In this column, I discuss biceps tendon rupture. This reader asks a question about these injuries at the shoulder. If you are interested in my thoughts on distal biceps tendon ruptures (elbow), click on the links to these articles included below.
Can I play golf with a ruptured long head tendon of my right arm? I am right handed and am 75 years old but still very active.
The long head of the biceps connects the biceps muscle in the arm to the shoulder through a tendon that attaches to the top of the glenoid and superior labrum. Rupture of the long head of the biceps differs from the distal biceps tendon at the elbow.
Usually the long head biceps tendon rupture occurs as the result of wear and tear over time. It can occur in younger athletes who perform repetitive overhead activity. In fact, two famous NFL quarterbacks supposedly suffered proximal biceps injuries. More often, though, partial or complete tears of this tendon occur in older patients.
The patient will notice pain with the rupture, but often the pain resolves fairly quickly. He will often notice bruising around the shoulder and upper arm. Also a prominence or bulging of the biceps muscle is common.
Frequently in older patients, orthopaedic surgeons will offer nonoperative treatment. The bulge in the arm, often called a Popeye deformity, remains. Otherwise most people have little functional deficit. There can be slight weakness with certain motions. Older patients can usually do all of their daily activities and exercise without problems.
In younger, more active patients, orthopaedic surgeons often consider surgery to reattach the tendon, especially soon after an acute injury. The surgery can be performed through a small open incision on the upper arm or possibly arthroscopically. Rehab and return to activity is a slower process for this biceps tenodesis, but it can be effective for patients who place higher demands on their shoulders and arms.
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