The biceps is a two-headed muscle that originates on the front and top parts of the scapula, and connects to the radius in the forearm. Ruptures to the bicep most often occur along the tendon near the shoulder, and usually affect people ages 40 to 60. They can happen to anyone, though, if there is a violent biceps contraction or traumatic event. Either one of the two heads can rupture, and treatment of a torn biceps may or may not require surgery. Consult your physician, but in some cases there are simple techniques you can use at home to help heal the torn muscle.
- Skill level:
Things you need
- Compression wrap
- Anti-inflammatory medication
- Elastic therapy bands (optional)
- Lightweight dumbbells (optional)
Symptoms of a biceps tear or rupture include sudden pain, loss of strength with elbow flexion and supination, a sensation of something "rolling up" in the arm and tenderness along the length of the biceps head.
Apply ice immediately if you suspect a biceps tear. Wrap the ice in place on the most painful area using a compression wrap, and place your arm in a sling. Visit an orthopedist or other health-care professional as soon as possible to confirm the diagnosis.
Control pain and swelling so that damage can be minimised and treatment can begin quickly. Use NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen or naproxen, and always follow the suggested doses on the bottle.
Follow the RICE (rest, ice, compression, elevation) protocol for at least the first 72 hours, with the sling used to keep the arm elevated. Apply ice with the compression wrap in a 20 minute on/20 minute off cycle for two to three hours for the first three days.
For patients in the 40-to-60-year age range, conservative management without surgery is often recommended. Rest the injured arm until the pain and swelling subsides completely.
Begin gentle range-of-motion exercises once all the pain and swelling are gone. These include forearm flexion (bringing your fist up toward your shoulder), forearm supination (with your elbow bent to 90 degrees and your palm facing down, slowly turn only your hand so the palm faces up) and shoulder flexion (with your arm at your side and palm facing forward, bring your arm up in front of you until it is parallel with the ground; keep your elbow straight).
These exercises should be done slowly. Perform three sets of eight repetitions for each motion. Perform the exercises to your maximum threshold once per day for the first week after the pain and swelling have subsided.
After one week, you can perform exercises with a light-resistance elastic therapy band or 0.907kg. dumbbells. Progress to heavier weights in 1 or 2 pound increments once per week as tolerable. If pain or swelling return after exercises, revert to the RICE protocol for 48 hours before resuming therapy.
If the biceps is ruptured in a person who requires full supination strength, such as an athlete, surgery may be required. Your surgeon will attempt to repair the defect and will prescribe physical therapy to restore pre-injury levels of strength and range of motion.
For the first two weeks following surgery, your arm will most likely be in a sling. The sling may be removed to perform light movements and range-of-motion exercises.
After two weeks, therapy will include the use of small-weight dumbbells or therapy bands in a similar fashion to the non-operative treatment. You can perform the same exercises using the same guidelines.
You'll continue therapy for six to eight weeks, continuing to progress with more functional activities and greater range of motion. Your return to full activity could take up to several months.
Tips and warnings
- Proper treatment of a biceps tear depends heavily on your use of the injured arm, so refer all suspected injuries to the area immediately to a physician trained to deal with muscle tears.
- Do not place ice directly against your skin, as this can cause tissue damage.
- Some people may have inadvertent reactions to NSAIDs, so if you use them, be sure to use one that you have used before.
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