Partial Tear Biceps Tendon at the Shoulder

[alec_ar]

So a few months back I strained my rotator cuff and it took around 6 weeks to heal fully. Just yesterday I partially tore my biceps tendon at it's insertion in the shoulder (long head). At least I think this is the case. I was doing something stupid on the rings at an odd angle and heard a "pop". Now it is painful to lift my arm to the side and my shoulder just feels....bubbly.

Long story short, I will go to the doctor probably but I thought I'd ask the forum for some advice. For a partial tear, how long should you usually rest and ice the tendon before starting PT? And what are some good PT exercises for a torn biceps tendon at the shoulder?

Thanks in advance!

[Joshua Naterman]

Talk to a doctor, and hope you didn't actually tear anything.

I hope you realize now why we consistently make the training recommendations that we do. They aren't random. Good luck!

[alec_ar]

Yea I know. Usually I'm more careful but was trying something new and stupid apparently. So I'm paying for my carelessness. There's no muscular deformity so I don't think it's complete haha.

[FREDERIC DUPONT]

I sincerely hope it is not a tear or partial tear - actually, a full tear would be better; you undergo surgery and 4 months after you are good to go!

A partial tear can take years to heal, if it does, and maybe is not as easy to repair surgically as a full rupture! The decision to undergo surgery is also harder to make!

Anyway, you might be lucky, it may only be the tendon that popped out of its groove and if you are really lucky, it went back in on its own leaving only minor consequences that will be okay in 2 weeks...

make sure your doc is competent; the long head of the biceps tendon integrity is near impossible to assess on MRI.

Goo luck.

[thenail01]

What were you doing when it happened? If you tore your biceps, the deformity should be pretty obvious especially with contraction - you should see bunched up muscle bulk in your distal arm. Usually there is very little ongoing pain. So, if you have continued pain and no abnormality, I would look for other sources.

For most people, biceps tears still result in preserved biceps strength (like 80+%). Most athletes won't get it surgically repaired. Of course, gymnasts rely on their biceps probably more than any other athlete, so pursuing further treatment is going to be a question of how important it is to you. Surgeries very rarely completely fix a problem without creating other issues, or at the very least require considerable rehab.

[Coach Sommer]

... I hope you realize now why we consistently make the training recommendations that we do. They aren't random ...

Sorry to hear about the injury.

Hopefully this injury will end up being relatively minor. This however does illustrate the reason why proper strength progressions are so heavily emphasized on the GB forum by both myself and the GB moderators. You may get lucky for a while, however in the long run you can only play Russian roulette so many times before ...

Yours in Fitness,

Coach Sommer

[Eddie Stelling]

I would highly reccomend you stop using it and go get it looked at it by an Orthopedic Surgeon ASAP and if you have insurance, go straight to an MRI. Last year I tore my Labrum and my rotator cuff in my left shoulder. I spent 2 months trying PT twice a week and was told at first that I had a strained biceps tendon, or had a torn deltoid in the same spot you are talking about. Turned out being much more and 2-3 months was wasted time. Sorry to hear about your injury, and if it makes you feel any better, I had 2 surgeries with 5-6 months of rehab after each one. My shoulder feels great, almost perfect, it is possible to have great recovery. Just listen to your PT 100%, and start listening to Coach and the moderators on this site!!!!!!!

[alec_ar]

Thanks everybody for the support and advice!

Thank you Coach as well, the funny thing is, the sudden 'pop' and Spontaneous injury occurred during an improvised 'warm up' that I did, not during any straight arm work or Victorian training. Whenever I train the VC or other elements it makes me feel stronger and without being too sore or hurt post workout. I've had rings almost three years now and I at least like to think that my connective tissue is pretty well conditioned. Although I wouldn't be surprised if all the tougher stuff I do on rings had softened me up for injury or something. 8)

The annoying thing is, like I said it happened during a brief warm up/bent arm session where I was doing some 'deep chest flys' on the rings but did them at an odd angle where my hands were not level with my shoulders or chest but rather at a higher angle, more towards my ears. Stupid. While descending in one of those reps I heard the pop and inside I cried a little haha! So I don't think the injury was from too much too fast, More so, careless technique and the angle was just too odd for my shoulder.

Anyway I'll probably go to the doctor over the next few days and no I'm not touching the rings for a while! The good news is, I think it may just be a strained biceps tendon, not a partial tear and definitely not a full tear. The pain is better than it was two days ago and I was able to go to work just fine today. Well see and hopefully it's just slightly injured. Feels very...soupy in my shoulder area though...hmm...

[Daniel Burnham]

... I hope you realize now why we consistently make the training recommendations that we do. They aren't random ...

Sorry to hear about the injury.

Hopefully this injury will end up being relatively minor. This however does illustrate the reason why proper strength progressions are so heavily emphasized on the GB forum by both myself and the GB moderators. You may get lucky for a while, however in the long run you can only play Russian roulette so many times before ...

