Distal Bicep tendon issue

[Andy Baker (KSC)]

An update and a cautionary tale.......

Had my 6-week Post Op follow up appointment with my surgeon and the physical therapists at the hospital. Upon their recommendation I was told I could come out of my sling, but was "to do no heavy lifting at all for another 6 weeks."

I asked "define heavy lifting." The PTs firm recommendation was nothing heavier than a cup of coffee until 12 weeks post-op.

After phone consultation with SSC Dr. John Petrizzo, we put together a more realistic protocol and six weeks post op I was able to High-Bar Squat 315x8 and Bench Press 135x5x3 with no pain. I did some light pulldowns, seated cable rows, and cable pressdowns for 3x20 each (upon Dr Petrizzo's recommendation) and today my arm and bicep feel better than they have since the injury 2 months ago.

We have some excellent resources within our community and if you have to unfortunately undergo surgery, I would suggest to anyone to use the resources available to you. We have a number of SSCs who are also PTs and are more interested in getting you back under the bar than what you will likely find in your local market.

[Keith Burnett]

Mine wasn’t rolled up all the way to my shoulder either. I had about a 1-2 inch gap where the distal head of my bicep had formerly been. My surgeon was able to diagnose my rupture with a manual exam, an MRI wasn’t necessary. Ask for the “hook test” by an orthopedic doc. I had my bicep reattached about 5 weeks ago, after a complete rupture. Get it diagnosed ASAP, surgery gets more complex after about 10 days. If you get the repair, insist that your doc use the endobutton procedure

Get it diagnosed ASAP....very good advice. The lacertus fibrosus will inhibit retraction of a fully torn BT as will high grade partial tears. You can't let it wait....as prognosis becomes fairly poor after a couple of weeks for surgery. I know many top notch orthopedic surgeons, and I myself was a faculty member for a Sports Medicine fellowship (teaching MRI to fellows). A good surgeon can certainly suspect a tear but needs accurate information for surgical planning, and they get MRI.(No they do not own). Push for MRI quickly if you can.

I never asked one of these surgeons how the integrity of a primary repair is affected by subsequent weight training. Lots of bros out their rupturing their biceps.

[JohnStrangeway]

Thanks for all the info.

I'm in the UK, so I won't have access to these guy's. I will discuss the procedure you've mentioned with the surgeon, I'm hoping to see one within the next few days. My private health care has stopped, so I'll be using the NHS, most of the time you don't have a choice on what procedure you want them to do.

Thanks.

I don't wish to derail the thread but its funny to read this today. I just started a blog about my journey back to competing after being out 4 years due to 4 surgeries(in the US) and I actually posted about the NHS.

This is a snippet from the post I did just this afternoon

"We all joke about British healthcare but the following is a true story.

Around that age, 15-16, I went to see our family Doctor, Dr Cameron. I told him about my left shoulder always aching. He pokes it a bit and then say's "can you do this?" as he lifts his arm overhead. I lift my arm overhead, "yes". "Does it hurt?" he asks, "no" I reply. He then tells me its fine and sends me on my way. I have never been much of a complainer and left it at that.

I wish I made that up."


I wish I bitched more to get it sorted back then to save me from a dodgy shoulder after repeated retears because the tissue was trashed with being tore for so long(20+ years). Although it was tore through my 20's and 30's I still lifted and didn't really think about it,it was just was pissy laying down. It's amazing what you can get used to though.

Anyway good luck and hope you get it sorted!

[Gav1]

I'm completely shocked. I went to see the surgeon today and he said he can do the surgery tomorrow. I told him that I couldn't do that as I'm moving house over the weekend and can't afford to be laid up over that time. I'm going in next week, so that's pretty quick for the NHS, it'll be just over 2 weeks.

He said he is doing the endo button procedure plus he adds a screw for extra strength. Not sure if that's a good thing or not.

I had a letter from the first hospital I went to, for an appointment near the end of July, so I'm glad I asked on here and got a second opinion.

