Question
After doing hours of research, I think I have proximal torn.  I know that surgery may not be required for certain situations.  But, I'm 27 and very active in sports especially martial arts.  I'm very competitive in martial arts.  I would like to have my biceps get back to normal without surgery, but I don't know if that is possible?  And how much is the surgery is going to cost?  

Answer
Dear Minh,

The first thing you need to do is get an examination and an MRI of the bicep.  Without knowledge of the extent of the injury, there is no way to know if you will actually need surgery or not.

If you have a full thickness bicep tear at the proximal end of the tendon, then you should see a bulge in the muscle towards the elbow.  If the tear is a full thickness tear, then you will not be able to rehab the muscle without a surgical re-attachment.  That being said, many full thickness bicep tears are not surgically repaired because the functional loss of strength is not great.  The other head of the bicep can usually compensate for the lost side.

In your case, again if the tear is full, you will most likely want to have the surgery though due to your age, level of physical activity and increased level of competition in martial arts.

Conversely, if the tear is less than 75% of the muscle, then you can rehab it with extensive physical therapy protocols.  The decision will be based on what level of competitive function you would like to attain, or retain in regards to your training and competition.  This is a decision that you need to make with a sports medicine physician or an orthopedist.

Concerning the costs of surgery, it depends on the surgeons fees, hospital fees, MRI fees, physical therapy and the level of insurance coverage you have...it is variable and can easily be over $15,000 dollars.  Again this is something you will have to explore and factor into your decision.

The good thing is that if you choose surgical re-attachment you should have close to 100% function after the rehab protocols have been completed.  Everyone is different, but this is not a major surgical procedure and can be accomplished with a lesser amount of tissue damage created by the surgery itself.  They will most likely be able to do the procedure with a scope and without large incisions.

Hope this helps Minh, you need to get it evaluated while the injury is fresh for the best resolution.  Get in for a consult as soon as possible.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net