Long head proximal bicep tendon

[tjm]

Anybody skiing with a completely torn long head bicep tendon. How’s it working out?

[motoskier]

Why not get it fixed

[tjm]

I’ve talked to three orthos who all say this tendon is not necessary, and available fix is mainly cosmetic. Very little benefit to the surgery. They say the small head tendon can take up the load.

[ski6jones]

Yes. Didn't get it repaired. No issues at all.

[vtmecheng]

My dad has this on both arms. Doesn't seem to impact anything he does, and he's really active.

[m_pags]

I've ruptured it on both arms and have chosen to have them repaired. After seeing the pictures of what was cleaned out from around my rotor cuff I was glad I did. I skied for 2 1/2 months before my 1st one was repaired and was getting a lot of bicep cramping. I'm 56 and now using a Power Vest.

[Horton]

I think if you're going to get it repaired you want to go quickly but if you're seeing you good ortho trust them.

 

@motoskier had his distal bicep tendon repaired just like I did except for whatever his doctor did his recovery was unbelievably fast and painless

[TravisNW]

I’ve been a trainer for 10 years, I’ve seen and worked closely with a dozen or so people that have had bicep tendon tears or bicepectomys as a shoulder injury repair. It does negatively impact people that act like athletes and use their bodies unlike the vast majority of folks these days. It’s true it will be asymptomatic for pain under ordinary circumstances but it won’t be as strong and won’t be as stable and that likely will lead to other issues. Really really stress the fact that you are an athlete, surgeons advocate leaving a completely torn bicep but being in the trenches on the front line it definitely doesn’t work the same. Be aware that you’re rehab will probably be longer and way harder having it re-attached. You have to take the rehab process very seriously but in the end worth it (this I assume is why surgeons advocate the easy way).

[tjm]

@TravisNW I agree with all you're saying. I’m aware of the PT involved having blown out my distal tendon 6 years ago. After listening to these guys explain it, I asked them if they would repair it for me anyways and the answer was no. It’s frustrating. My ortho friend who fixed the distal is retired and moved to the other side of the country. He would do it but he’s not around. I’ve got a couple more appointments set up, I’ll see what they say.

[davemac]

@tjm Curious as to your age? I had mine repaired in my 40's. As I recall, doctors seemed to rely heavily on the age of the patient in determining whether to do the repair. Obviously your health and level of activity should also be taken into account.

[tjm]

@davemac 65, my opinion is calander age should have nothing to do with it, but I agree with you in that they probably have a bias in that regard.

[Moskier3ev]

@tjm I am 16 weeks out on a full distal tear repair skiing short sets at 60% all 3 events. I am 56. If your not seeing a sports med specific clinic I would check one out. The difference is. My wife full tear ACL and her surgeon ask are you a 50 year old athlete or a just want to repair it. Surgeon had her Skiing in 3 months at 50%. Full plan to be back competing at 6 months. San Antonio sports med was awesome. My surgeon was great on the distal tear (local ortho with a great sports med background)but did not have a plan to get me back competing. Like SA Sports Med. When I ask him about getting back I just get the protocol sheet answer. My PT skis and has been great. The decisions to ski we’re mine. My experience is sports med clinics don’t want to make you functional they are more about getting you back to where you were.

[tjm]

@Moskier Distal is a different animal. As said mine was repaired 6 years ago. All the guys I'm talking to are sports/ortho's so therin lies my frustration. They all say I'll get back to where I was without the repair. I'd like to believe them, but my way of thinking is to fix things that are broke, so it's hard to trust what they are saying.

 

@Horton They also say the window of opportunity to fix is longer than with distal. The window with distal before atrophy sets in was approx 2 weeks. Because the small head is keeping the muscle stretched I'n told the window is longer, 10-12 weeks. But I'd like to just fix it now and rehab over the winter, Have to find a doc that thinks the way I do.

[ktm300]

I had rotator cuff repair that included tenodesis of long head tendon anchored above the bicipital groove. Shoulder healed up okay but long head bicep tendon let go. I felt it when it did. My Ortho and PT both said it had not ruptured. Got MRI that showed it had. By time of MRI I had already done 6 months of rehab for shoulder. Numerous people, including two orthos, advised against repairing it. I'm fine. Can ski no problem.

However, I am not as strong, it looks messed up and I do get cramping sometimes. I now wish I had it repaired. It would have required another 6 months for rehab and healing and, coming off the shoulder rehab and having the experts advise against it, I passed at the time.

 

Shorter version: You can do fine without it and can most definitely ski w/o limitation. You can also do fine and ski w/o limitation if you have it repaired; plus you won't be left with a messed up arm. Do it now and you'll be 100% ready to go come spring.

[tjm]

I hear you @ktm300 Have to find a guy that will do it. Met another doc this morning and got same answer. That makes 4 unwilling orthos.

[RLW]

As a shoulder and sports medicine orthopedic specialist, I would not recommend surgery for a proximal biceps tear, even in a high level athlete. As some others have suggested, proximal and distal tears are treated differently. The exception for proximal tears would be for patients or athletes who also have a rotator cuff tear. Even in that setting, though, we generally operate on the rotator cuff and leave the biceps. If you search hard enough, I have no doubt you could find an orthopedic surgeon to fix it, but most well trained specialists will appropriately recommend against it.

[RLW]

If you find a surgeon that will fix it, make sure you ask him/her to explain all the potential complications that can occur. It's not highly risky, but you should make an educated decision.

[tjm]

@RLW thank you

[Tai_pan]

TJM, I'm interested to hear if you managed to get the surgery done as I'm in the same boat

[BigGerald3]

The questions you have to ask yourself, does it hurt or cramp excessively? If yes; consider a tenodesis. New studies indicate No strength difference but increased cramping in those not fixed.Distal tears need to b fixed, no question.

[Jody_Seal]

know the tune to Popeye the sailor man?I have been told there are a couple NFL quarterbacks that had that procure on purpose..my shoulder instantly gained more rotational use as well as flexibility in the shoulder when mine went.

[Rw3]

cosmesis and supination strength.

[tjm]

@Tai_pan no surgery, no fix, and really never looked back. All is good.

[Bruce_Butterfield]

I got mine fixed. It was very uncomfortable with one end of the muscle completely disconnected. It “may” have improved over time, but I’m glad I got it fixed.

[Drago]

@Bruce_Butterfield Is that the fixed model⬆️?

[Bruce_Butterfield]

@Drago no :o They don't call it the Popeye biceps for nothing!

[Drago]

Goodness ?