Thursday, 29 January 2015

Biceps Tendon Rupture

Towards the end of last year, I wrote a blog about an Achilles tendon rupture. A similar type of injury can occur in the upper arm to the biceps tendon, where this tendon is torn off the humerus bone in the upper arm. The biceps tendons attach the biceps muscles to the bone at the shoulder joint (long and short head of biceps tendon) and at the elbow joint.


Causes
Biceps tendon rupture is either caused by chronic degeneration of the tendon, or by an acute traumatic injury. Prolonged tendinitis of the biceps tendon, as a result of excessive prolonged overhead movements, such as swimming, make the tendon weak and more susceptible to tearing. In biceps tendon ruptures at the shoulder, the rupture tends to occur as a result of the tendon continually passing over the head of the humerus, causing degeneration of the tendon. This is more commonly seen in older individuals who have participated in activities involving repeated overhead movements of the arm over a long period of time. Alternatively, the biceps tendon can rupture during a traumatic event, such as heavy weightlifting.

Signs and Symptoms
An individual may hear and/or feel a snapping sensation at the site of the tear and there is usually intense pain. The following may also be present:
·         Skin discolouration and bruising in the upper arm
·         A visible abnormality in the muscle belly when the elbow is bent
·         In the case of a rupture of the long head of the biceps tendon at the shoulder, there is an obvious “Popeye” appearance, where the muscle belly bulges out (like Popeye when he flexes his biceps)
·         Ruptures at the elbow result in pain and weakness near the elbow, especially when bending the elbow and turning the palm upwards

Treatment and Management
In a complete biceps tendon rupture, surgery is required to reattach the tendon to the bone, especially in younger, more active individuals. A sling is then used to ensure the arm remains immobilized while the tendon heals. Physiotherapy is required to regain range of motion in the shoulder joint. Finally, biokinetic therapy is essential to final phase rehabilitation, to provide stretching and strengthening exercises in order to regain full function. In the less active population, surgery is not necessary, as adequate function can be regained with the help of an appropriate exercise rehabilitation programme.

References
Foundations of Athletic Training: Prevention, Assessment and Management

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