Houston Methodist. Leading Medicine

Elbow FAQ

Question:

What's the treatment for a ruptured biceps tendon and how long before I can get back to work? It just happened yesterday. Pulled the tendon right off the bone at the elbow. Saw the emergency room doctor and I'm scheduled to see the surgeon tomorrow.

Answer:

To confirm the diagnosis, the surgeon can order MRIs, which will show exactly what's happening in the soft tissues around the elbow. Of course, the diagnosis is confirmed if/when surgery is done. But sometimes, operative repair isn't needed. Older adults or people who are fairly inactive may regain enough strength and motion to remain functional without surgery. The arm is placed in a sling for a few days up to a few weeks. Medications may be used to control pain and make the patient comfortable. Physical therapy is a key part of conservative (nonoperative) care. The therapist helps the patient learn how to regain motion, strength, and proper motor control. The therapist will also use manual (hands on) techniques to help the healing tissue fibers line up correctly during the healing process. Surgical repair is really the most common treatment approach and recommended for those who want to regain full strength, motion, and return to work at their preinjury level. The method of operative care isn't as straight forward as nonoperative care. Surgeons have a wide range of methods they can use to complete this repair. The first decision is whether to try and reattach the tendon to its proper (native) location or stitch it to a muscle nearby (the brachioradialis muscle). Reattaching it where it belongs is called an anatomic repair. Suturing the tendon to the brachioradialis muscle instead is referred to as a nonanatomic repair. Once the operation has been completed, the work of rehab and recovery begins. Studies have shown that it is acceptable to follow a more aggressive postoperative plan than was used in previous years. Immobilizing the arm is still done in the early days but motion is started much earlier than before. Different surgeons use different approaches. Some put the patient in a splint right after surgery (limiting all motion), while others use a hinged elbow brace (set to allow certain movements). When to start motion and how much to allow also varies from surgeon to surgeon. Some of this is determined by the type of surgery that was done. Some decisions are made based on reports from other studies. And, of course, surgeon training, experience, and preferences play a part in the plan of care. For the most part, patients can expect to get back to normal daily activity four to six weeks after surgery. Full strength and return-to-work (especially manual labor or activities requiring lifting) may take longer. Ryan G. Miyamoto, MD, et al. Distal Biceps Tendon Injuries. In The Journal of Bone and Joint Surgery. September 1, 2010. Vol. 92-A. No. 11. Pp. 2128-2138.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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