The biceps brachii is a large muscle located on the ventral surface of the shoulder bone. Most often it is called biceps. The main function of the biceps is flexion in the elbow joint. Sometimes there is a rupture of the biceps, which leads to the loss of flexion function.
The biceps muscle is formed by two heads holding the muscle in its area. The heads end with a tendon that is attached to the radius. In the upper part of the muscle is attached to the scapula.
In cases where there is a complete rupture of the biceps, there is a shift of the muscle up. In this position, the tendon does not grow to the designated place on the bone.
Gap features
Most often, trauma is diagnosed in men over 35 years old. In women, bicep rupture is rarely detected.
Tendons lose strength with age, and rupture can occur when carrying heavy loads. To prevent it, it is necessary to perform a warm-up before physical efforts, but people do not attach any importance to this requirement.
You can strengthen the tendon if you start playing sports. There are no other ways to make biceps stronger.
Risk factors for rupturing biceps are:
- use of corticosteroids - the use of certain drugs leads to necrosis and tendon rupture;
- smoking - nicotine destroys tendon tissues;
- taking antibiotics from the fluoroquinolone series;
- some systemic pathologies.
Types of gap
Tears of the biceps muscle can be full or partial. The latter include incomplete breaks, in which part of the tendons remains intact, the muscle does not move.
With a complete break, the muscle completely departs from the bone, contracts by contracting to the shoulder area. Distal rupture of the biceps can occur equally often on the left and right arm.
With a complete break, you can bend your arm at the elbow. This is due to the fact that not only the biceps muscle, but also the brachial muscle is responsible for flexion of the limb. If you do not restore the integrity of the biceps, then the flexion will be performed only by the brachial muscle and only 50-60% of the strength of the elbow flexion. For normal life, these indicators are enough, but, for example, bringing purchases from a car will already be problematic, and any physical activity will be impossible to complete at all.
Clinical picture
When the arm biceps breaks, a click occurs in the ulnar zone. After an injury, the muscle moves up, its abdomen takes the form of a ball. Hematomas often occur in the area of injury.
Immediately after the break, severe pain occurs. It gradually subsides and after a couple of weeks passes completely. In addition to pain, it is noted:
- swelling in the elbow area;
- when bent, weakness is felt in the elbow joint;
- bruising is visible in the separation zone, which becomes more extensive and can reach the hand;
- when the forearm rotates, weakness, soreness occurs.
When the biceps ligaments are torn, spherical compaction is observed in the upper part of the shoulder. It occurs due to contracted muscle. On the front surface of the elbow there is a zone of retreat.
In some people, the gap is asymptomatic. They feel a seal between the shoulder and elbow. This manifestation indicates chronic tendon damage.
Diagnostics
In order to accurately diagnose, the doctor not only collects an anamnesis, clarifies the circumstances of the injury, but also examines the damaged limb, prescribes instrumental methods of research to confirm or refute the diagnosis.
Each patient, with suspected biceps rupture, is assigned a radiography. This method does not display soft tissues very well, but helps determine the causes of pain in the elbow joint that are not caused by muscle problems. But in order to determine the integrity of muscle tissue, the type of rupture - full or partial, an MRI is performed. This examination allows you to see soft tissues, assess their condition.
Your doctor may order an ultrasound scan. Special ultrasound sensors evaluate the integrity of the distal tendon of the muscle.
In most cases, the diagnosis of the gap is obvious and does not cause any doubt, even without instrumental research methods.
Treatment features
The technique for treating the gap is selected depending on its type. With partial injuries, conservative methods are prescribed. They are usually recommended for those who have low physical demands. With this method of treatment, the flexion strength of the elbow joint is reduced by 30-50%. Supination suffers more.
Conservative treatment is performed for patients with low physical activity, in old age, in the presence of contraindications for surgical therapy.
The essence of therapy is reduced to local application of cold in the first hours after an injury. Mandatory immobilization on a headscarf, lasting at least two weeks. Immobilization will allow the limbs to rest, relieve pain.
In other cases, an operation is performed when the biceps tendon ruptures.
Operation
Surgical intervention allows you to restore the anatomy, flexion strength of the limb in the elbow joint, supination. After it, the contour of the shoulder is restored, the cosmetic defect is eliminated.
In order for the surgical treatment to give the desired result, it is carried out on the first day after the biceps rupture. At later dates, irreversible changes occur in the biceps muscle and it is already impossible to stretch it to its original length. In the later stages of the rupture, operations are performed, but the results in this case are worse.
Recently, surgeons began to use the minimally invasive method. It allows you to reduce the likelihood of damage to nerve endings, as well as to minimize the incision, which is almost invisible.
As medical practice shows, no method of surgical intervention is safe and can lead to complications, including minimally invasive technique. Most often, chronic pain in the elbow joint is recorded. In isolated cases, rotational movements are limited. Very rarely, a specific infection of the surgical area may occur.
Possible operations
The doctor can choose one of several methods of fixing the muscle to the radius Some surgeons prefer to perform one incision, while others prefer two. Each method has its own characteristics.
Some doctors fix the muscle with sutures through artificially drilled holes in the bone. Sometimes metal implants are used to fix the tendon to the bone.
After surgery, inflammatory processes may occur. To eliminate them, medicines of general and local action are selected. The drugs not only help relieve inflammation, but also reduce pain, which is especially important in the first days after an injury.
After a muscle break, athletes can return to sport no earlier than four months later. At this time, physiotherapy exercises are carried out, which helps to restore mobility, flexion strength of the joint.