The bicep muscle is at the front of the upper arm, and assists in rotating the forearm and bending the elbow. The bicep muscle is attached to the forearm near the elbow by the distal bicep tendon. When the arm is flexed and then the elbow is forced straight, this tendon may partially tear or completely rupture. This is a common injury in weightlifting and with every-day heavy lifting. Symptoms of distal bicep injury may include swelling and bruising, weakness in bending the elbow and twisting the forearm, and a bulge in the upper arm along with a gap in the lower arm caused by the shortened bicep muscle.
With partially torn tendons and in patients who are older, Dr. Shani will discuss non-surgical rehabilitation focused on strengthening the damaged tendon through physical therapy. For fully ruptured tendons, Dr. Shani completes precise Distal Bicep Repair surgery with the goal of a full return to pre-injury strength and range of motion in the elbow. Using specifically designed medical instruments, Dr. Shani expertly reattaches the ruptured distal bicep tendon at its original position on forearm with either stiches or metal anchors. This is a small open surgery made through a 2-3 cm incision around the elbow guaranteeing a minimally invasive outpatient surgery.
Dr. Shani and a physical therapist work with patients on an individualized rehabilitation protocol for about six months. The arm is kept immobile in a splint for at least two weeks, and in a locking elbow brace for at least six weeks. Full range of motion may return to the elbow after six weeks, and patients progress to using full weights in physical therapy over three months. After six months of physical therapy and consultations with Dr. Shani, most patients return to heavy lifting at pre-injury strength levels.