A rupture of the biceps (tendon of the biceps of the shoulder) is considered to be full or partial separation from the place of attachment to the bone. Typically, such an injury is diagnosed in males who are involved in sports or are associated with power loads. This pathology is quite common today. Surgery is most often used for her therapy.
Description and description of the problem
Separation of the biceps is a frequent injury, which occurs in 90% of cases in the proximal section. The biceps muscle is involved in the process of the arm, it flexes it in the elbow joint. It has two tendons that attach to the scapula. When separated from the biceps attachment site, the entire upper limb suffers, as the flexion strength in the elbow joint and the forearm rotate outward. Important vessels and nerves are located in this place, therefore surgical intervention can provoke complications in some cases.
Separation of the biceps tendon leads to the fact that a person tolerates physical exertion worse. So, there is a restriction of movements, acute pain. Most often, the gap occurs on the dominant hand. In the absence of therapy, a pronounced cosmetic defect will be observed, the functionality of the entire upper limb will be impaired.
Tendon rupture can be partial when the injury does not completely block it, and complete, which divides the tissue into two parts. Most often, damage begins with small perforation intervals, then with the progression of the pathological process, the biceps are completely torn. Most often, its long head is damaged.
Why does pathology arise?
The reasons for the separation of the biceps can be various. Sometimes this happens due to chronic inflammation (most often with rheumatoid arthritis, ulnar bursitis) and chronic microtraumas in the subacromial zone. These injuries lead to a decrease in tendon strength, increasing the risk of rupture after a minor injury. Detachment of the tendon often occurs during excessive force during exercise. Also, biceps detachment can be observed in old age due to damage to the rotator cuff.
Smoking, taking certain medications, steroids is a provocative moment, which often leads to damage.
The separation of biceps most often occurs under the influence of such risk factors:
- Senile age. In this case, an increased load on the biceps is observed for a longer period of time than at a young age.
- Lifting weights associated with professional activities, as a result of which tendons wear out faster.
- Strong loads on the shoulder joint. Most often, the separation of biceps occurs in athletes involved in swimming or tennis.
- Smoking. It is known that nicotine affects the delivery of nutrients to the tendons - it slows it down.
- Reception of corticosteroids.
Symptoms and signs
With a partial rupture of the bicep, pain appears in the ulnar fossa, swelling, weakness when bending the arm in the elbow joint, and movements do not suffer. Negative changes in soft tissues in the damaged area also occur, the biceps of the shoulder muscle is deformed as a result of the upward movement of the biceps. It becomes difficult for a person to turn his hand down or up with his palm.
Often during the separation of the biceps, patients hear a characteristic clap or click, a bruise appears, which goes from the shoulder down to the elbow. In some cases, the injury is asymptomatic, there is only a bulge or seal in the area between the elbow and shoulder.
Diagnostic measures
Diagnosis of separation of biceps occurs without difficulty. For a diagnosis, it is usually enough to make a visual examination and study of the history of pathology. Radiography will not provide important information in this case, it is carried out to exclude fractures.
In some cases, the doctor may prescribe an ultrasound or MRI. Usually instrumental examination methods are used to exclude other pathologies.
Therapy
Treatment may be conservative or surgical.
In the first case, the doctor recommends applying a cold compress for 20 minutes twice a day to reduce swelling. He will also prescribe NSAIDs, for example, Ibuprofen or Naproxen for relief of pain and inflammation. It is necessary to avoid power loads, movements with raised hands. Mobility of the limbs will help restore physiotherapeutic procedures.
Some patients require surgery. The operation is also prescribed for the ineffectiveness of conservative therapy, when negative symptoms persist for a long period of time.
The purpose of the operation is to attach the tendon to the bone. The doctor develops a treatment regimen in each case. Intervention is carried out using general anesthesia. Below and above the ulnar fossa, the surgeon makes incisions, through them he secures the torn tendon, sutures it and fixes it to the bone using buttons, anchors or screws. Then the affected limb is immobilized with an orthosis for three weeks.
Complications after surgery develop extremely rarely. They can occur only in the absence of therapy. In this case, the muscle may grow together incorrectly, which will have a negative impact on its functionality. Also, in the absence of treatment, a chronic defect may appear, it will be impossible to eliminate it even by a surgical method.
Today it is advisable to apply an individual therapy strategy, taking into account the characteristics of the body of each person. It involves the following actions:
- Full examination of the patient to determine the pathology of the shoulder and elbow.
- Analysis of the benefits and harms of surgery, taking into account the patient’s age, profession, pain, etc.
- Conducting a full rehabilitation for the maximum restoration of limb functions.
Rehabilitation period
For six months after surgery, you must avoid playing sports and lifting weights. At this time, it is recommended to perform therapeutic stretching exercises to restore the range of motion in the joints. Physiotherapy in this case is an important factor that affects the time to return to daily activities.
In some cases, with successful surgery and physiotherapy, a 30% reduction in elbow flexion strength may be observed compared to a healthy limb. But usually it is possible to fully restore the functioning of the muscle.
Prevention
To prevent pathology, it is necessary to stretch the muscles well before training, you can not overstrain them and subject them to heavy loads, swing your arms over your head, you need to avoid injuries. Doctors recommend leading a healthy lifestyle, adhere to proper nutrition.