A Complete Guide to Regain Strength and Function after Biceps Rupture

Our bodies are incredibly resilient. However, sometimes injuries occur, consequently hindering our ability to perform daily tasks and pursue our passions. One such injury that can have a significant impact is a biceps rupture. This occurs when the tendon connecting the biceps muscle to the shoulder or elbow tears. As a result, it can cause pain, weakens the muscle, and limit mobility. But listen up! There is hope for recovery! In this article, we will explore the anatomy of the biceps, various treatment options, and how our physical therapists can guide you through the recovery process.

WHY DID IT RUPTURE?

• Age-related degeneration
• Predisposing conditions
• Overuse and repetitive motion
• Trauma or Acute injury

Age-related degeneration

As we age, our tendons gradually lose their elasticity and strength, making them more prone to injury. That’s why biceps ruptures generally occur in people who are between 40 and 60 years old. People in this age group who’ve had shoulder problems for a long time are at most risk. In this case, the biceps can rupture even with daily activities.

Aging adults with rotator cuff tears also commonly have a biceps tendon rupture. Unfortunately, rotator cuff injuries are very common. When you tear a rotator cuff, the ball of the humerus is free to move too far up and forward in the shoulder socket and can impact the biceps tendon. The damage may begin to weaken the biceps tendon and cause it to eventually rupture.

Predisposing conditions

You might have a higher risk of rupturing your biceps if you have a long history of shoulder pain from tendonitis (inflammation of the tendon) or shoulder impingement syndrome. That’s why we don’t want ‘small problems’ to become ‘big problems’. If you have chronic shoulder discomfort, consult with your local physical therapist today to prevent more significant injury.

Overuse and Repetitive Motion

Repeatedly performing activities that strain the biceps tendon, such as throwing a baseball or lifting heavy weights, can weaken the tendon over time, making it more susceptible to rupture.

Trauma or Acute Injury

A sudden forceful impact or direct injury to the upper arm or shoulder can also result in a biceps rupture, such as accidents or falls where the arm is forcefully extended or twisted.

What are the symptoms of biceps rupture?

• A sharp pain followed by hearing a loud ‘pop’ or snap. Did you notice that the pain went away immediately after you felt it? Unfortunately, this might indicate that you have a complete rupture because tension is immediately taken off the pain sensors in the tendon.
• Bruising in the middle of the upper arm and down to the elbow.
• Balled-up biceps, especially in younger patients who’ve had a traumatic biceps rupture.
• Weakness and unable to bend the elbow or lift the shoulder.

How Can I Recover from Ruptured Biceps?

Do I need to get surgery to fix the ruptured biceps?

Good news! Doctors usually treat a ruptured long head of the biceps tendon without surgery. This is especially true for older individuals who can tolerate a loss of arm strength or if the injury occurs in the non-dominant arm.

Not having surgery usually only results in a moderate loss of strength. The short head of the biceps is still attached and continues to supply strength to raise the arm up. Flexion of the elbow may be affected, but supination (the motion of twisting the forearm such as when you use a screwdriver) is usually affected more. Not repairing a ruptured biceps reduces supination strength by about 20 percent.

Nonsurgical measures could include a sling to rest the shoulder. Patients may be given anti-inflammatory medicine to help ease pain and swelling and to help return people to activity
sooner after a biceps tendon rupture. These medications include common over-the-counter
drugs such as ibuprofen.

How Can I Treat Ruptured Biceps without Surgery?

Reach out to your local physical therapist to discuss non-surgical treatment options for biceps rupture. At Advanced Physical Therapy, we have had successful results with patients who had biceps rupture by implementing the key principles below:

1. Individualized treatment plan: As we discussed various risk factors that can lead to biceps rupture, we will take a thorough history to tackle the factors that lead to biceps rupture. Through the following sessions, we will guide you through the rehabilitation process assessing your unique history of injuries and discomfort.
2. Pain Management: We utilize various techniques to minimize your pain, such as manual therapy, instrument-assisted soft tissue release techniques, pain-modulating exercises, and electrical stimulation. These are highly effective tools to alleviate pain and reduce inflammation in your biceps.
3. Restoring Mobility and Strength: Through a tailored exercise program, we are experts in guiding patients to regain range of motion and strength gradually and successfully.
4. Functional Rehabilitation: At Advanced Physical Therapy, we take pride in treating the whole patient, not just the injury. We will focus not only on the recovery but also on returning to specific activities that you are missing out on. Whether playing sports or working on projects around the house, our personal and functional programs guide patients to regain confidence and safely return to their daily lives and athletic endeavors.
5. Injury Prevention: We always educate patients about proper body mechanics, posture, and techniques to minimize the risk of re-injury. This empowers them to adopt preventive measures to maintain their health and well-being. Rupturing the biceps once is enough. You can prevent a second one by committing to physical therapy.

Do I still Need Physical Therapy after surgery?

Yes! Physical therapy will increase your chance to have a successful outcome after the surgery. Here is what it’s going to look like:

<UP TO 4 WEEKS AFTER SURGERY: Establish individualized treatment plan and manage pain>

1. Wear your sling for about four weeks.
2. Share your history and ideal outcome with your physical therapist.
3. Learn to gradually regain range of motion. At this stage, less is more.
4. Reduce swelling and pain. When you start therapy, your first few therapy sessions may involve ice and electrical stimulation treatments to help control pain and swelling from the surgery. Your therapist may also use massage and other types of hands-on treatments to ease muscle spasms and pain.
5. Gradually start exercises to improve movement in the forearm, elbow, and shoulder.

<UP TO 6 WEEKS AFTER SURGERY: Restore mobility and strength>

1. Begin light isometric strengthening exercises. These exercises work the biceps muscle without straining the healing tendon.
2. Strengthen the muscles around the shoulder and elbow
3. Gain further range of motion of the shoulder and elbow. Progress might be slow, but patience is the key!

<6 WEEKS AFTER SURGERY: Functional rehabilitation and injury prevention>

1. Start doing more active strengthening geared towards your goal. As you progress, your therapist will teach you exercises to strengthen and stabilize the muscles and joints of the elbow and shoulder.
2. Learn to perform your daily tasks or sports activities in a way to prevent a secondary injury.

Experiencing a biceps rupture can be a frustrating setback, but it doesn’t have to be a permanent one. By understanding the causes of biceps ruptures and the benefits of physical therapy in the recovery process, you can take an active role in your rehabilitation journey.

If you suspect a biceps rupture or have been diagnosed with one, reach out to us and our physical therapists will design a personalized treatment plan to address your unique needs. Through guided exercises, pain management techniques, and a comprehensive rehabilitation approach, physical therapy can help you regain strength, mobility, and confidence, allowing you to resume the activities you love.

If you have further questions about starting physical therapy with us, check out our frequently asked questions.