Biceps tendon "just hanging on"

[Bestafter60]

Rip, my next door neighbor is a very active, bright, optimistic 73 year old who doesn't lift weights (yet). Yesterday he told me in 2 weeks he'd be having shoulder surgery because an MRI showed his doctor that his biceps tendon was "just hanging on" and "would soon break away unless he had surgery". He has full ROM and mostly feels pain when pushing his truck door open.

Assuming the MRI is correct, a general question: can a tendon that is damaged but still attached be remedied by weight lifting?

I told him about your shoulder rehab program post op and he's very interested.

[Mark Rippetoe]

He needs the repair. A badly torn tendon will not scar down well enough to ensure its continued existence. Had it already ruptured, I don't know that I'd have it repaired if I was 73, but he'll be fine.

[Daniel Cavallari]

This question has been floating around my mind with the recent biceps tendon tear posts, if you will indulge me Rip.
What exactly happens when the biceps tendon ruptures but is not fixed? You seem to be of the opinion of not repairing it past a certain age, but does this not limit movement of the affected arm?

[Bestafter60]

Thanks, Rip.
Here's an article I found by a Swedish orthopedic researcher that explains, in layman's terms, the healing process after tendon rupture. It reinforces the use of progressive loading to signal the injured tendon just how it is to heal: How do tendons and ligaments heal? | Per Aspenberg

[Mark Rippetoe]

This question has been floating around my mind with the recent biceps tendon tear posts, if you will indulge me Rip.
What exactly happens when the biceps tendon ruptures but is not fixed? You seem to be of the opinion of not repairing it past a certain age, but does this not limit movement of the affected arm?

That head of the bicep goes away. It is a supinator of the forearm, and other muscles assume the function and hypertrophy accordingly. If you're 50, you fix it. If you're 73, maybe not.

[Will Morris]

This question has been floating around my mind with the recent biceps tendon tear posts, if you will indulge me Rip.
What exactly happens when the biceps tendon ruptures but is not fixed? You seem to be of the opinion of not repairing it past a certain age, but does this not limit movement of the affected arm?

That head of the biceps atrophies and continues to atrophy. Range of motion should be fine. A ruptured biceps will result in about a 30% loss of elbow flexion strength, generally speaking. YMMV. If I were 73 and only had some pain with pushing my truck door open, I wouldn't chance surgery for that. I'd just push my truck door open with my elbow. There is every possibility this active, bright, optimistic 73 year old comes out of surgery not nearly as active, not nearly as bright, and not nearly as optimistic. Of course, that is his decision and his own analysis of risk / reward.

[Daniel Cavallari]

Interesting. Thanks for the replies Rip and Will, I learn something new here everyday.
In the case of a rupture of the distal tendon of the biceps, however, I'm guessing the effect is much more drastic, correct? As in, the whole biceps is essentially useless at that point?

[Will Morris]

Interesting. Thanks for the replies Rip and Will, I learn something new here everyday.
In the case of a rupture of the distal tendon of the biceps, however, I'm guessing the effect is much more drastic, correct? As in, the whole biceps is essentially useless at that point?

Same effect overall. You will just have a weird Popeye shaped arm.