Does deformed biceps neccessarly indicate torn (completely/partialy) distal tendon?

Hi,

About a couple of months ago I got injured in my biceps of my right hand (dominant hand) while doing BL .. Actualy I was doing it after I walkup directly in early morning without enough warmup (which was stupid of me to do so) ..normaly I used to hold straddle BL for ~30s since about 2 years ago..after injury a doctor checked my injury and asked me to make several movments by my hand under external resistance.. he told me that it's a mild tear and my hand is functionaly good and told me I can start training lightly and increase load gradually .. I asked him if I should make MRI scan to check if my distal tendon was affected so in case I need an operation .. but he confirmed that my tear mild and it's mostly a muscle tear and I don't need to undergo an operation.. So I started working up again I was able to make close grip chinups(only 2 reps) and some ring dips .. I didn't try german hangs or BL yet as I'm still afraid of trying.. I still feel my right my right hand is lagging in terms of biceps flexion strength (but I can say it's much better than after injury) .. also there is still some deformation/bulging in my biceps and muscle seems softer than left hand .. so my question is should I susspect that there is something wrong in my distal tendon that needs surgical interferece and I should advice another doctor? or I should have some patiance and I could still have some more improvments? as I'm not sure if 2 months period is enough to recover from such tear or no?

Thanks in advace for your advice

Listen to the doctor.

Visit at least one other doctor.

tear it's damage with loss function, since scar tissue does not respond as the normal tissue.

if the pain it's not solved along 2 months or it returns with activity, if you have loss of strength and bicep deformity then you have a serious problem with tendon. i'd like to see a photo of you with relaxed arms and then  only a few degrees of flexion with squeezed biceps (10-20°), from here it's easier for me to judge.

Visit another doctor and see what he or she says.

Another thing, did you do your back lever Supinated or Pronated (chin up grip or pull up grip)?

alex87 said:

tear it's damage with loss function, since scar tissue does not respond as the normal tissue.

if the pain it's not solved along 2 months or it returns with activity, if you have loss of strength and bicep deformity then you have a serious problem with tendon. i'd like to see a photo of you with relaxed arms and then  only a few degrees of flexion with squeezed biceps (10-20°), from here it's easier for me to judge.

Hi Alex,

Actually I didn't had pain when injured, actually I had following symptoms after injury:

1. Weakness.

2. Deformation in biceps : bulging+ some emptyiness in lower part of biceps + softness + it apparent tissue is torn near elbow where muscle is highly mobile in this part

3. A blue colour on the elbow (which resulted from hemorage caused by tear) which disapaeared after ~3 weeks.

These symtoms improved after a while for some extent (but not fully recovered ..)

I attached image for affected arm hope it'd be helpful to judge, Thanks in advance for your help !

Thanks for your reply all Guys !

@Paulizdaman : Chin up grip i.e. palms were facing floor

well from my POV i have only bad news, your bicep shows a very bug deformation and it seems to retract over the center of the upper arm. this is a typical situation of distal bicep tendon rupture or biceps fiber slapped from tendons. I'm working with eco and RMI and I've seen a lot of them especially from rugby player and lifters. You situation seems not to be different.

Thanks a lot Alex ! I'll check another doctor, hopefully he could figure out what is wrong..

Is it possible to tell me more about other probability "biceps fiber slapped from tendons" .. actually I did a little search and what I understood that SLAP tear could recover without an operation ..

Hi,

Just got my MRI, seems there is some tear in the tendon .. not sure how bad it is and whether it is in myotendoites joint or in tendon itself .. I will re-check with a doctor .. I attached my MRI report maybe someone could tell me how bad is my tear ..

Good thing you got the mri. You'll need to see a physician or sports medicine physician to help you decide what to do next, and what the ramifications of the injury are. 

I'm sorry this happened to you, but have to repeat this, in hopes that others begin to head the warning,

Do not attempt back lever work without having gong through the progressions laid out by Coach Sommer, start with the Foundations courses, at a bare minimum get through F3 before even looking at rings, other than their use in the Foundation courses. We've seen far too many of these kinds of injuries, and for the most part, patient prudent training would have prevented them.

We're not making this stuff about torn bicep tendons up! Here is graphic proof of what is actually a 'best case' scenario of only a partial tear.

my suspect was founded. I'm sorry about that, take care of yourself, don't push again over your limits at evaluate a reasonable rehab protocol with a physio.

Hi,

It has been long since my last post in this topic. After visting some more doctors I'd a final conclusion that the tear is in the myotendoites juction of the biceps (it's a parial tear ~30-40%). Actually in my case the muscle tears from the part attaching it to tendon (unlike the common case where the tendon tear from the  avulsion i.e. tendon attachment to bone). I tried to dig internet about operative treatment for such injury but I didn't find much, just they say it goes fine with none operative treatment .. also doctors said it is better not follow operation.. however I didn't get a solid feedback from anybody if I can engage in an activity that stress biceps like rings..however most of them are conservative and think it is better to avoid this ..for my current situation my hand is much better however the deformation is clear where biceps torn(in short head) .. for rings I'm doing only support on rings with hands turned out from time to time and I find no problem doing them.. 

