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As we discussed in a previous blog post, Achilles Tendon Ruptures, traumatic complete tears of the ligament have been increasing across the population. We are seeing a similar occurrence with a rupture of the biceps bracchi, or the muscle located in the front of the upper arm. Just like the Achilles tendon is crucial for the functioning of our lower body, the biceps are just as important for functional activities in our upper extremities. 

Although the biceps are popular when training at the gym, they are even more important when it comes to our ability to use our upper extremities throughout the day. They are active with our functional movements, such as pressing your body up to get out of bed, brushing your teeth, and controlling your body as you lay down at night to go back to bed. A traumatic rupture of the tendon of this muscle can lead to challenges with all functional activities when your dominant arm is involved.   

Biceps Anatomy

For those who understand the prefix bi-, we know that the biceps are named because they have two heads. The biceps begin just below the elbow, with one of the heads attaching into the short head of the humerus (upper arm bone) and a second long head attaching into the scapula (shoulder blade). Because of the long head going beyond the shoulder joint and to the scapula, the biceps are unique for the fact that they cross over multiple joints. 

With an awareness of where the muscle originates and where it inserts, it is easy to understand that the biceps would be active during both flexion of the elbow and the shoulder. The biceps can be active during motion of each joint individually, as well as if you were to flex both your shoulder and your elbow at the same time.

Mechanism Of Injury

Typically, a biceps rupture occurs when there is a sudden forceful lengthening of the muscle while it is being contracted. An example of this is if you suddenly have to catch a heavy weight that is falling in front of you. Or, when you are falling with your elbows bent and you try to brace your body from hitting the ground. This will usually result in a rupture of the distal end of the biceps near where it attaches in your forearm. 

Less frequently, the biceps can also be ruptured when your arm is forcefully pulled behind your back. Because the biceps cross both the shoulder and elbow joint, if both are stretched to the extreme ranges of extension, it can lead to giving way of the tendon. No matter what the mechanism, we typically see a balling of the muscle tissue after the tendon ruptures. This will look like an overly inflated muscle, but you will not be able to actively lift your forearm up towards your shoulder. 

Timeline For Recovery

At Functional Physical Therapy, we are typically a proponent of a conservative, or non-surgical, approach to all injuries. However, when it comes to a complete biceps rupture, there is little to no hope of full functional recovery without surgical intervention. If there is an incomplete tear, or a grade 2 muscle strain, there is a potential to recover from the injury without surgical intervention. 

A typical timeframe of recovery from a surgical repair is between three and four months to return to full functionality. Beyond that, return to high intensity exercise or athletic performance may be an additional 3-4 months, bringing a total recovery time of between 6-8 months. The broader timeline will make it possible to regain significant strength in both the muscle belly and tendon to be able to hold up to higher weight or the pressures of athletic competition. 

Whether you have been diagnosed with a strain, a partial tear, or a full thickness tear of your biceps, Functional Physical Therapy is here to help. No matter the intensity of the injury, your body will compensate. For you to return to your prior level of function, those compensations will have to be addressed. When you are ready to return to full function, email nick@functional-physicaltherapy.com to schedule your full body assessment!