Yours in Fitness,

Coach Sommer

I would like to emphasize this point. In my gymnastics club there are several people who have chronic issues due to their past training. One guy tried to do an iron cross and tore his shoulder. Another tried to lower into a split before preparing himself that day and tore a hamstring. There are also several others with hurt elbows and ankles from not preparing for dynamic work.

There are no short-cuts. Everything will catch up to you eventually. I tried to push it too fast and had issues with my elbow. Fortunately I realized early in this injury not to push it and I have healed well and passed the point where I was without pain. Follow the progressions and stay slow. In the end this with yield the greatest results.

[Joshua Naterman]

It is very hard to tell when tissue is degenerating until it is fairly severe. What you are describing could certainly be a random injury of bad luck, but given my history and my interactions with everyone here, I do believe that you have been pushing too far, too fast.

You listed warning signs of this, like your rotator cuff injury. You also, at least from what you typed, didn't rehab long enough.

I'm not suggesting you are training like a moron, but I am suggesting that you are working in highly disadvantaged positions much too often. You have extremely long arms and not a lot of muscle mass to bear the load. You don't have to be huge, but there's a good reason why the rings guys, even Balandin, are pretty heavily muscled around the shoulders, and why they all have some fairly impressive upper body development in general.

Anyhow, don't worry about the past right now, just relax and get that shoulder checked asap! Get imaging if you can, that really is quite important. Especially right now, while the injury is fresh and clear pictures can be taken.

I did a bit too much a few weeks ago and am just now feeling it in the right bicep/brachialis a bit. Happened during filming the straight arm strength video... I did everything back to back and I am not used to doing that much work at once. It has taken a few weeks to really show up.

Fortunately I am smart enough these days to immediately back off and work the rehab It is easy to go too far too fast, even when you have a pretty good idea of what you're doing. When in doubt, slow down with the low leverage stuff.

[alec_ar]

Yea my armspan is like 3 inches longer than my height or something like that! Makes the iron cross pretty tough. I agree with you, a better structured workout program would be good, as it usually consists of very high intensity--low volume. The layoff from the injury will allow for me to rethink my training program, because I'm sure you're right, too much disadvantaged leverage training too often. I tend to exercise With a kind of ferocious attitude, so I guess I got what was coming to me :wink:

[Nic Branson]

Bicep tendon at the shoulder attachment in not fun. Get it thoroughly looked and see what is said. Rehab for that should include much more than just the bicep itself. Typically many factors are involved and as you know now, warning signs popped up but they seemed minor and you pushed through. Those minor issues need rehab as well. Your movement patterning along with the tissue need work.

Just an example of how the body will compensate and allow you to continue working as best it can. Ultimately that compensating costs us.

[alec_ar]

Yep I'm sure I was just too careless to notice the warning signs. And going full throttle after only Taking 6 weeks to let my rotator cuff heal was probly not wise! I tend to just listen to my body instead of using common sense and it told me that it was ready after a month and a half, but I'm sure the longer term damage contributed to what just happened.

I'm now thinking that what happened was during a rep of the chest flyes I was doing, my tendon might have snapped out

Of place, And on the descent of the next rep snapped back in. Something along those lines, because there's no visible swelling or bruising, and no muscle deformity.

Anyway, thanks guys, youre the best!

[Joshua Naterman]

Yep I'm sure I was just too careless to notice the warning signs. And going full throttle after only Taking 6 weeks to let my rotator cuff heal was probly not wise! I tend to just listen to my body instead of using common sense and it told me that it was ready after a month and a half, but I'm sure the longer term damage contributed to what just happened.

I'm now thinking that what happened was during a rep of the chest flyes I was doing, my tendon might have snapped out

Of place, And on the descent of the next rep snapped back in. Something along those lines, because there's no visible swelling or bruising, and no muscle deformity.

Anyway, thanks guys, youre the best!

If that is what happened, it could be the transverse humeral ligament that snapped. It is what holds the long head of the biceps tendon in place in the intertubercular groove (also called the bicipital groove). Fixing that is a pretty simple surgery.

Let us know what the doc says!

[Paul Richards]

I hate to make this my first post, but your situation strikes too close to home.

I managed to tear my transverse ligament in 2010 while trying to progress (too fast) towards a MU. Did a series of jumping MUs, my arm swung sideways during the transition from fatigue, and there was the characteristic pop.

Even though I laid off for a while until it didn't hurt (mostly), I continued to exercise (crossfit) on it for another four months. Didn't know the extent of the injury during that time until my repeated visits to my GP finally resulted in an Ortho consult.

Imaging found that the long head bicep tendon had frayed beyond repair in addition to the transverse ligament problem. I had to have a bicep tenodesis (reattachment of the bicep tendon to the humerus) for repair, along with 4 months rehab. I don't know if the additional tendon damage happened during the original injury or from using it post-injury.

While I had a great surgeon and the arm is stronger than before, I'm very motivated now to do shoulder strength work in very gradual increments. Especially important for someone in the 50+ y/o crowd.

I guess the take-away from the story is "Don't ignore an injury like this, get it checked ASAP".