Distal Bicep tendon issue

[Gav1]

Hi.

Earlier today my dog was sprinting up to me to chase a cat across a road. He’s a 25kilo Staffy and built like a tank. I put my arms out to stop him, but he just steamed right past. In the process he hyper extended my right elbow and I felt a pop on the inside.
I don’t think it’s a complete detachment as my Bicep hasn’t rolled up to my shoulder. However, it looks as though it has mover up a couple of inches. I’ve been to the hospital, because I was hoping for a scan, but they just gave me an ex-ray.
They’ve past my details onto a different department which will assess it in about 8 days and then scan if they think it’s necessary. I’m guessing there are different severity’s to this type of injury and would like to know what i should be doing whilst waiting to see these other doctors. Is this something that will heal by itself or will it need surgery?

Thanks.

[Mark Rippetoe]

Depends on whether you have private insurance. Your PHS will likely just put you in a cast.

[Andy Baker (KSC)]

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

[Gav1]

Thanks both.

I didn't have a cast, she just sent me away to wait. All she kept going on about was the popeye effect, as if, it is only damaged if the bicep is rolled all the way up your arm. I'm so fed up of these doctors in the UK, they're shit. I hardly use them, but when I do, they don't do any good.
I'm going to another hospital this morning to see if I can find somebody decent. I've tried the hook test and can't feel the tendon in the bad arm, so I'm assuming it's damaged.
Thanks.

[Gav1]

Thanks very much for the advice.

I have had a scan and have torn the tendon. I'll be seeing the Surgeon in the next couple of days to discuss surgery.

If i didn't go back to another hospital, I'd still be hanging around waiting as the first person I saw said there was nothing wrong.

Thanks.

[Andy Baker (KSC)]

Try to get in as quickly as possible. Try and discuss with your surgeon the procedure he will use. I did a lot of research on this and it seemed pretty clear that the single incision endo-button procedure is the strongest repair if you intend to get back into lifting. If the anesthesiologist offers you a nerve block, do not accept it. I've heard from multiple patients/athletes that when that thing wears off the pain gets pretty severe. I denied it and my pain level was very manageable with nsaids and tylenol. Had some numbness and tingling in the forearm for a few weeks but that has pretty well worn away after about 5.5 weeks. I'll see my surgeon again at the 6 week mark and hoping to get cleared for some light lifting. My pain level is gone, my range of motion (including supination) has mostly returned, and I can tell some strength is back (although I was compliant with his recommendation to try and lift next to nothing for the first 6 weeks).

They may or may not recommend some physical therapy during the first 6 week recovery period. I had planned on a PT regimen with Darin Deaton or John Petrizzo but there really is nothing much you can do (I discussed in detail with Dr. Petrizzo). You can't lift anything and they don't want you to stretch the muscle, so that pretty much eliminates everything. You just have to wait it out for a few weeks. Both John and the surgeon told me they want the repair to "heal tight" and then slowly stretch back out over time once you are cleared to resume exercise. I'll talk to Dr Petrizzo again after I meet with my surgeon to see what the next step is, but it sounds like PT may be unnecessary and I'm hoping to just use some light weight training as my therapy.

Hope this helps. I researched a lot and there was a lot of conflicting information online (surprise!) so hope this helps clarify things for you moving forward. I'd recommend setting up an online consultation with Darin Deaton or John Petrizzo as you go through this process. Both gentleman are familiar with the surgery and will likely be more helpful to you than your doctors once the surgery is done.

Andy

[John Petrizzo]

OP, sorry to hear about your injury. Everything Andy has said is on the money. Try and get yourself in for surgery ASAP. If I can help you at all from there, just let me know.

[jbmillard]

Try to get in as quickly as possible. Try and discuss with your surgeon the procedure he will use. I did a lot of research on this and it seemed pretty clear that the single incision endo-button procedure is the strongest repair if you intend to get back into lifting. If the anesthesiologist offers you a nerve block, do not accept it. I've heard from multiple patients/athletes that when that thing wears off the pain gets pretty severe. I denied it and my pain level was very manageable with nsaids and tylenol. Had some numbness and tingling in the forearm for a few weeks but that has pretty well worn away after about 5.5 weeks. I'll see my surgeon again at the 6 week mark and hoping to get cleared for some light lifting. My pain level is gone, my range of motion (including supination) has mostly returned, and I can tell some strength is back (although I was compliant with his recommendation to try and lift next to nothing for the first 6 weeks).

They may or may not recommend some physical therapy during the first 6 week recovery period. I had planned on a PT regimen with Darin Deaton or John Petrizzo but there really is nothing much you can do (I discussed in detail with Dr. Petrizzo). You can't lift anything and they don't want you to stretch the muscle, so that pretty much eliminates everything. You just have to wait it out for a few weeks. Both John and the surgeon told me they want the repair to "heal tight" and then slowly stretch back out over time once you are cleared to resume exercise. I'll talk to Dr Petrizzo again after I meet with my surgeon to see what the next step is, but it sounds like PT may be unnecessary and I'm hoping to just use some light weight training as my therapy.

Hope this helps. I researched a lot and there was a lot of conflicting information online (surprise!) so hope this helps clarify things for you moving forward. I'd recommend setting up an online consultation with Darin Deaton or John Petrizzo as you go through this process. Both gentleman are familiar with the surgery and will likely be more helpful to you than your doctors once the surgery is done.

Andy

I had a nerve block and it was wonderful. I had my shoulder rebuilt and had no pain for about 24 hours. After it wore off, I took Ibuprofen for a couple of days and no issues after that (dumped the stupid sling after two days). One thing about the nerve block that I did like -- my anestesioligist said that with a nerve block, all they do is keep me asleep -- no pain management. That means less in the way of drugs for anesthesia. I've had surgery (under a general) five times and that one was the easiest.

[Gav1]

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.

[Mark Rippetoe]

You poor bastard. Under these circumstances, I might decide to just leave it alone, since it's unlikely you'll be given timely access to a surgeon with experience with this injury.