RFI - Ruptured bicep tendon

[Paso Quito]

I had an interesting weekend... was loading 50lb bags of horse feed into the Tahoe and felt/heard a loud POP from my left shoulder area. Did some research and found that the new look to the bicep probably meant a ruptured tendon. A doctor visit confirmed this but added that one of the tests indicated that I may have also torn another tendon that forms part of the rotator cuff. This injury is to my non-dominant arm. One good thing though, my shoulder had been hurting badly for the week prior and after the pop it quit hurting! Now it's the bicep hurts when I move it wrong.

The Dr. says if the MRI shows no tear in the rotator cuff that all I need is a little therapy & all will be good. If the other tendon tore he recommends surgery to correct it.

My experience with friends & shoulder surgery is not good. I don't know one person who is glad they had it done.

My question is this: does anyone here have any experience with this injury? Did you have surgery? What are the long term impacts... surgery or not?

I just turned 61 and my athletic days are behind me but I still want to be active outdoors. I think that this issue is due to having too much fun when I was younger and indestructible!

I appreciate your input.

[Duces Tecum]

That doesn't sound like a good thing. Get an opinion from a specialist (ie, a physician who has successfully treated similar injuries).

[Doc_Glock]

If you Poll Orthopedic Surgeons on this issue, and what they would do for their own Biceps rupture, you will find the results pretty evenly split between those who would ignore it and repair it. That is not really helpful, but it is true.

[LSP552]

Sorry to hear this! Hope you heal up fast!

I have a good friend who did this this in elk camp one year while we were unloading water drums. He stayed but wasn’t able to hunt. One of our friends was a medic in Vietnam who put him in a sling and immobilized the arm. He ended up with surgery for a completely detached tendon.

He recovered completely.

[Robert Mitchum]

Triceps tendon rupture 15 1/2 years ago .... came off the bone.
Left side of my shoulder has been cashed for 30 years ..I can not lift my left arm up past shoulder height.
I had the surgeon who worked on the UConn Huskies Football and Basketball teams... he did my Surgery on my Triceps tendon
.
I never had Surgery on my shoulder ..... but have lifted weights ever since.

My Bench press and deadlift are over the State record for 65 year old 242 pound class.
Go to Doctors who work with athletes ..they are the best ones to deal with.


"Injury to the triceps tendon is almost always traumatic. It is usually the result of a strong force that suddenly bends the elbow while the triceps muscle is trying to straighten the arm. This causes the triceps tendon to separate from the bone, which is known as a triceps tendon rupture".

[blues]

I thought I ruptured or tore the biceps tendon but it turned out I had torn the capsule. Orthopedic surgeon said no surgery required and gave me a note for work excusing me from qualifying that quarter. Got my strength back but the bicep never looked quite the same. It looked like it had rolled up a bit toward the shoulder.

When my rotator cuff in the other shoulder was giving me hell I wouldn't submit to a knife and spent months giving myself trigger point therapy after buying the best (expensive) medical volumes on the subject.

It worked but it took a long time until I could lift weights again.

[scjbash]

I tore my bicep tendon and the subscapularis. I felt it happen, and it wasn't my first rodeo with tears. The doctor I saw is supposed to be a great surgeon, worked for two professional sports teams, etc. He insisted it was tendonitis and treated it for over a year with injections and pills. I eventually got fed up with him and changed doctors. The new doc diagnosed the tears with the first physical exam and confirmed it with MRI.

By that point I had serious issues with atrophy and loss of range of movement. I spent almost every day of the next year in physical therapy. I quit going to PT a little over a year ago. Life being life I didn't keep up with it at home like I should have. Just today I was telling someone I'm going to have to start it again. I still have problems with pain, tightness, and strength and stamina in that shoulder. It hurts right now from shooting a couple hundred rounds this evening.

I should have trusted my instincts and what my body was telling me and got a second opinion from the beginning. My advice is to not hesitate to get a second opinion and stick with PT as long as you have to. Don't do something stupid like running a chainsaw for a week before you're truly healed. Find out if any of the good physical therapists in your area have class IV laser therapy available. I received the laser treatment at the end of most sessions and can't recommend it enough. I felt much, much better on days I had the laser than days I didn't. My therapist said he had a lot of success using the laser for those injuries.

