Distal Biceps surgery?

Since: Jun 07

Traverse City, MI

#41 Jun 7, 2007

Here is my experience. I had a complete rupture of my left distal biceps tendon on 5/11. Like you, I had relatively little pain once the initial sting of the injury subsided. I also had a void between my biceps muscle and the inside of my elbow. I suspect that the relative lack of pain might be do to the tendon itself having few nerve endings (just a guess) and the fact that tearing the tendon loose doesn't by itself cause much other damage (again, an uneducated guess). I had surgery exactly one week after the injury. My doctor used a single incision with endobutton technique. I'm now three weeks post-op and I think I'm doing pretty well. Post-operative pain and swelling is pretty much gone. Physical therapy was initiated 4 days after surgery and I'm already close to having full range of motion. As for numbness and dexterity, I had numbness in my forarm from the incision site up into my thumb and index finger but no problems moving either my thumb or fingers. Thumb thawed out within a day or so, the sensation in my index finger three weeks later is almost normal. Numbness in my forearm is steadily going away but I'm prepared for it to be a few months before that all goes away. My doctor is very confident that in time my arm will be as strong and reliable as it ever was. Bottom line - I think anyone who has this injury should strongly consider getting it surgically repaired. I would suggest, if possible, to have the surgery performed by an orthopedic surgeon who specializes in the hand and arm. I was lucky that there is a good "hand doc" in my area who is well experienced in repairing distal biceps ruptures. All I know is that when my injury occurred, you couldn't have got me into surgery quick enough to suit me! If you decide to have the surgery, have it done as quickly as possible... within a couple of weeks is best... the longer you wait, the more complicated the surgery becomes and the less likely you will have a completely good outcome. Whatever you do, good luck.... Brian

Edmonton, Canada

#42 Jun 8, 2007
Thanks for the comment Brian. Unfortunately the system is so slow here, I would be lucky if I could get the surgery within 2 months and from what I have read that will be too long of a wait.

Does anyone know if weightlifting can be employed by those who don't opt for surgery?

[email protected]
Jac in Perkasie Pa

Chester Springs, PA

#43 Jun 9, 2007
I tore the distal bicep at the end of March 07. After the first day, the discomfort went away, and I resumed life. 3 weeks later I lightly tossed a ball for the dog and completed the tear. About 8 weeks after the tear I had the two cut method of surgery. No real pain to talk of. I take 25mg of indomethacin 2xs a day. The surgery was done 11 days ago. I was put into a removable cast 4 days ago. Can I re-injure myself by using my hand (as I am typing this)? I am not lifting just using the hand. Doc wanted a full cast I said no way, this removable is working out great. PS I have discomfort in the muscle that runs on the top of arm from inside the elbow to wrist. Any comments.

Since: Jun 07

Traverse City, MI

#44 Jun 9, 2007

I too have a removable cast or splint that I wear all the time except when I shower and when I do my range of motion excersizes (4 times a day). My quess is that you won't hurt anything by using your hand to type but I would wear the cast as much as your doctor recommends. As for the discomfort in your arm to the wrist, I had the same discomfort that lasted about 2 weeks. The discomfort is gone now but it is still a bit numb. My doctor says the numbness will go away in time. Thats all I know... Good Luck!


Bellevue, WA

#45 Jun 11, 2007
Surgery can be performed after the initial window, however it may require a graft, and the risk of complication is higher.

If you don't have the surgery, the affected bicep is functionally useless (a muscle attached at only one end can't do anything). Other muscles will take up as much of the slack as they can, but there will still be significant loss of strength.

United States

#46 Jun 11, 2007
I ruptured distal bicept tendon 11 days ago Doc set surgury for next Monday. I am having doubts as to if I should have surgury, I'm 50 yrs old and in average health, not sure if I want to put my self through all of this. Has any one not had the surgury and what was the effects?


#47 Jun 13, 2007
Tore my distal bicep(r)last Wednesday doing curls,I heard a popping sound and saw a lump appear on the inside of the elbow and when i bent my arm the bulge i usually had was gone.
Surgury done last Friday and the weekend was murder but the pain is now wearing off just the cast that is annoying me.Stitches due out in 2 weeks and then maybe another cast or hopefully I can persuade the doctor to use a brace.I think Ihad the one incision technique,anyone had this before?
Leningrad Cowboy

Bozeman, MT

#48 Jun 13, 2007
Jim wrote:
Thanks for the comment Brian. Unfortunately the system is so slow here, I would be lucky if I could get the surgery within 2 months and from what I have read that will be too long of a wait.
Does anyone know if weightlifting can be employed by those who don't opt for surgery?
[email protected]
2 months is not preferred, but I don't think it completely rules out the surgery. Just might require them to harvest some tissue from your leg or a cadaver in order to have enough good material to work with. As for weightlifting, I would guess you could, but you'll have one strong side and one weak side on any exercise that involves the biceps. I'd be concerned about overcompensating on the good side and causing a problem that way. For exercises that rely on the biceps, you'd probably would want to lift in a way that each arm works independently and at its own level.
Those are best guesses, not professional opinions.
Leningrad Cowboy

Bozeman, MT

#49 Jun 13, 2007
I'm reading about a lot of people with casts and splints. I imagine that depends on the doc and the procedure, but when I had mine done, all I had was a sling. Technique was the single incision endobutton. Very happy with the results. If your doc is talking casts and splints, ask about the technique he'll use.
I read a lot of medical journal articles pre-surgery (late 2005), and the endobutton was the latest and best technique. And I'm definitely pleased with the results = stronger now than before the surgery with no pain.

