Torn Distal Bicep Tendon … any experience?

Apparently this is a relatively rare tendon to bork – more common with the tendons at the top of the bicep to the shoulder-  so I’m not sure if there are as many experiences to share as there are in the hernia and sciatica threads 🙂

So – I’ve snapped the tendon between bicep and elbow – properly detached. Weirdly painless experience (so far). Got a minor injuries appointment the next day (having been first tended to by our medic at work) and it was decided without any scans or whatever is was a case for surgery. Seemingly quite soon – prob by the end of this week (snapped in on Saturday) I’ll apparently get a call the evening before I go in.

In many ways its great the treatment is going to happen so fast (and I’m sure that gives a hint of the severity of whats happened even though I broadly feel fine, even if my arm looks alarmingly weird) , but on the flip side I’m sort of going into this blind in the middle of an intense and daily deadline driven period of work not know how long I might be out of action so I’ve got to try and plan for that and deligate and brief folk around me as well as I can until I’m back on the scene – knowing how long that might be is therefore pretty crucial in doing so

Anyone had this kind of surgery?

What’s the short term (how soon can I expect to be able enough to get dressed and get a taxi to work) and long term recovery expectations form people’s experience?

Can’t help with your specific injury but I tore the tendon from the shoulder off the bicep muscle in Feb 22. Not even BUPA are prepared to operate as the chances of a successful reattachment not the tendon to the muscle lasting long term is unlikely.

Has to be operated on fairly quickly as it shortens rapidly and then the surgeon cannot reattach it. Generally outcomes are very good but do not push it too hard, too fast. You will be given strict instructions post op – follow them to the letter.

Check out shoulderdoc.co.uk for the post op protocol for distal biceps repair. It is a great resource and will answer a lot of your questions

As above, the ends of the tendon dtart to get increasingly ‘tacky’ after a few days, so they are less and less likely to reattach if left for too long.

As for getting back to work, get the specific guidance from the ortho team (make sure you ask this question if you are lucky enough to meet the surgeon before or after, if not your physio will know afterwards), as the exact details can sometimes change a little bit. However, generally speaking, it may well be something like no/low loading for 6 weeks and then no heavy loading (ie contact sports) for another 6 weeks. By loading I mean picking something up with the affected arm. What you need to know is how much you’ll be able to move your elbow, and this is where it gets a little tricky- they may put you in a brace for the first few days and weeks, to limit how much you can straighten your arm, but you should be able to get dressed (short sleeved shirts with buttons and zip up tops will be the easiest) and get a taxi, and work if your job is desk based and not manual.

Are you having general or local anaesthetic? General takes a couple of days to stop feeling groggy

A gymnast I know had similar, although I can’t quite remember if it was top or bottom of the bicep.  He had a notch cut in the bone and the tendon “tied in a knot and put in there” in technical language.

From my memory he was back training quite quickly from that as he was training for a big competition, although that level of athlete are quite different from us mere mortals.

Pretty sure that’s what Eddie Hall had that delayed his ‘fight’ with Thor? He has a video up on YouTube of the operation.  Drilled a hole in the bone and put the tendon through with a bone bitton on the end to hold iirc.

I don’t suppose you can just nip to your Harley Street surgeon like him though?

Someone I used to know did it (Police Officer doing training with one of those battering ram things). Had to get it sorted within days for any chance of recovery. Hence the urgency. Took a while to get strength and movement back iirc.

As far as I know it is worked and he is back to knocking doors down and pointing his gun at bad guys.

Thanks guys – looks like I might be under the knife / drill on Friday at the earliest if no more urgent cases come in (snapped it last sat)

great resources above – will help with short term planning and getting folk to cover for me

About 10 years ago I pulled the bicep tendon off at the elbow. Was sewn back on.
I would say the arm only had 25% strength compared to the other arm, but as I’m no longer a weight lifter, that’s not really an issue.
It’s odd you can feel the tendon ache before the muscle.

I’m surprised at how ‘able’ I am with it detached – not real much clue anything is wrong in normal every day movements despite the seemingly most important muscle not attached to anything.

was getting twinges in that area a couple of years ago that must have been the beginning of it coming lose. But i guess the bits with any feeling came lose first and from that point it’s been failing without me knowing until the ‘sound’ happened

I did exactly this back in 2019. Had it reattached a few days later by specialist arm surgeons in France.

I had the standard method of reattaching it – screw with kevlar cord attached fixed into bone and cord woven/stitched into tendon to reattach. If done quickly, the tendon should reattach itself to the bone and not just be held by the screw.

I had really good results from mine. Surgery end of April. Riding my bike by end of June. Full-time Alpine guiding a couple of weeks later! It took a while before it felt as strong as the other arm / as strong as before. I remember having some issues trying to shift some furniture six months or so afterwards. All very solid now though, don’t notice it at all any more. I have a fairly impressive looking scar as I’m prone to keloid scars, but in most cases the scar should be almost invisible.

The surgery aftermath was much more painful than the injury. As you say, I was surprisingly pain-free and capable with the bicep tendon borked. Docs explained that, while the bicep gets all the glory, there’s actually a whole bunch of muscles in your upper arm that can do a lot of the same tasks. There are some specific movements that can only or largely be performed by the bicep. Rehab wasn’t too bad, essentially just increasing the range of motion steadily over a few weeks.

Docs advice was that at my age (40 at the time) they might consider not operating if I had a desk job as most people can manage OK without a bicep. However, since I’m a pro-athlete of sorts (I’m a snowboard and mountain bike guide, the French state considers me a pro athlete!) then I need a fully-functioning bicep and they would operate immediately. I was in surgery about 18 hours after seeing my GP!

There is a more invasive but slightly more bombproof version of the surgery where they drill a hole all the way through the bone, pull the tendon through it, then stitch a button (of sorts) into the end of the tendon so that it can’t pull back out. Once the bone closes around the tendon, it’s very solid but the tendon is obviously now very short, so more rehab is required to lengthen it.

PM me if you like!

EDIT: We’d just bought our mountain bike chalet at the time and were about to start a pretty intense renovation to get it ready in time for summer. We had to start with me working one-handed (left-handed!) and giving my wife a lot of “no dear, not like that” type directions. That went down about as well as you might imagine.

I’m surprised at how ‘able’ I am with it detached – not real much clue anything is wrong in normal every day movements despite the seemingly most important muscle not attached to anything

It’s a bit of a funny old muscle, the bicep: it helps with a variety of different movements, but isn’t necessarily the prime mover for any of them

A few years ago I tore the lower tendon on my left bicep moving a motorbike around.  I heard it tear and my bicep was a strange shape.  The surgeon was perplexed that I could still move my arm in a particular direction  despite locating the snapped tendon.  They were talking about reattaching it with a screw before realising that I had a spare, redundant tendon.  Some kind of mutation apparently.  It was the first the surgeon had seen in 30 years. The same thing had happened to my dad when he was younger, but he hadn’t sought medical attention. He might have the same thing.  Not much help to you, I’m afraid, but it was an odd discovery.  My bicep is still a bit misshapen, but there’s no lasting effects.  It took a few months to regain full strength.