[Paso Quito]

Thanks to all for the replies. The doctor I am seeing works for a couple of MLB teams, one NHL team, one arena football team. He seems to know his stuff pretty well even if he also seems to be in quite a hurry. The MRI is tomorrow and I'm hoping to find out I didn't tear the subscapularis like scjbash. I've done the wait & see thing thinking/hoping it would get better and ended up paying for it later... not going down that road this time. I am highly motivated to do what it takes for a full recovery. I have slowed down a lot since I was 25 but I'm not ready for a rocking chair on the porch yet. I'm praying that PT is all it will take, I really don't want to be cut on again.

I'll look at the trigger point therapy, never heard of it until now.

The laser therapy sounds good. I use infrared LEDs to treat joint inflammation... I have this pretty often as a result of playing sports with reckless abandon when I was younger. Back then we didn't do PT after an injury, we simply suited up as soon as we could walk and went at it again... stupid looking back at it but that was all we knew and I am paying for it now. I will always follow through on PT & at home exercises, especially with a very active wife who helps keep me motivated.

[Malamute]

Are they going to use contrast in the MRI?

When I was injured, they did an MRI (without contrast) on the shoulder and said it wasnt too bad, and just keep doing all the excruciatingly painful PT exercises and other therapy I was getting. After 4 or 5 more months and slowly degrading abilities, the therapist said there was something else wrong and I probably needed surgery. Another MRI,..."Oh, look! Theres more damage than we first thought, you need surgery on that shoulder". To shorten a long story, had the surgery, recovery was complicated by other aspects of the injury. After more than 2 years its still painful in an interesting variety of ways including being able to sleep on that side, doesnt have the range of motion as before, such as problems being able to draw many holster types on the right side, and i still cant shoot any long guns with much recoil right handed. Hoping some shots may help with the pain.

[Paso Quito]

Had the MRI this morning, no contrast. I did have to drive an additional 20 miles to get to the biggest, baddest MRI machine in the valley though. The operator said that it is the most powerful MRI used on people (3 Tesla magnets) and that anything bigger was for research only. Will find out Monday whether it's PT or surgery then PT. The bicep & shoulder don't hurt as much now so I am really hoping for PT only.

[11B10]

I had an interesting weekend... was loading 50lb bags of horse feed into the Tahoe and felt/heard a loud POP from my left shoulder area. Did some research and found that the new look to the bicep probably meant a ruptured tendon. A doctor visit confirmed this but added that one of the tests indicated that I may have also torn another tendon that forms part of the rotator cuff. This injury is to my non-dominant arm. One good thing though, my shoulder had been hurting badly for the week prior and after the pop it quit hurting! Now it's the bicep hurts when I move it wrong.

The Dr. says if the MRI shows no tear in the rotator cuff that all I need is a little therapy & all will be good. If the other tendon tore he recommends surgery to correct it.

My experience with friends & shoulder surgery is not good. I don't know one person who is glad they had it done.

My question is this: does anyone here have any experience with this injury? Did you have surgery? What are the long term impacts... surgery or not?

I just turned 61 and my athletic days are behind me but I still want to be active outdoors. I think that this issue is due to having too much fun when I was younger and indestructible!

I appreciate your input.


Well, I'll start with my FIRST shoulder reconstruction - on my right shoulder in 2005. It required this surgery because of a long history of throwing baseballs - then it finally tore completely while doing incline bench press on the accursed Smith machine. The surgery was a success, after a full year of rehab. I was cleared to do anything weight-related, but absolutely NO throwing, ever. I then blew up my left shoulder in 2010. Same everything as the first one. Surgery, followed by a full year of rehab. Today my left shoulder is as good as it will ever be - right one is trashed again, a result of my "catching" a lawn mower that was rolling off the tailgate of my truck a couple years ago. Will I have surgery again? MAYbe. Oh, for the record, I'll be 70 in July and still pump iron three times a week. Some guys never learn, or, as my smart ass self says: "Weightlifting is good for you - I've got the scars to prove it."