El Segundo, CA

#50 Jun 15, 2007
I ruptured mine on May 2nd. and had the surgery on May 14th. I had no pain after and it's now 5 weeks post op. I take my brace off while working in my home office and I do have bouts of tingling down my forearm and into my hand but nothing I am concerned about. The only thing that I noticed is that my Bicep is still retracted but I believe that is because I haven't started PT for ROM yet. can anyone comment on the Bicep position? I would highly recommend having the surgery just make sure you go with the 2 incision tech.

Calgary, Canada

#51 Jun 16, 2007
I just had a complete rupture of my dominant Distal Bicep Tendon.

My Information:
Age: 25
Previous Injuries: Left ACL rupture x 2, right ACl/MCL rupture
Sports: Played lots of soccer, extreme snowboarding (this explains my knees) Was into body building for a couple years around 20-22 yrs old. Never took any steroids, just supplements ie creatine, etc... I now have a pretty sedentary lifestyle sitting in front of a computer and rarely make it to the gym

When the tendon snapped I could actually feel it ripping then heard an audible SNAP or POP. Reminded me instantly of the same SNAP I've heard come from my knees. It was pretty painful when it happened but after the fact I only experience pain while flexing my bicep with palm facing up or supinated. I still have full range of motion in my arm and while my forarm is pronated I can still lift a fair amount of weight with my arm.

It's hard to explain the exact mechanics of how it happened but we'll just say an unexpected load was placed on my arm while it was flexed. My arm never hyper-extended during the trauma.

I have little confidence in my body now. I'm wondering if there are factors that may be contributing to my connective tissue woes such as lifestyle of genetics or something.

As far as I can tell no one in my family has any history of ligament and tendon issues. My aunt on my mothers side and her son both have something called "Bilateral congenital radial ray defect" Which affect their hands.

The Ortho Resident at the hospital didn't seem to believe me when i told him I had never done steroids. He told me that is a risk factor for this kind of tendon rupture.

Now what to do...

I visited the emergency room here and they had me in for sugery right away as a 'drop in day surgery' patient. Unfortunately the doctor on staff that day hasn't done this particular procedure for 12 years so he elected not to do the surgery on me.

Now I will go in again and wait to see if I can get the surgery done right away. The ortho resident seemed to think that It wouldnt matter too much how long we left it as long as the surgery happens within about a week to 10 days after the injury.

Risks they told me about include damaging a major artery in the forearm and also the nerves that were discussed in other posts above mine. He assured me that this isn't a complicated procedure and within about 3 months I should be close to being 100% again.

I'll pot again after surgery.

Hollywood, FL

#52 Jun 18, 2007
Just wanted to clarify something,my butcher Doctor is Barry Shapiro he's part of Total Orthopeadic Care in Broward county Florida. Avoid him at all costs. In Broward county try Dr Gilbert he's been terrific. Always get a second opinion and make sure he's plenty experienced, this is a high risk procedure, much higher than he stated, or maybe he was just incompetant.

Calgary, Canada

#53 Jun 21, 2007

Just had surgery on June19, injury happened on June 13. I was released the next day and spent the night in the hospital, mainly because my surgery took place in the late afternoon. Doc did the two incision method believes it is more robust.

Today is June 21, 2 full days after surgery and I have stopped taking pain killers, pain is very little as long as im not moving around too much. Id rather know when its hurting so i don't stretch the tendon. I have full feeling in fingers and movement so there is apparently no nerve damage. Will keep this half cast on for approx. 3 weeks then see the doc again. Normally would only be 2 weeks but i am travelling out of country and doc has approved me for light duties at work as long as I am not gripping anything or turning my wrist.

Will update again later

New Westminster, Canada

#54 Jun 24, 2007
Ruptured my left distal tendon on June 6 in similar fashion already described by others,(snap, snap, pop)Very little pain but muscle was bunched up on the upper portion of my upper arm. Family doc seen on the 7th but insisted I had only torn a bit of the bicep. "It will heal by itself but will never be quite right" is what I was told. I saw another doctor on June 11 suggested surgery but had no idea how long it would be before I even could see a surgeon for a consult.(Vancouver, BC area)
I went to the states and had the single incision method on Friday June 15.
No Pain after two days, removable splint after one week.
Doing entry level PT now and very happy with the results.(50 years old)

New Westminster, Canada

#55 Jun 24, 2007
Brian S., who did your surgery there in TC?

