biceps: broken long head tendon

Hi Guys,
Last Thursday, I've just raised a bag (less than 10 kilos) and I've heard a strange 'noise' (like a 'pop') inside my shoulder....no pain, no spill, no tumefaction...probably if I hadn't heard that 'pop' inside my shoulder I would not notice anything. However, the long head tendon collapsed! Both my physiotherapist and a orthopaedic surgeon (he's a climber too) suggested me to avoid the surgery. Apart from 'appearance motivations' (some people hate that bump on the arm) there's apparently no functional justification to repair it, since the whole contraction can be managed by the short head and surrounding muscles (brachial). It seems that this kind of injury could affect the strength of the arm, but only of about 5% (obviously the injured biceps has to 'adapt' to this new 'morphology' and needs to be trained specifically to gain back its strength. Is there anyone that had the same injury? Can you tell me a few words about your experience?   

Isn't that the tendon they typically cut or shorten ( reattach lower ) when you have shoulder surgery? If so don't lose any sleep over it, I think it's mostly for throwing. If you make your living throwing 100mph fast balls then get a second opinion.

I ruptured my distal biceps tendon 10 months  ago and had the repair. While not the same very similar.

You can get by without the repair but you will lose strength in certain directions. Will this affect your climbing? Yes but how much depends. Are you climbing 5.13+ then sure think about the repair but be quick. You only have 3 weeks since the incident to re-attach. After that the surgery gets more complicated. Anyone who says 5% loss is just guessing not that you will ever know to compare. I lost 20% strength by measurement on my wrist from a ruptured ligament repair but can’t really tell.

Cost - how much? My repair was free so I cannot advise and my time off work for 6 weeks was also fully paid so can’t comment on how this will affect your decision

I do know others have not had the repair and wish they had but also others who have not noticed any real loss 

It is true that the long head tendon only contributes about 5% to overall biceps strength. But it does also contribute to shoulder stability.

If you don't have any pain, I can see waiting on surgery and just re-adjusting to the new normal. I've seen only one person with the torn biceps tendon, another climber. The lump did look weird, and he ultimately chose to go on with the surgery, and was happy with the results.

Not the same thing as your injury, but I had biceps tenodesis (the long head tendon was frayed, not fully torn, it got cut and re-attached as part of SLAP/rotator cuff repair), and it took some time for the body to re-learn how to move with a different attachment point, even though it was only 5% of the strength, the shoulder didn't move quite the way it was supposed to. I think it moves just fine now, and I was happy with the surgery.

It's been about a month since my diagnosis; blown longhead in my right arm,and arthritis in both of my shoulders.
Shoulder control for sure, even just eating seems clumsy.
Still pretty weak when lifting anything above the plane of my shoulder.
Can't imagine swinging tools overhead much more than a short pitch.
Best of luck.

Hi guys thanks a lot for your feedbacks and opinions...I’ve asked many orthopedics and almost all of them suggested me to avoid surgery. Maybe here in Italy they prefer to have a more ‘conservative’ approach. I’ve spoken with many climbers round here that had the same injury and none of them, after some training, have any limitation in climbing due to the missing tendon. I came back in the climbing gym this week, and, at the same time, I worked out on the biceps with progressively increasing weight lifting. My actual feeling is that I don’t notice a critical loss in the strength, but the arm tends to get tired in a shorter time with respect to the ‘good’ one...I suppose that it’s just a matter of training, but I don’t fell any pain at all. As far as my shoulders are concerned, they look pretty good (considering the stresses due to climbing). Lena, yes, you’re right, the long cape also plays a role in the shoulder stability, but the surgery does not provide any improvement in this sense: the tendon is fixed through a screw in the humerus, not in his original position (well, no orthopedic in this world would touch your shoulder to fix the bicep long cape...the shoulder is too ‘precious’). Kuginis the distal tendon is a different matter, more serious, because in that case you have no choice: it has to be fixed (it’s the only connection of the bicep with the forearm). However, thanks a lot by now, I’ll keep you informed about my status...next week I’m planning to go back to the crag, I’ll attempt some easy routes (5.10/5.11) to check my confidence with this ‘different arm’...well, it looks a little bit weird, but I’m settling into it...

I've completely ruptured one bicep tendon each on my left and my right arms.
No surgery.

So I have a lump of rolled-up tendon on each of my biceps.
Symmetry.
I'm coming to like the "popeye" look.

Has had no noticeable effect on my climbing.

Ken

I also ruptured the long bicep tendon on each arm. I did not get the surgery. It's been about ten years. It has had more of an impact than I was led to expect. I have limited strenght in both arms and am unable to improve much. My injuries were exacerbated by nasty shoulder separations on both shoulders also. In hindsight, I think I would ahve gotten the bicep surgery.

I had the same injury about 20 years ago. I'd say there was little to no loss of strength and that's still the case. However, I'd say shoulder stability has become more of an issue over the years. I suppose it could be due to something other than that injury, but I havent had another major incident which I could blame it on. Some basic things like playing catch, scratching my back, etc. have become difficult. I'm sure it's not always the case. I've cetainly not been careful with it since the original injury.

Hi guys here I’m again...after more or less 5 week after the injury I can provide you some feedback. I came back to the climbing gym and to the crags smoothly, trying to focus on the behavior of the injuried arm. I’ve been able to climb routes up to 5.11d and the only difference that I noticed is that the left arm get ‘tired’ faster than before (especially on overhanging routes). I suppose that this issue could be solved with some specific training. Apart from this,  at the present time I do not experience any other critical issue...in the next months I’ll try to push harder...

1. D Condit wrote: I also ruptured the long bicep tendon on each arm. I did not get the surgery. It's been about ten years. It has had more of an impact than I was led to expect. I have limited strenght in both arms and am unable to improve much. My injuries were exacerbated by nasty shoulder separations on both shoulders also. In hindsight, I think I would ahve gotten the bicep surgery.

Dear ‘D’, I get many feedbacks from ortophaedics and other climbers  with the same problem and, taking into account their opinions, I presume that most of your problems rely on the shoulders...the rupture of the long cape is often associated to shoulder pain and instability, but, as far as I’ve understood, the surgery on your biceps has nothing to do with the shoulders: the tendon is screwed in the humerus, so it has no impact (positive or negative) on the shoulder...

Hi all, well I have blown out both long head tendons, no surgery,
Biggest issue is underclinging as that is a primary function of the bicep
My surgeon didn’t take that movement into consideration
I cramp up on really strenuous moves
I wish I had it reattached when I had shoulder surgery