Question
QUESTION: GREETINGS DOCTOR,I WOULD LIKE TO ASK YOUR HELP REGARDING A TORN BICEPS.I AM A STRENGTH ATHLETE 6'1" 370LBS 25YO AND I LIFT REALLY BIG WEIGHTS.WHILE TRAINING THE OTHER DAY,DURING A 915LBS DEADLIFT WITH DOUBLE UNDERHAND GRIP,I HAD A PARTIAL TEAR OF MY RIGHT DISTAL BICEPS TENDON.I HAD STRESSED THE MUSCLE FOR WAY TOO LONG AND IT WAS JUST A MATTER OF WHEN.THE TEAR IS LOCATED AT THE INNER SIDE(TOWARDS THE BODY),I HAVE A BIT OF TROUBLE EXTENDING AND SUDDENLY MOVING MY ARM,AND FOR NOW I CAN'T SEEM TO LIFT EVEN A FRACTION OF WHAT I USED TO.I HAVE NO PAIN IN MY ELBOW,WRIST,SHOULDER OR BRACHIALIS.MY DOC ADVISED ME NOT TO HAVE SURGERY BECAUSE THE TEAR IS PARTIAL AND MY ARM SEEMS FUNCTIONAL ENOUGH,CONSIDERING THE BRIEF TIME THAT HAS PASSED.NOW,I TORE MY PECTORALIS MAJOR ABOUT A YEAR AND A HALF AGO,DIDN'T HAVE ANY SURGERY AND FOLLOWED MY DOC'S REHABILITATION ADVICE.THE MUSCLE HASN'T FULLY RECOVERED YET,BUT MY STRENGTH IS BACK AND IS GROWING DAY BY DAY.NOW HE ASKS ME TO DO EXACTLY THE SAME THING AND FOLLOW THE SAME STEPS.I LIVE IN A SMALL COUNTRY WHERE SUCH INJURIES SEEM ALIEN TO MOST PEOPLE(AND DOCTORS..),SO I WOULD REALLY APPRECIATE YOUR TAKE ON THIS MATER.SHOULD I RISK A SURGERY,CONSIDERING THAT THE TEAR IS NOT FULL?HOW LONG SHOULD THE REHABILITATION PHASE LAST?IS MY STRENGTH EVER COMING BACK AND DOES THE FACT THAT THE BICEPS IS MUCH SMALLER THAN THE PECTORAL MUSCLE CAN GIVE ME ANY HOPE THAT IT WILL RECOVER AS MUCH OR EVEN BETTER?
THANK YOU IN ADVANCE
PANAGIOTIS VASILOPOULOS

ANSWER: Panagiotis,

Did you have an MRI scan of the biceps?  There are two-head of the biceps muscle (Bi-Ceps) and if one ruptures from the tendon, it may give the appearance of a partial tear when in fact you have a complete rupture of one of the heads.  If this is so, surgical re-attachment is best if you want to continue as a strength athlete.  Feel free to contact me again with more information, e.g. whether you had an MRI or not.  

Dr. G


---------- FOLLOW-UP ----------

QUESTION: HELLO DOC,IT SEEMS YOU WERE RIGHT.I COULDN'T HAVE AN MRI DUE TO MY SIZE(IT WAS IMPOSSIBLE TO FIT INTO THE MACHINE AND WE ONLY HAVE THOSE OLD NARROW MRI MACHINES AROUND HERE),BUT UPON FURTHER PHYSICAL EXAMINATION AND SEEING HOW THE INJURY IS PROGRESSING,THE DOCTORS BELIEVE THAT I HAVE A COMPLETE TEAR OF THE INNER BICEPS MUSCLE.UNFORTUNATELY NONE OF THEM COULD GUARANTEE ME A SUCCESSFUL OPERATION AS THEY HAVE NO PREVIOUS EXPERIENCE AND THEY WOULD HAVE TO CUT THE REMAINING TENDON,RESULTING IN POSSIBLE NERVE DAMAGE AND LEAVING ME OUT OF THE GYM FOR MONTHS(AND ON TOP OF THAT THEY ASKED ME FOR A RIDICULOUS AMOUNT OF MONEY).I WILL FACE IT THE OLD FASHIONED WAY,LIKE I TREATED MY OTHER INJURIES AND I WANTED TO THANK YOU FOR YOUR HELP AND CONSIDERATION.
PANAGIOTIS VASILOPOULOS

Answer
Panagiotis,

'Too bad you can't make the trip to the USA (Boston, Mass.) and have this procedure performed.  One of my patients recently underwent the procedure (Charles Cassidy, MD, Tufts-New England Medical Center, Boston) and had nearly full range of motion within a few weeks, and now at about 6 weeks is ready to go back to weight training.  Maybe your orthopedists should do a bit of research and learn how to do the procedure.

'Regards,

Dr. G