[scjbash]

I'm surprised he didn't order contrast. I'm no expert and maybe he had a reason not to, but my doctor said contrast was important because it reduced the chance of something being missed like Malamute dealt with.

[Paso Quito]

Shoulder injuries suck... I know about that process of working hard to get full strength & motion back only to injure it again just living life. It seems like my shoulders have never been quite as stable after rehab as before the injury. Anyway, can't stop doing what it takes to live... activity is what keeps us young! I gave up heavy weights, especially bench press when I figured out that my right shoulder started to dislocate when I dropped the weight. I just couldn't get myself to do bench without bring the bar clear to my chest & that caused problems so I stopped. Now I'll use fairly light dumbbells very slowly or pushups and that allows me to move the shoulder joint the way it wants to move & still stay where it is supposed to. The heaviest thing I work with now is 100+ lb bales of hay. Not really heavy but awkward. Anymore I don't even pick them up much... learned to build stair steps and flip them up when stacking.

I agree that working your body hard is the best thing you can do (within reason of course) to stay healthy and active. When I quit doing my 3x/week workout it seems that my whole body starts to ache & joints start to tie up.

[Paso Quito]

MRI shows partial tear of the rotator cuff but not bad enough to require surgery. Going to do PT twice a week for a month and re-assess. The PT will be good because I 'll work both shoulders & that will help the right side too.

[blues]

MRI shows partial tear of the rotator cuff but not bad enough to require surgery. Going to do PT twice a week for a month and re-assess. The PT will be good because I 'll work both shoulders & that will help the right side too.

At least the news wasn't as bad as it might have been. Good luck with the PT.

[Malamute]

MRI shows partial tear of the rotator cuff but not bad enough to require surgery. Going to do PT twice a week for a month and re-assess. The PT will be good because I 'll work both shoulders & that will help the right side too.

Hope for the best, but...

Thats similar to what they told me when they did the first MRI without contrast. The second one 7 months later with contrast showed more damage than they first thought and that it needed surgery. Hopefully yours wont be a repeat of that.

[Mjolnir]

MRI shows partial tear of the rotator cuff but not bad enough to require surgery. Going to do PT twice a week for a month and re-assess. The PT will be good because I 'll work both shoulders & that will help the right side too.

Have you looked into a process using YOUR stem cells?

If you haven't or are interested look into a company called Regenexx. They aren't the only ones doing it as I see advertisements for local doctors here in BTR, LA.

I'm having shoulder issues and this would assist.


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[Paso Quito]

Thanks all for your support.

I am reasonably optimistic that the PT will do the job since the shoulder/bicep pain has reduced dramatically over the past week. I start PT Friday and follow up with the Dr after four weeks of PT. I am going to work hard to get both shoulders in the best possible shape in the next four weeks. The Dr is a surgeon and seems to lean that way given any reason for surgery. I am against shoulder surgery unless there is no other option.

Thanks for the heads up on Regenexx... it turns out that they have an office about 5 miles from my home! I have looked into stem cell treatments for my ankles (years of basketball & running have taken their toll) but had not thought about it for shoulder work. It looks like the treatment has come a long ways since I first read about it. If the PT doesn't produce the results I want I will definitely go talk to the Regenexx people (or someone who does similar treatments). I would really like to talk to actual patients who had the treatment a few years ago to see what they think now!

