s hamstring tendon or Achilles tendon. After the surgery, the elbow will be placed in a protective brace.
In this surgery special anchors are used to keep the tendon in its original place. A surgeon makes an incision across the arm. The anchors will be either implanted or screwed into the bone. The long thread, or suture, connected to the anchor will be woven into the lower end of the tendon. The surgeon will tighten the sutures once the tendon is fixed in place. You will have to wear a cast or range-of-motion brace.