It's a bit of a pain as I'm still recovering from ACL surgery 7 months later. I've got pain in the joint and they are saying it's due to a Chondral defect. The PT has me doing some pathetic exercises, but squatting and deadlifting seem the only thing to make it feel better.

I'm thinking of getting a safety squat bar, so I can still squat with one arm. What's a good alternative Hamstring exercise instead of deadlifts?

Thanks.

[Mark Rippetoe]

You really should get this done tomorrow.

[Andy Baker (KSC)]

I'm completely shocked. I went to see the surgeon today and he said he can do the surgery tomorrow. I told him that I couldn't do that as I'm moving house over the weekend and can't afford to be laid up over that time. I'm going in next week, so that's pretty quick for the NHS, it'll be just over 2 weeks.

He said he is doing the endo button procedure plus he adds a screw for extra strength. Not sure if that's a good thing or not.

I had a letter from the first hospital I went to, for an appointment near the end of July, so I'm glad I asked on here and got a second opinion.

It's a bit of a pain as I'm still recovering from ACL surgery 7 months later. I've got pain in the joint and they are saying it's due to a Chondral defect. The PT has me doing some pathetic exercises, but squatting and deadlifting seem the only thing to make it feel better.

I'm thinking of getting a safety squat bar, so I can still squat with one arm. What's a good alternative Hamstring exercise instead of deadlifts?

Thanks.

Yes, the endo button procedure is generally coupled with a Arthrex Screw that adds further strength and helps to tension the reattached tendon properly. I had that done as well.

[Gav1]

You really should get this done tomorrow.

I did ask if it would make much of a difference and he said not within the 5 days it will be. I could have juggled things around if he said it was urgent, but he was going to have me on stand by for today anyhow. If somebody needed surgery more urgently then they would have taken my place. I'm just glad that it'll be getting done so quickly, I thought I'd be waiting months with the NHS.

Yes, the endo button procedure is generally coupled with a Arthrex Screw that adds further strength and helps to tension the reattached tendon properly. I had that done as well.

How long after the injury did you have surgery? I'm not at all confident about the PTs here as my knee surgery rehab hasn't gone very well. He's had me doing some ridiculous things and when I tell him what is making it feel better (squats and deadlifts) he tries to stop me doing them and gives me something stupid in place.
How do i go about speaking with one of the more experienced PTs mentioned?

Thanks.

[Andy Baker (KSC)]

I had my procedure done 1 week from the date of the injury. I did no physical therapy and have yet to do any. For the first 10 days I kept the arm in a sling pretty much all the time. After 10 days I did just a little passive stretching through the day, and while I was active I kept the arm in a sling. Pretty much for 6 weeks I didn’t lift anything more than a few pounds and I didn’t stretch it beyond what was just moderately uncomfortable.

At 6 weeks I took the sling off completely and started lifting. I’ve done two squat workouts, first one was high Bar, second one was low bar. Feels fine. Worked up to 325 for 3x8 on second workout back. Been able to Bench and Press normally except for being super weak and not having full ROM of the elbow yet. Been using very light cable rows and Pulldowns to gently stretch the elbow and restore ROM. It’s working and I have no pain. PT at the hospital told me nothing heavier than a coffee cup for 12 weeks and no lifting for 6 months. Preposterous. But I still can’t do any chins, heavy rows, etc for another 6 weeks or so.

Go to startingstrength.org and look up John Petrizzo and Skype consult with him. Worth the money to speak with a pro to get a little peace of mind once the surgery is over.

[Gav1]

Thanks Andy for all the advice.

I'll contact John Petrizzo and take it from there.

[Gav1]

I'd just like to say thanks to Rip and Andy, for both this forum and the advice you've given.

I had the surgery yesterday and have spoken with John Petrizzo about working with him. I'll be starting with him after the first follow up appointment. Im confident that this rehab will go a lot better than the one for my knee.

Cheers.