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Thread: biceps tendon tear

  1. #1
    Join Date
    Jul 2018
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    3

    Unhappy biceps tendon tear

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    Hi Coach!

    I've got a complete distal tear in my left bicep, scheduled for reattachment surgery next week. Doctor says to expect 10d post-surgery in a cast, then weeks in a brace with the elbow at 90 degrees, then weeks in a brace + PT gradually straightening the arm, then months of rehab to restore functionality. The good news is, he says that prognosis is generally for a complete recovery, but that's months away right now.

    I'm looking for training guidance to minimalize strength losses while I rehab; none of my coaches have experience with this injury, and I searched in the Starting Strength forums and couldn't find much detail about training with this injury.

    1. DL is obviously out for now. What about BSQ? I note that I definitely flex my biceps for stability under a heavy BSQ. (As you note in your book, everything is tense in a heavy squat.) Can I do BSQ with a wide grip on the barbell? Are front squats safe?

    2. Should I continue to unilaterally train the good side with dumbells or kettle-bells? Will this lead to a problematic imbalance? Or am I going to have an imbalance anyway and training the good side will prevent some atrophy there?

    Background: 50 yo male, 5+ years of strength training since discovering your methodology. (Thank you, it's been very successful for me.) On and off with coaches making sure I do things right. (~50%? of that time coached overall) Prior to injury, BSQ 3 sets of 5 reps at 1.5x BW, DL 1 set of 5 at 2x BW, BW power clean, max set of 30 pull-ups. Now...?

    Thank you!

  2. #2
    Join Date
    Jul 2007
    Location
    North Texas
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    42,973

  3. #3
    Join Date
    Jan 2018
    Posts
    683

    Default

    Quote Originally Posted by rabbi View Post
    Hi Coach!

    I've got a complete distal tear in my left bicep, scheduled for reattachment surgery next week. Doctor says to expect 10d post-surgery in a cast, then weeks in a brace with the elbow at 90 degrees, then weeks in a brace + PT gradually straightening the arm, then months of rehab to restore functionality. The good news is, he says that prognosis is generally for a complete recovery, but that's months away right now.

    I'm looking for training guidance to minimalize strength losses while I rehab; none of my coaches have experience with this injury, and I searched in the Starting Strength forums and couldn't find much detail about training with this injury.

    1. DL is obviously out for now. What about BSQ? I note that I definitely flex my biceps for stability under a heavy BSQ. (As you note in your book, everything is tense in a heavy squat.) Can I do BSQ with a wide grip on the barbell? Are front squats safe?

    2. Should I continue to unilaterally train the good side with dumbells or kettle-bells? Will this lead to a problematic imbalance? Or am I going to have an imbalance anyway and training the good side will prevent some atrophy there?

    Background: 50 yo male, 5+ years of strength training since discovering your methodology. (Thank you, it's been very successful for me.) On and off with coaches making sure I do things right. (~50%? of that time coached overall) Prior to injury, BSQ 3 sets of 5 reps at 1.5x BW, DL 1 set of 5 at 2x BW, BW power clean, max set of 30 pull-ups. Now...?

    Thank you!

    I have seen KrAzY stuff. It depends how bad you want to train.

    https://www.instagram.com/p/BfeOR0dD...=tim_kamppinen

    Jim Moser on Instagram: “#Repost @james_moser17
    • • •
    227kg/500lb. #NoNoNoNosquat #squats”


    Good mornings too (for deadlift substitute).

    Safety Squat bar comes to mind.

  4. #4
    Join Date
    Jul 2018
    Posts
    3

    Default

    For the record, and hopefully for the benefit of future sufferees of this injury...

    I continued training between the injury and the surgery, doing nothing with the left arm. Lots of DB / KB work on the right side. I found that I was able to squat by putting my arms wide -- all the way out on the collars -- and reducing loads.

    I had a great surgeon, he barely even left a scar! I was in a cast for a week post-op, then in a brace for many weeks. The brace at first kept my arm at 90 degrees, then gradually allowed the arm to open over a period of weeks. During this time, I did physical therapy several times each week.

    Once cleared by my doctor to exercise in general, I went back to the same regimen described above during pre-op, keeping my left arm either in the brace or in a sling during workouts. I used the squat safety bar for squats, being careful to merely balance with the left arm and not actually support anything.

    As physical therapy progressed, I began doing unloaded work on the left side, putting my left arm through the same range of motion / reps as the right side, albeit unloaded. Then I worked with my physical therapist to gradually add load back.

    For pull-up work, we started with "just hang from the bar" and continued with that for a while before I was allowed to do a pull-up.

    At ~6 months post-op, I was fully back in action, able to do everything I could do pre-injury, and had regained most of my strength back too.
    At ~12 months post-op, my strength + fitness was ahead of pre-injury numbers.

    The only change to my training pre-injury vs. today is that I never alternate grip a deadlift; I hook-grip instead, and if my numbers are lower because of that, so be it!

  5. #5
    Join Date
    Oct 2018
    Posts
    49

    Default

    Congratulations on the great recovery.

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