تمزق وتر العضلة ذات الرأسين biceps tendon rupture (subtitled)

Biceps Tendon Rupture.
The biceps muscle is present on the front side of upper arm and functions to bend and rotate arm.
The biceps tendon is a tough band of connective fibrous tissue that attaches muscle to the shoulder.
Overuse and injury lead to fraying of the biceps tendon and eventual rupture.
A Biceps tendon rupture can either be Partial, where it does not completely tear the tendon.
Or complete, where the biceps tendon completely splits in two and is torn away from the bone.
Causes.
Biceps tendon ruptures occur most commonly from an injury, such as a fall on an outstretched arm.
Or from overuse of the muscle from repetitive overhead movements such as with tennis and swimming.
Biceps tendon ruptures are common in people over 60 who have developed chronic micro tears from degenerative changes and overuse.
These micro tears weaken the tendon making it more susceptible to rupturing.
Other causes can include frequent lifting of heavy objects while at work such as weightlifting.
Long term use of corticosteroid medications has been linked to increased muscle and tendon weakness.
Smoking can affect tendon strength and increase risk of tendon rupture due to poor circulation.
Symptoms.
The most common symptoms of a biceps tendon rupture include.
Pain along the front of the upper arm.
Audible popping sound at the time of injury.
Bruising to the upper arm.
Weakness at the shoulder.
The Weakness is typically a result of pain, since the short head of biceps and the more powerful brachialis muscle preserve the elbow’s flexion strength.
A cosmetic deformity of the biceps called a “popeye sign”,This happens when the muscle belly of the biceps drops down toward the elbow.
Tenderness with palpation over the bicipital groove.
Diagnosis.
Your doctor diagnoses a biceps tendon rupture after observing your symptoms and taking a medical history.
A physical exam is performed where your arm may be moved in different positions in order to see which movements elicit pain or weakness.
Your doctor may order X-rays to identify other conditions that accompany biceps tears.
MRI can be helpful to confirm the diagnosis and to identify associated conditions.
An ultrasound in patients who cannot obtain an MRI.
Treatment.
A sling is used to rest the shoulder for three to four weeks.
You are advised to avoid overhead activities and heavy lifting until healed.
Applying ice packs for 20 minutes at a time,3 to 4 times a day, helps reduce swelling.
Non-steroidal anti-inflammatory medications (N-saids) help reduce pain and inflammation.
Biceps stretching and strengthening exercises help restore strength and mobility to the shoulder joint.
In some instances, corticosteroid injections can provide relief for patients with significant pain.
These injections are often performed under ultrasound guidance.
When it is possible to move the arm in all directions without pain, it is safe to begin slowly returning to normal activities or sports.
Surgical treatment.
Surgery may be necessary if conservative management has not been successful.
and for patients who require full restoration of strength, such as athletes.
the surgeon will release the tendon from its attachment in the shoulder (tenotomy).
it is indicated for partial tears in patient older than 50-year-old.
or release and reattach the tendon lower down on the humerus (tenodesis).
It is indicated for partial or complete tears in patient younger than 50-year-old and athletes.
The torn end of the tendon is cleaned.
and the bone is prepared by creating drill hole.
Sutures are woven through the holes and the tendon to secure it back to the bone and hold it in place.
Rehabilitation.
For about 4 to 6 weeks, you will need to wear a sling to restrict the use of your arm and let the tissues heal.
The pendulum stretch may be performed for five to ten minutes several times a day during the first few weeks.
Physical therapy should be initiated after 4 weeks post-operation to regain strength and function in the shoulder.
You should be able to drive when you are no longer taking analgesic medications, and feel that you can control the wheel.
This is around 4 weeks.
by 6 months after surgery, you’ll have good flexibility and strength and will be able to gradually return to sports and heavy work.
and complete recovery may take even a year after surgery.

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