So just wanted to know if someone had experience about similar injury.. and if it is possible for me to be able to engage in rings activity again and go through different progressions .. or I should completely avoid them.. Appretiate any feedback as it would greatly help me ..

Thanks a lot !

Read my post above, there is a very solid reason Coach Sommer removed BL from the basic progressions, he doesn't like bicep tears.

I don't think any of us can say wether or not you'll ever be able to do ring work, but it is safe to say that you need to be especially cautious and meticulous in following prerequisites. And if you aren't there is a high likely hood you'll tear more.

Another 30-40% tear due to impatience will leave you with very little leeway.

Why wasn't it repaired?

Yours in Fitness,

Coach Sommer

TLDR: What Cole  Dano said + talk to a Dr.

What does your orthopedist say? Did he say you need surgery or you can possibly resume normal activity within some time frame? I am betting you will likely need surgery to stop the likelihood of a complete rupture.

Anyway, I suggest you don't take any of our advise until you talk to an orthopedist and ask him. If he gives a go ahead without other cautions, then come here to ask about progression.

Your distal biceps is torn and retracted off the radial tuberosity.  It's been what... at least 5-6 months since this happened?  I doubt any surgeon would be optimistic about repairing this and having a good functional outcome.  Your tendon stump is scarred down at this point.  You won't do further damage to your biceps continuing to exercise/stress it.  But... that doesn't mean you won't precipitate injury to your other elbow and shoulder musculature since they are bearing more stress.  

Should you continue doing ring work?  That's your decision.  Elite athletes (for instance, football players) do continue on without repair of their biceps in all cases, but not elite level gymnasts, they need every ounce of supination/elbow flexion they can muster.  It's definitely not recommended for long term shoulder health, at least higher level elements relative to your own level of fitness.  Regardless of what you chose to do, scapular stabilization will be integral.

Go to a Dr.; regardless of medical expertise on this board, no one knows your medical/surgical history or specifics in history of present injury. Further, how can we be sure of people's actual vs. internet-claimed expertise. I do not think it makes sense for people to be advising you to exercise without knowing your specifics. Go to a Dr.

Hi again,

Thanks all for the feedback!

@Coach Sommer, It was not operatively repaired because it was opinion 3 different doctors (first one was 3 weeks after having the tear and another 2 , 3 months later ...). The first one said that the tear didn't affect hand fuctionality so need to go though none necessary surgery.. The second one said that he doesn't prefer going via surgery as tear is less than 50%. Third one said that he won't excpect good outcome for surgery after 3 months as scar tissue is formed, and in my case it is even harder as he'll bere-attaching tendon to muscle belly as it is a myotendoits juction tear.

@thenail001, yes my tear is about 9 months now but tendon is still attached to radial tuberiosity. the tear is is in the junction that attaches the tendon to muscle belly, so I beleive retraction is in this part where a gap between tendon and muscle is formed ..

@Prometheus, different doctors I visted had different opinions one said I can progrssivelly my previous activity others said it is better not in order to avoid re-tearing the muscle .. probably I'd visit another doctor though I'm not optimistic that would provide me with different feedback .. and probably surgery is not a good option after 9 months ..

Fady,  in the future always go to a high level sports medicine orthopedist.  A regular doctor or surgeon is not going to cut it.  Remember that not everyone graduated at the top of their class.  

It is probably too late now, but go now and at least find out for sure.

Yours in Fitness,

Coach Sommer

While I see Coach's point on class placement, it really isn't that simple at all; I digress.

As Coach already said though, you need to see the sports medicine specialist. Medicine is far too complex for a non-sports medicine specialist to have the experience to be right often enough. The only exception is a physician who has special interest in a specific topic, but there is no guarantee he will get the same experience in what his interests are. Hopefully this can be a lesson for those reading these posts on what to do if they ever are in a similar situation.

fady said:

Hi Alex,

Actually I didn't had pain when injured, actually I had following symptoms after injury:

1. Weakness.

2. Deformation in biceps : bulging+ some emptyiness in lower part of biceps + softness + it apparent tissue is torn near elbow where muscle is highly mobile in this part

3. A blue colour on the elbow (which resulted from hemorage caused by tear) which disapaeared after ~3 weeks.

 

These symtoms improved after a while for some extent (but not fully recovered ..)

 

I attached image for affected arm hope it'd be helpful to judge, Thanks in advance for your help ![/quote

I'm new among you

Actually, I'm suffering the same injury , I've lost the original shape of my biceps , I've been wounded since 2013 and until now my biceps kept the same deformation .

You need to get to a medical professional about this. Surgery is the only way to repair it.

Cole Dano said:

You need to get to a medical professional about this. Surgery is the only way to repair it.[/quote

is it possible to repair it after all this time ? I hope so bro

]

Find the best specialist you can for this type of injury and see what they say.