[Hemiram]

I messed my left shoulder up in the early '80's. It was minor until I fell asleep under a ceiling fan and when I woke up, it was pure hell. It got worse and worse, and eventually I went to a well known orthopedic practice, who took Xrays and said I had "an impingement", and sent me to PT. I resisted the therapist's suggestion of ice packs followed by ultrasound and heat, and just got the US and heat, and it got better and better. Then I cracked with only a few more sessions and allowed them to use the ice. BIG mistake. When I was done with PT, my shoulder was worse than ever. One night, I took my mother out to dinner for Mother's Day, and I was hurting so bad, I could barely eat. Over time, the pain was less, but I always had some, and once every 3 months or so, I would set it off and have a week of misery. In 2007, I had a life changing fall at a gas station one night. I piledrivered my right knee into the sidewalk, and it went numb instantly, and I put my right arm out to keep my face from planting itself into the sidewalk. I felt some pain in my shoulder and felt something tear. It wasn't all that bad, as my left shoulder hurt worse. I went to the ER by ambulance and mentioned my shoulder was hurt, but the main issue was my 2X normal knee size, stretching my Achilles tendon to almost the breaking point and bending my foot way further than it wanted to, causing the "Bacon Foot" seen in this pic, taken well over 2 weeks after it happened:
23528
My knee, taken at the same time as the above pic:
23529
Ten years later, my knee is still partially numb, and every so often, it decides to just fold up, but at least it doesn't hurt.
Getting back to my shoulder, They did an MRI and I had two torn rotator cuffs, and I also tore my bicep all up:
23530
This was taken about the same time as the others, it was with a cheap digital camera that didn't do red very well, so it doesn't look as bad as it did in real life.
About three months after the fall, I tore my left quadriceps tendon, where else? PT. I had surgery and it had a decent outcome, but I found out the hard way not to trust it. I get up and down fine, but something causes me major issues on stairs more than about 3" high. I've fallen down a bunch of times over the years going up and down stairs.
They recommended surgery on my shoulder right after the quad repairs, but I don't know a single person who had a good surgical outcome, and besides, I wasn't walking worth a shit, so I passed on it. I was more scared of falling than I was about my shoulder not working right. I was "warned" that not having surgery would be a huge mistake, and that I would have little use of my right arm. In the beginning, I could partially dislocate my shoulder joint just by shrugging, It hurt a little, but not much, really. Three years later, I suddenly was able to raise my arm above my head, and I have about 80% motion. My torn up bicep is a hassle, anything over 50 pounds is too heavy to lift, and if I do lift something heavy, I can feel my bicep tearing. It's all full of scar tissue now, and pain is minimal, so I see no real need to do anything more about it. So at this point, I have one ok shoulder(Left), one bad one, and two bad knees. Isn't life grand?

[Nephrology]

The operator said that it is the most powerful MRI used on people (3 Tesla magnets) and that anything bigger was for research only.

The FDA actually just approved the first 7T MRI back in October. Mayo probably has one ;)

I used to use a 16.4T NMR magnet to take MRIs of mice... if my imaging protocol was too long or had too many slices I would occasionally microwave the poor mouse to death. That was a pretty fun project, in retrospect.



Thanks for the heads up on Regenexx... it turns out that they have an office about 5 miles from my home!

I would be extremely suspicious if a company claimed to be able to use your mesenchymal stem cells therapeutically. At present the only FDA approved stem cell therapy for any disease is stem cell transplant (aka bone marrow transplant) for hematological maligancy. This company Regenexx reeks of snake oil.

Platelet rich plasma injections are supposedly helpful (albeit highly understudied). However, you do not need a snake oil salesman to administer those. You might be able your PT if they know anyone that will do that for you - the technology is stupid simple.

[Paso Quito]

Hemiram... I feel your pain. Getting old isn't for sissies (not that you said you are old but it sounds like you might be past your best used by date like I am)! It sounds like you too need to keep moving to prevent lockup. Good luck with everything. If I can get back to throwing around 50lb feed sacks I will be OK with that.
Nephrology... I didn't know about the FDA approval issues you mention. I did notice that you have to travel out of the country to have the Regenexx treatment that grows stem cells (If I understand their website correctly). I too am skeptical about this technology. I would like to be able to sit down with several people who have been through it & pick their brain.

At this point I'm doing PT, it's going well and I am pushing to get as much out of it as possible. Initial visit to PT shows that mobility is still good in the bad arm/shoulder with pain only at certain points. We are not doing much strength work yet but are working to get/maintain a good range of motion while giving the torn tendon a chance to heal before adding to much strengthening exercises. I am doing some resistance so that any scar tissue that forms will be oriented so that it will be less likely to tear again.

