Long biceps tendon injury


Q: In a 54-year-old man what is the best treatment for "detachment of the subscapularis tendon from the lesser tuberosity with medial dislocation of the long bicep's tendon"? I just found out that by tomorrow (!)I have to make a decision on whether to have the bicep tendon repaired or cut. Thank you.


A:   The biceps muscle is in the front of your upper arm. It helps you bend your elbow and rotate your arm. It also helps keep your shoulder stable.
Tendons attach muscles to bones. Your biceps tendons attach the biceps muscle to bones in the shoulder and in the elbow.
If you tear the biceps tendon at the shoulder, you may lose some strength in your arm and be unable to forcefully turn your arm from palm down to palm up.
Many people can still function with a biceps tendon tear, and only need simple treatments to relieve symptoms. Some people require surgery to repair the torn tendon.
For many people, pain from a long head of biceps tendon tear resolves over time. Mild arm weakness or arm deformity may not bother some patients, such as older and less active people.In addition, if you have not damaged a more critical structure, such as the rotator cuff, nonsurgical treatment is a reasonable option. This may include:  Applying cold packs for 15-20 minutes at a time, several times a day to keep down swelling. Anti inflammatory medication (“Motrin”, “Aleve”0 to reduce pain and swelling.  Avoid heavy lifting and overhead activities to relieve pain and limit swelling. You may be using a sling for a brief time. Physical Therapy: Flexibility and strengthening exercises will restore movement and strengthen your shoulder.
The indications for a surgical repair include: some patients who require complete recovery of strength, such as athletes or manual laborers. Surgery may also be the right option for those with partial tears whose symptoms are not relieved with nonsurgical treatment.

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