Distal tear of the biceps tendon

Dear all,

I am an avid albeit not a very good climber. On a recent trip to Alaska, I had an unfortunate fall with a heavy backpack and while arresting my fall I tore the distal tendon (At the elbow) of my biceps in my left arm. I have just had surgery to repair this injury today and I’m looking for some information from other climbers who have sustained similar injury and underwnt surgical repair and subsequent rehabilitation. How was the recovey, how well were you able to return to climbing. How long did it take? Unfortunately I’m not exactly a spring chicken being 42 years old. Thank you for your information, stay away from COVID-19, Ferenc

I had a distal bicep tendon rupture/tear in 2004 and underwent reattachment surgery. Within a week, I tore it again by overusing it (be very careful!).

I was preparing to undergo a second surgery (I was in the hospital in pre-op) when the orthopedic surgeon and I discussed it one last time.

He said that one option was to not have the surgery (there are risks to the surgery such as nerve damage, infection, etc.). And that I would lose 20%+ strength in that arm when the bicep was needed.

I opted out of the surgery and have lost some strength in that arm. I don't regret forgoing the second surgery.

My recommendation is to really baby your arm for the first few weeks so you don't ruin the reattachment, like I did!

Thank you for your advice!

Successful recovery is possible.  I completely tore my distal biceps tendon eleven years ago.  Loud pop and suddenly my entire bicep was up in my shoulder.  Not much pain compared to what it looked like.  Three days later I had surgery to drill a hole through my forearm bone (radius), pull the tendon through the hole and attach it to the outer (distal) side of the radius.  It was an unproven procedure but thought to be stronger than the normal surgery, possibly making the tendon attachment stronger than the pre-injury state.  Six months later I started doing gentle easy climbs, gradually ramped up training and one year after the injury I could do a one-arm pull-up on the recovered arm.

No problems since then.  Nowadays I skip the one-arms and try to remember not to arm-wrestle big dudes in bars, but I can still do 30 pullups and redpoint 5.12.  On my 50th birthday earlier this year I soloed 100 pitches.  I'm very grateful for the badass surgeon who fixed my arm.

Matt Robertson wrote:

Successful recovery is possible.  I completely tore my distal biceps tendon eleven years ago.  Loud pop and suddenly my entire bicep was up in my shoulder.  Not much pain compared to what it looked like.  Three days later I had surgery to drill a hold through my forearm bone (radius), pull the tendon through the hole and attach it to the outer (distal) side of the radius.  It was an unproven procedure but thought to be stronger than the normal surgery, possibly making the tendon attachment stronger than the pre-injury state.  Six months later I started doing gentle easy climbs, gradually ramped up training and one year after the injury I could do a one-arm pull-up on the recovered arm.

No problems since then.  Nowadays I skip the one-arms and try to remember not to arm-wrestle big dudes in bars, but I can still do 30 pullups and redpoint 5.12.  On my 50th birthday earlier this year I soloed 100 pitches.  I'm very grateful for the badass surgeon who fixed my arm.

My experience was VERY similar to Matt's.

I ruptured my Biceps tendon indoor bouldering in early 2010 - the "POP" was so loud, everyone thought I had spun a hold.  What Matt didn't mention, was prior to the shift in procedures, there was a very invasive surgery that left folks filleted with a massive "z" scar in their forearm. 

Unlike Frank's experience, it was very clear to me that I should not use the arm AT ALL for the first month. It was in a sling for a solid month, then month 2 I could hold things "no heavier than my car keys or a can of soda". After that I could very carefully and slowly start to use the arm.  The crux for me was to avoid reflex actions - breaking a fall while hiking or trail running, catching a falling object, etc. 

I was told 8 Months to full recovery, but after very aggressive PT I was climbing again and pulling down in about 5 months.  I do remember enjoying first early climbs on Slabs like Whitehorse Ledges where 99% of the climbing is on the feet. I'm no doubt stronger and more experience as a climber than before I was injured.  

It will feel like a slow, long road - but use the time to work on other skills and passions. Heck, I met my wife when I was laid up. - I couldn't climb so I joined a group of friends at Rumney to photograph them and my wife happened to join the crew.  

It'll be over quick!

Jason

Good morning guys,

Thank you very much for all the encouragement and the great information. I had the repair which entails drilling then reaming a hole through the radial tuberosity and then threading the tendon into this hole and securing it there. It is very encouraging to read most if you did well after the surgery although the recovery seem to have been rather ardous.. My arm is currently in a splint but it appears I will be transitioning into a brace 10 days postop and start passive motion at that time. In the meantime, I am in a Globo gym practically daily trying to work on the contralateral side... 

It is very valuable and inspiring to be a part of this site and feeding off your great experience, Ferenc 

PS congratulations to meeting your wife, im sadly past that stage

I suffered a left distal bicep rupture in spring of 2015 at age 30. It was a bit of a freak climbing accident with overtraining, dehydration, & nicotine also being contributing factors.

I had an endobutton repair surgery 9 days after injury. I took 3 months off, then slowly came back to climbing & training. Started with 1 pound curls in sets of 20, then added weight, slowly. I would say i made a full recovery in about a year. Was back to 1 arm pull ups in 9 months. 5 years later & I trust the repaired side more than  the other, the tendon is about 5 times thicker on the repaired side. Hang in there!

I ruptured my right distal biceps tendon bouldering indoors a few years back. Surgical repair a couple weeks after, followed by a 3-4 month recovery period. Getting back on the wall was scary but I eased back into it and ended up sending my hardest grades not long after. Take the recovery seriously and you should be just fine. And you get a bitchin' scar afterwards!

Thank you guys for your kind replies. I am officially 8 days out after surgery, still in a splint but hope to transition into a brace in two days. I believe after I get into the brace the very slow rehab, first with passive motion, will start. Currently, I'm hitting the gym every day working on the other side and doing a lot of squats with the safety bar just to maintain conditioning. I am sure that the rehabilitation process at 42 years old will not be a cakewalk. Regardless thank you again for all the encouragement, Ferenc

Ferenc Toth wrote:

Thank you guys for your kind replies. I am officially 8 days out after surgery, still in a splint but hope to transition into a brace in two days. I believe after I get into the brace the very slow rehab, first with passive motion, will start. Currently, I'm hitting the gym every day working on the other side and doing a lot of squats with the safety bar just to maintain conditioning. I am sure that the rehabilitation process at 42 years old will not be a cakewalk. Regardless thank you again for all the encouragement, Ferenc

I went through this at age 50. That is 2 years ago. Take it slow. Retear is a disaster. I started easy climbing after about 4 months and lead my first route 2 weeks later. Feels scary when you first start and may get an occasional muscle tweak. Be very aware of isolating the tendon attachment- you will isolate in the undercling position as if you were trying to pull up on a tufa above your head (which is what I did). When you start back on training be slow and steady ie I started at 16 kg pull down and added 2.5kg per week. Don't rush as you risk tearing but also keep up the training as you need to orientate the tendon fibres. With bicep curls start at 1 kg and add 0.5kg/week. Don't rush!!!!!! When to start ? Listen to your surgeon but probably around week4-6

Don't rush and you get back to good muscle strength in 9 months but 2 years before the attachment is at peak strength 

Thank you sir! I‘m 10 days out from surgery and it looks my rehab schedule is nearly identical to the one you described!

thankmyou all for the support! Ferenc