Since: Jun 07

Traverse City, MI

#56 Jun 25, 2007

First I am very happy you took control of your medical care and got a second opinion from another doctor when your family doc seemed to suggest that you let your biceps tendon rupture heal on its own even though it "would never be quite right" You made the right decision in my opinion. Dealing with recovery after surgury is no picnic but it sure beats having a degree of disability for the rest of your life! You are the second person I have seen on this forum that seemed to indicate that being treated for this injury in Canada is a very slow process. I feel lucky to live here in Northern Michigan where there is a good hospital and good doctors and was able to be treated for my injury very quickly. I'm glad you were able to come here to the US and have your surgery quickly also. You obviously didn't waste any time!
I am now almost 6 weeks post-op. I have been doing range of motion excersizes every day since 4 days after the surgery. I have regained practically all my range of motion. I see the surgeon again this Friday for my 6 week follow up and I'm expected to discontinue use of the removable splint. My arm is starting to feel normal again but I still have strength training ahead of me yet. I still have a bit of numbness in my forearm but it seems to be slowly getting better.
To answer your question, Dr Paul Jacobson of "Hand Surgery of Northern Michigan" performed my surgery. He is located in Traverse City, MI. As far as I can tell he did a good job. Good Luck with your recovery!

Brian S

Newburyport, MA

#57 Jun 25, 2007
My Mom (very active 63 yr old) ruptured her dominant distal bicep on 6-23-07. Over a few different actions in the course of a month caused the damage. First, she grabbed a runaway cart at work before it hit someone, some minor pain but kept on working. Then a few weeks later, she was reaching to scratch the back of her leg caused a weird tearing noise for which she reaceived chirpractic treatment with massage making it feel better (maybe too much better). The final tear was holding a bag of dry food on non-dominant shoulder while picking up a 12-can case of dog food like it was a book under her dominant arm. About an hr later, at dinner she started feeling more and more pain. Her arm swelled double in size. The next day the bruising started and by day 2, it's really bruised but pain had lessened.
On 6-25-07 Ortho Dr. said he wouldn't do surgery on 63 yr old with high blood pressure. The risk didn't outway the benefits of surgery.
I've read some of risks within site ... what would you do? Is there anyone out there that has not done surgery and how are they doing? My Mom is very active and I'm not sure if I should push for her to seek someone that will do surgery.
Also, they only did x-ray, no MRI. Seems that would be standard to do MRI just to know exactly what's going on in there -- do you think?
Any advice on Dr. in Massachusetts? specifically North Shore area?

New Westminster, Canada

#58 Jun 26, 2007
Brian S wrote:
To answer your question, Dr Paul Jacobson of "Hand Surgery of Northern Michigan" performed my surgery. He is located in Traverse City, MI. As far as I can tell he did a good job. Good Luck with your recovery!
Brian S
Dr. Jacobson did mine too! When you see him on friday tell him hello from Gerald in BC.
My recovery is on the way, i do the PT that the girls across the road gave me to do. the rotation of my hand are the worst, palm down just kills. but it is getting better.
Good luck with the strentgh training.

Since: Jun 07

Traverse City, MI

#59 Jun 26, 2007
Hello Gerald,

Well its a small world, isn't it! As a matter of fact, I just had my weekly visit with the physical therapist ladies across the road a few hours ago. I was relaying some of the stuff I have read here with Kate. I told her of your case and she asked me if you were the guy from BC! If so, she asked me to tell you hello!

Yes the rotation of the hand is the most difficult thing you have to work on at this point. Rotating my hand palm down was very difficult for me to do also. I recall coming home after my first PT session and trying to do the excersizes and feeling faint from the pain! Just keep working at the excersizes everyday as prescribed and they will get easier! At nearly 6 weeks post-op I pretty much have my normal range of motion back with very little discomfort now. Even that nasty palm down motion is pretty easy for me to do now and nearly painless. In fact, my arm in general is getting to a point where it is starting to feel normal again.

I will say hello to Dr. Jacobson for you on Friday morning. I will back in PT Friday afternoon as well and will be starting on the strengh training. Good Luck with your recovery.. Keep me posted as to your progress. I check this forum periodically so I will be watching.


Since: Jun 07

Traverse City, MI

#60 Jun 26, 2007

After reading your post, I have a couple of thoughts... I would suggest that you get a second opinion regarding your mother's situation. While your mother's age and high blood pressure are surely factors to be considered I think you will find that another doctor may evaluate the risk factors differently and advise you differently. I know that my doctor told me once that he still advises patients in their 60's to have the surgery if they are still in good health and active. I guess the way I would look at it is this... a lot of people, especially women, are living well into their 80's... Would your mother be satisfied living with a significant loss of strength in her arm for perhaps the next 20 years? Whatever your mother decides, please get a second opinion and more information. At least, whether she decides to have surgery or not, she will be more likely to have peace of mind knowing she had done her homework. Best of luck you you and your mother... please let us know how it goes..


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