[Hemiram]

Hemiram... I feel your pain. Getting old isn't for sissies (not that you said you are old but it sounds like you might be past your best used by date like I am)! It sounds like you too need to keep moving to prevent lockup. Good luck with everything. If I can get back to throwing around 50lb feed sacks I will be OK with that.

At this point I'm doing PT, it's going well and I am pushing to get as much out of it as possible. Initial visit to PT shows that mobility is still good in the bad arm/shoulder with pain only at certain points. We are not doing much strength work yet but are working to get/maintain a good range of motion while giving the torn tendon a chance to heal before adding to much strengthening exercises. I am doing some resistance so that any scar tissue that forms will be oriented so that it will be less likely to tear again.

I'm 61 now. I was 51 when I had the "big fall". My lesson learned in PT is if you don't think something is working, or it's a bad thing to do, such as the ice packs with me, stand your ground and don't let them talk you into anything. I hope to void PT forever at this point, my results have ranged from mildly negative to total disaster. The last time was the least negative. At least I avoided an ambulance ride to the ER or Ortho Doc's office, unlike the last two previous times, where I went to the ER, and then to surgery. Several of the things that PT and the ERs did would probably make me get a lawyer if they happened now. Good luck.

[Nephrology]

[MENTION=1559]Nephrology... I didn't know about the FDA approval issues you mention. I did notice that you have to travel out of the country to have the Regenexx treatment that grows stem cells (If I understand their website correctly). I too am skeptical about this technology. I would like to be able to sit down with several people who have been through it & pick their brain.

There is no good evidence that shows that this technology works outside of the lab. This is why you have to travel outside the US to get their stem cell therapy: the FDA has not approved it for use in the United States, precisely because nobody has shown that it will do more harm than good. I would strongly advise that you pass.

[Paso Quito]

My lesson learned in PT is if you don't think something is working, or it's a bad thing to do, such as the ice packs with me, stand your ground and don't let them talk you into anything.

This is great advice... not only in this particular instance but for living in general. Looking back over my life to date I have many times disregarded that feeling that I was being told to do something that I shouldn't... not something morally wrong but something that just wasn't right for me. I regretted not standing firm every time. I appreciate the reminder!

[Paso Quito]

There is no good evidence that shows that this technology works outside of the lab. This is why you have to travel outside the US to get their stem cell therapy: the FDA has not approved it for use in the United States, precisely because nobody has shown that it will do more harm than good. I would strongly advise that you pass.

What is it we were taught when young... if it seems to good to be true it probably is...

I really want the technology to work as described because it would be so cool to regenerate joint fluid, cartilage, etc and get rid of that nagging constant irritation. Having said that, the claims I see on the web remind me of the carpet bagger in the Outlaw Josey Wales who was selling the snake oil... good for everything & priced at what the market would bear.

I just don't see myself ever going down the stem cell path unless we start seeing fantastic results here in the States. I am kind of anti medical field (as it is today) anyway... too many tests, too much covering of the hind end, too many pills to treat stuff that should be dealt with by changes in lifestyle. My blind adherence to recommendations by specialists when I was younger resulted in many of my current aches & pains. Back then I assumed that MDs really knew their stuff. After spending a month with my dad in intensive care almost 40 yrs ago (him in the hospital and me visiting) I learned very clearly that doctors/nurses/specialists/etc are people... good ones and bad ones. I learned to ask questions about everything and to do my own research.

I figure that I know my body better than anyone else. I want learned people to advice & assist but feel that my health is my responsibility. This mindset and decent genetics have allowed me to reach 61 yrs without taking any medications other than the temporary Ibuprofen I've mentioned before. I see friends & family taking medications for something, then adding another prescription to treat the side effects of #1 and this snowballs. God willing, I will never go down this road. I try to stay active, accept the limitations that come with age (I'm not very graceful about this though) and keep on moving forward and improving those things I can.